If you live in Pennsylvania, the following health insurance contact information may be helpful to you:
Pennsylvania Department of Insurance
The Pennsylvania Department of Insurance is responsible for regulating all types of insurance sold in the state of Pennsylvania -- including health insurance policies.
If you are looking for health insurance coverage, the Department of Insurance has a list of insurance companies licensed to sell individual policies in Pennsylvania.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Department of Insurance. You can fill out a consumer complaint form electronically or print one out and mail it.
Pennsylvania Department of Insurance
Office of Consumer and Producer Services
1209 Strawberry Square
Harrisburg, PA 17120
Phone: 717-787-6174
Fax: 717-787-8585
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees -- for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if 20 or more employees are at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage -- for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan -- contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Philadelphia Regional Office
170 S Independence Mall West, Suite 870 West
Philadelphia, PA 19106-3317
Mabel Capolongo - Director
Phone: 215-861-5300
Fax: 215-861-5347
Buying Individual Policies in Pennsylvania
Most insurers in Pennsylvania are allowed to reject your application for coverage based on your health status. The one exception to this rule is Blue Cross Blue Shield. Blue Cross Blue Shield offers a special "guaranteed issue" plan to residents with pre-existing medical conditions.
You may also qualify for coverage as a "HIPAA-eligible" individual if you:
- had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
- you have exhausted all COBRA continuation coverage which was available to you.
People who are HIPAA-eligible are guaranteed a choice of at least two individual policies offered by Blue Cross Blue Shield. If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Pennsylvania Department of Insurance can help you find out.
Pennsylvania Children's Health Insurance Program
The Pennsylvania Children's Health Insurance Program provides health insurance coverage for children whose family income meets certain guidelines.
Pennsylvania Children's Health Insurance Program
Phone: 1-800-986-KIDS
APPRISE - Pennsylvania's Medicare Counseling Program
APPRISE provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit, or Medigap coverage.
APPRISE
Phone: 800-783-7067
Pennsylvania Medicaid (Medical Assistance)
Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. The Pennsylvania Department of Public Welfare has more information on Medicaid eligibility.
Pennsylvania Department of Public Welfare
Phone: 1-866-542-3015
