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Experts Say: Make a Plan for Health Coverage

By Emily Scott © Public News Service
The Tube City Almanac
September 25, 2021
Posted in: State & Region

Pennsylvania Gov. Tom Wolf joined state and local officials in East Liberty in June to celebrate the 56th anniversary of Medicaid and the second anniversary of Pennsylvania’s state-based health insurance marketplace, known as Pennie. (Commonwealth of Pennsylvania photo)

Pennsylvanians have less than two months until open enrollment through Pennie, the state-run health insurance marketplace, and medical professionals say there is a lot to consider when trying to pick a plan which is right for you.

For residents who need to purchase their own plan for 2022, open enrollment through Pennie will run from Nov. 1 through Jan. 15. Twelve insurance companies are offering individual market plans through the exchange, with an average proposed rate increase of 2 percent from the previous year.

Dr. Rhonda Randall, chief medical officer for UnitedHealthcare employer and individual, said planning ahead is key when finding an affordable plan.

“Anticipate what your expenses are for next year,” Randall said. “Are you anticipating you’re going to need to have a certain procedure, or you’ve recently been diagnosed with a specific condition, or maybe you’re planning to expand your family?”

More than 330,000 Pennsylvanians are enrolled in coverage through Pennie, which replaced Healthcare.gov in the state in Sep. 2020.

Nearly 2.8 million state residents get their insurance through Medicare, which is for people 65 and older or living with a disability. Medicare offers robust coverage, but does not pay for outpatient prescription drugs or other types of care.

Randall recommended enrolling in a Medicare Advantage plan, which includes prescription drug coverage.

“You need to pick a separate prescription drug Part D program,” Randall said. “It generally doesn’t cover supplemental benefits and things like vision, dental and hearing in most circumstances.”

There were 31 stand-alone Medicare Part D plans available in the Commonwealth for 2020, with monthly premiums ranging from $13 to $168. Medicare recipients can make changes to their coverage during the fall election period each year, from Oct. 15 to Dec. 7, with coverage taking effect Jan. 1.

Emily Scott is a reporter and producer in Philadelphia for Public News Service. She previously worked at WHYY, Philadelphia’s NPR station and is a 2018 graduate of Temple University and the Salt Institute for Documentary Studies.

Originally published September 25, 2021.

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