Affordable health insurance in Pennsylvania comes from three places: Pennie plans with a premium tax credit, Medical Assistance (Medicaid) for adults up to 138% of poverty ($22,025 for one person), and CHIP for uninsured kids. Pennie Open Enrollment for 2027 runs Nov 1, 2026 – Jan 15, 2027; enroll by Dec 15 for Jan 1 coverage.
Updated for the 2027 plan year (October 2026). Reviewed by a licensed agent.
- Where affordable coverage starts
- PA state health insurance options
- 2027 income limits by household
- Your share of the benchmark plan
- Low-income health insurance in PA
- How to get medical insurance in PA
- Cost-sharing reductions on Silver
- 2027 Pennie rates and insurers
- Pennsylvania cities
- Frequently asked questions
Where affordable health insurance in Pennsylvania starts
For most people who buy their own coverage, affordability depends on one thing: the premium tax credit. In Pennsylvania you can only get it through Pennie, the state-based Marketplace that replaced HealthCare.gov for Pennsylvanians in the 2021 plan year. The credit caps what you pay for the benchmark Silver plan at a fixed share of household income.
Pennsylvania adds one state-level tool behind the scenes. Its reinsurance program, run under a federal Section 1332 waiver that CMS extended through the 2030 plan year, helps hold down the sticker price insurers charge (CMS 1332 waivers). It is not a separate subsidy you apply for, so your income estimate and plan choice still do the heavy lifting.
A plan that looks cheap each month isn’t always affordable health insurance. Pennsylvania families also need a deductible they could actually pay and a network that includes their doctors. For the full statewide picture, see our Pennsylvania health insurance guide; for the national basics, read affordable health insurance.
PA state health insurance options: what “state insurance” really means
There is no single “PA state health insurance” plan. When people search for state or government insurance in Pennsylvania, they usually mean one of three public programs, and one application can screen you for all of them.
| Program | Who it’s for | Where to apply |
|---|---|---|
| Pennie (state Marketplace) | People without affordable job coverage, Medicare or Medicaid; the only source of premium tax credits | pennie.com or a certified broker |
| Medical Assistance (Medicaid) | Adults 19–64 up to 138% of poverty, plus children, pregnant people, older adults and people with disabilities under separate rules | COMPASS, your County Assistance Office, or through Pennie |
| CHIP | Uninsured children and teens under 19 who don’t qualify for Medical Assistance | COMPASS or Pennie |
Pennie checks Medical Assistance and CHIP eligibility as part of its application, so you don’t need to guess which door leads to affordable health insurance Pennsylvania offers. Medicare is a federal program for people 65 and older or with certain disabilities and is handled separately.
2027 income limits for affordable health insurance Pennsylvania households can get
Savings for 2027 coverage use the 2026 HHS poverty guidelines. Because Pennsylvania expanded Medicaid in 2015, most adults up to 138% of poverty go to Medical Assistance, and the premium tax credit picks up above that line until it stops at 400%.
| Household size | 100% FPL | 138% FPL (Medical Assistance line) | 400% FPL (credit ends) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
For larger households, add $5,680 per person at the 100% level. Source: HHS poverty guidelines.
Watch the cliff: the enhanced credits that reached above 400% of poverty expired at the end of 2025 and were not extended. For 2027, earning even a dollar over 400% means losing the whole credit. Retirement contributions and HSA deposits can lower the income Pennie counts.
Your share of the benchmark plan in 2027
IRS Revenue Procedure 2026-26 sets the share of income each household is expected to pay for the benchmark Silver plan in 2027. The tax credit covers the rest of that plan’s price.
| Household income (% of FPL) | Expected contribution (share of income) |
|---|---|
| Under 133% | 2.15% |
| 133% – 150% | 3.23% – 4.30% |
| 150% – 200% | 4.30% – 6.78% |
| 200% – 250% | 6.78% – 8.66% |
| 250% – 300% | 8.66% – 10.22% |
| 300% – 400% | 10.22% |
| Over 400% | No credit |
Choose a plan priced below the benchmark and you pay less than your expected share; choose a richer plan and you pay the difference. The credit is reconciled on the 2027 tax return you file in 2028, as the IRS explains. Our 2027 subsidies guide walks through examples.
Low-income health insurance in PA: Medical Assistance and CHIP
For low-income adults, Medical Assistance is usually the most affordable health insurance Pennsylvania offers. Adults ages 19 to 64 qualify with income up to 138% of poverty, and there is no asset test for this expansion group. You can apply any time of year.
Two federal changes arrive with 2027, according to the Pennsylvania Department of Human Services:
- Work and community engagement rules from January 1, 2027. Adults 19–64 without a dependent child under 14 will need at least 80 hours a month of work, volunteering, job training or school, unless an exemption applies (for example pregnancy, disability, medical frailty or caring for a young child). Current members report at their next renewal in 2027.
- Six-month renewals and shorter retroactive coverage. Some expansion adults will renew every six months, and retroactive coverage for expansion adults drops to one month.
Keep your address current on COMPASS and answer every renewal letter. If you lose Medical Assistance, that loss opens a 60-day Special Enrollment Period on Pennie, so you can move to a subsidized plan instead of going uninsured.
Children have a strong safety net. Pennsylvania’s CHIP covers every uninsured child under 19 who isn’t eligible for Medical Assistance. It is free for households up to 208% of poverty, low-cost from 208% to 314%, and available at the state’s negotiated full cost above that, per DHS CHIP eligibility.
Honesty.AI checks Medical Assistance, CHIP and Pennie savings together and compares every plan in your county.
How to get medical insurance in PA, step by step
Getting covered in Pennsylvania takes one application and a little preparation. Gather these first: Social Security numbers, your best estimate of 2027 household income, any job-coverage offer details, and a list of your doctors and prescriptions.
- Apply once. Start at pennie.com, with a certified broker, or with free help from a Pennie assister found at pennie.com/connect.
- Let Pennie screen the household. Members who qualify for Medical Assistance or CHIP are routed there; everyone else sees their premium tax credit.
- Compare by total cost. Add premiums to the deductible and copays you’d realistically pay, and check each network.
- Pick a plan by December 15, 2026 for coverage starting January 1, 2027, or by January 15, 2027 for February 1.
- Pay the first premium and report income changes during the year.
Those dates come from the Pennie Board’s July 2026 decision to restore the November 1 to January 15 window after a federal court paused a rule that would have shortened it (Pennie Board minutes). Because the case is on appeal, confirm on pennie.com.
Immigrant families: starting January 1, 2027, premium tax credits are limited to green card holders, Cuban/Haitian entrants and COFA migrants. Other lawfully present immigrants can still buy Pennie plans at full price. See our 2027 immigrant rules.
Cost-sharing reductions: the quiet savings on Silver
Households at or below 250% of poverty qualify for cost-sharing reductions, but only on Silver plans. They lower the deductible, copays and out-of-pocket cap, often a lot at the lowest incomes.
That’s why a Silver plan can beat a cheaper Bronze plan for anyone who expects regular care or prescriptions. For many lower-income shoppers, it ends up being the most affordable health insurance Pennsylvania sells once the reductions apply. Without reductions, the 2027 out-of-pocket maximum is $12,000 for one person and $24,000 for a family. For help weighing tiers, read how to choose a health plan.
2027 Pennie rates and insurers: protect your budget
Premiums are rising again. The Pennsylvania Insurance Department approved an average 15.97% increase for 2027 individual plans, down from the 17.14% insurers requested. Increases vary widely by insurer and region.
Insurers selling 2027 individual plans include Highmark, the Independence Blue Cross companies in the Philadelphia region, UPMC, Geisinger, Capital Blue Cross companies, Jefferson Health Plans, Oscar and Ambetter, but each covers only certain counties. The department’s 2027 coverage-area list shows Philadelphia County with several insurers and Allegheny County with two.
Rising rates don’t rule out affordable health insurance in Pennsylvania. The tax credit rises with the benchmark price, so subsidized shoppers are partly shielded. Households above 400% of poverty are not. Either way:
- Report your expected 2027 income, not last year’s.
- Compare every insurer in your county; rate changes are uneven.
- Check networks before switching to a cheaper plan.
- Don’t auto-renew without looking at your new premium.
Questions about an insurer can go to the Insurance Department’s consumer line, 1-866-PA-COMPLAINT. Pennie customer service is 1-844-844-8040.
Pennsylvania cities: local ways to save
Local insurers, hospital networks and clinics change the math from one region to the next. Our city guides cover the two metros with the most searches.
- Philadelphia: one of the widest insurer choices in the state for 2027, plus City Health Centers run by the Department of Public Health that charge uninsured patients a small fee based on income and help them apply for coverage.
- Pittsburgh: Allegheny County has just two individual-market insurers for 2027, Highmark and UPMC, and the region’s two big hospital systems make network checks essential before you choose.
In central and rural counties, Geisinger, Capital Blue Cross and UPMC plans are more common, and the choice of insurers can be smaller. Nonprofit hospitals everywhere must publish a written financial assistance policy, so ask about one if you face a large bill.
Wherever you live, comparing every plan in your ZIP code is the surest route to affordable health insurance Pennsylvania families can keep. Prices for 2027 differ more by county than most shoppers expect.
Find affordable 2027 coverage the honest way
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Frequently asked questions
How do I get affordable health insurance in PA?
Apply through Pennie, Pennsylvania’s Marketplace. One application checks you for Medical Assistance, CHIP and a premium tax credit. For 2027 coverage, enroll between November 1, 2026 and January 15, 2027, and by December 15 for a January 1 start.
What is PA state health insurance for low-income adults?
It is Medical Assistance, Pennsylvania’s Medicaid program. Adults 19 to 64 qualify with income up to 138% of the poverty level, which is $22,025 a year for one person. Starting January 1, 2027, some adults must meet work or community engagement rules unless exempt.
Is CHIP free in Pennsylvania?
CHIP is free for children in households up to 208% of the poverty level and low-cost from 208% to 314%. Above that, families can buy CHIP coverage at the state’s negotiated full cost. It covers uninsured children under 19 who don’t qualify for Medical Assistance.
How much did Pennie rates go up for 2027?
The Pennsylvania Insurance Department approved an average 15.97% increase for 2027 individual plans. Your own change depends on your insurer, plan and county, and the premium tax credit absorbs much of the increase for subsidized shoppers.
Can I get Pennie savings above 400% of poverty in 2027?
No. The enhanced credits that reached above 400% of poverty expired after 2025. For 2027, households over 400% of the poverty level get no premium tax credit, so comparing plans and networks matters even more.
Keep learning: read the Pennsylvania health insurance guide, city guides for Philadelphia and Pittsburgh, the 2027 subsidies guide, and how to choose a health plan.
