Affordable Care Act:
Enrollment Through PENNIE
Finding the right health insurance can feel overwhelming, but PENNIE, Pennsylvania’s official health insurance marketplace, makes it easier to access affordable, high-quality coverage. Whether you’re an individual, self-employed, or a family looking for the best plan at the lowest cost, we’re here to help.
Many Pennsylvanians qualify for financial assistance, reducing monthly premiums and out-of-pocket costs. Not sure where to start? Our licensed agents provide free, expert guidance to help you compare plans, maximize savings, and enroll with confidence.
Find the right health plan with expert guidance and financial assistance options.
Who is Eligible for ACA Plans?
PENNIE provides options that meet your healthcare needs and many individuals and families qualify for financial assistance to lower their monthly costs. Below are the key eligibility requirements to enroll.
General Eligibility Requirements
Pennsylvania Residency
You must live in Pennsylvania to enroll in a health plan through PENNIE. If you recently moved to the state, you may qualify for a Special Enrollment Period (SEP) to get coverage outside the standard Open Enrollment window.
No Access to Other Qualifying Coverage
You are eligible for PENNIE if you do not have employer-sponsored insurance and do not qualify for Medicare or Medicaid. If your employer offers health insurance, but it is too expensive or does not meet minimum coverage standards, you may still be able to enroll.
U.S. Citizenship or Lawful Immigration Status
PENNIE is available to U.S. citizens and lawfully present immigrants. You’ll need to provide documentation (such as a Social Security number or immigration status details) when applying.
Income-Based Financial Assistance Eligibility
Many individuals and families qualify for Premium Tax Credits and Cost-Sharing Reductions based on household income. If your income falls within certain limits, you could pay significantly less for your plan.
Enrollment Periods for ACA Plans
Health insurance through PENNIE is only available during specific enrollment periods, unless you qualify for a Special Enrollment Period (SEP). Knowing when to enroll ensures you don’t miss your opportunity to get covered. Call us for help! We are always here to answer your enrollment period questions.
Open Enrollment Period (OEP)
The main enrollment window runs from November 1 to January 15 each year. If you apply during this time, your coverage will begin the following year.
Special Enrollment Period (SEP)
If you experience a qualifying life event such as losing health coverage, getting married, having a baby, or moving to Pennsylvania. Medicaid and CHIP enrollment is available year-round for those who qualify. Not sure if your situation qualifies as a SEP? Contact us to find out!
ACA Financial Assistance
Health insurance may be more affordable than you think! PENNIE offers financial assistance to help lower monthly premiums and out-of-pocket costs for those who qualify.
Premium Tax Credits
Cost Sharing Reductions
Premium Tax Credits
These reduce your monthly premium based on your income and household size. Available for those earning 100% to 400% of the Federal Poverty Level (FPL), these credits are applied directly to your premium or can be claimed as a tax refund. The lower your income, the higher your potential savings.
Cost-Sharing Reductions (CSRs)
Lower out-of-pocket costs, including deductibles, copays, and coinsurance, for those earning 100% to 250% of the FPL. CSRs are only available on Silver-tier plans, but they significantly reduce the amount you pay when you receive medical care, making it easier to afford doctor visits, prescriptions, and hospital stays.
ACA Plan Options and Coverage
When choosing a health plan through PENNIE, it’s important to understand the different options available. All ACA-compliant plans cover essential health benefits, ensuring you get the care you need, from routine check-ups to emergency services. However, plans are divided into tiers based on cost-sharing between you and your insurer. Whether you prefer lower premiums with higher out-of-pocket costs or a higher monthly payment for reduced expenses when receiving care, there's a plan designed to fit your budget and healthcare needs.
Need help choosing a plan? Our agents can help you compare options and maximize savings!
Preventative Care
Doctor Visits & Hospital Care
Prescription Drugs
Mental Health & Substance Abuse
Maternity & Newborn Care
Understanding ACA Plan Tiers
Health insurance plans through PENNIE are divided into tiers based on how you and your insurer share costs. While all plans cover essential health benefits, the difference lies in monthly premiums, deductibles, and out-of-pocket expenses. Bronze plans have the lowest premiums but higher costs when receiving care, while Platinum plans offer higher premiums but lower out-of-pocket costs. Silver plans strike a balance and are the only tier eligible for Cost-Sharing Reductions (CSRs). Choosing the right tier depends on your budget, healthcare needs, and financial assistance eligibility.
Bronze
Lower premiums, higher out-of-pocket costs
Silver
Balanced costs & eligibility for Cost-Sharing Reductions
Gold & Platinum
Higher premiums, lower out-of-pocket costs
Have Questions?
Call us with questions on tier levels and coverage.
Stellar Health Benefits offers plans from top insurance companies including Ambetter, Geisinger, Highmark and UPMC health plans.
Your Stellar Health Journey Begins Here!
1
Give us a Call
Start with a free, no-obligation consultation. We’ll take the time to understand your needs and answer any questions about Medicare, individual health plans, or small business coverage.
2
Explore Your Options
We’ll walk you through plans from top insurance providers, breaking down your choices so you can find the right coverage at the right price—without the confusion.
3
Get Enrolled
Once you’ve chosen a plan, we’ll guide you through the enrollment process—making it simple, stress-free, and ensuring everything is done correctly.