At EIMA Health, we help residents of Pennsylvania get health coverage without the confusion. Whether you need an ACA Marketplace plan, Medicare for seniors and people with disabilities, or Pennsylvania Medicaid and CHIP, we walk you through the process step-by-step.
Navigating the health insurance landscape can be confusing, but it doesn’t have to be. From our corporate office in Dallas, EIMA Health is dedicated to helping residents of Pennsylvania get the health coverage they need without the hassle. We serve clients across the state, from the major metropolitan areas to the most rural communities, with a dedicated local team on the ground. Whether you need an ACA Marketplace plan, Medicare for seniors, or Pennsylvania Medicaid and CHIP, we walk you through the process step-by-step.
The Challenge of Health Coverage in Pennsylvania
While Pennsylvania has one of the lowest uninsured rates in the country at approximately 5.4%, this still means over 670,000 residents are without coverage. The majority of the uninsured are working adults who are not offered employer coverage or cannot afford private plans. Many of these individuals are part of the working poor—earning too much to qualify for Medicaid but not enough to comfortably afford private health plans.
This is where our team at EIMA Health makes a difference. We are not just agents; we are advocates for the underprivileged in our community. We simplify the complex world of health insurance and empower you to find the right coverage for you and your family.
How EIMA Health Can Help
We specialize in helping residents of Pennsylvania get health coverage without the confusion. Our licensed agents are local experts in the state’s health insurance landscape and are ready to provide free, personalized guidance.
We provide a hand-held approach to help you:
- ACA Marketplace Enrollment (Pennie): We will help you navigate Pennie, the state’s official ACA marketplace, to find the best plan for you. We will ensure you receive all the financial assistance you’re entitled to, including federal subsidies (Advanced Premium Tax Credits) and Cost-Sharing Reductions. Our experts will explain how these subsidies can dramatically lower your monthly premium and out-of-pocket costs, making health insurance affordable.
- Medicare Plan Guidance: For seniors and people with disabilities, we provide tailored advice to help them choose the right Medicare Advantage, Medigap, or Part D plan. We understand the unique financial concerns of those on a fixed income and can help you find a plan with a low or $0 premium that still covers your doctors and prescriptions.
- Medicaid and CHIP Application Support: We can assist you in understanding the complex eligibility requirements for Pennsylvania Medicaid and CHIP. We will help you with the application process on the COMPASS website to ensure all information is submitted correctly and you get the benefits you deserve. We can also help those affected by the ongoing Medicaid unwinding process to find new, affordable coverage.
- Special Enrollment Period Assistance: If you lose your job, have a baby, or experience another qualifying life event, we can help you find a new plan during a Special Enrollment Period (SEP). We know that these events can be stressful, and we are here to help you get covered quickly.
About the Programs
- Pennie: This is the official marketplace for residents to shop for and enroll in ACA-compliant health plans. Pennie is the only place to get financial savings from the government to lower the cost of your insurance.
- Pennsylvania Medicaid: Medicaid (or Medical Assistance) provides comprehensive coverage for low-income individuals, families, seniors, and people with disabilities who meet certain eligibility criteria based on income and household size.
- CHIP: Pennsylvania’s Children’s Health Insurance Program provides free or low-cost health and dental coverage to eligible children and teens who are not eligible for Medical Assistance. No family makes too much money to get some level of CHIP coverage.
FAQs About Affordable Health Coverage in Pennsylvania
What is Pennie and how does it make plans affordable?
Pennie is the state’s official health insurance marketplace. It is the only place you can apply for financial assistance from the government, such as an advanced premium tax credit (subsidy) that lowers your monthly premium, or a cost-sharing reduction that lowers your copays, coinsurance, and deductibles. Our EIMA agents are experts in this process and will ensure you receive all the savings you are entitled to.
How does EIMA help low-income families get covered?
We specialize in finding plans that offer the most comprehensive benefits at the lowest possible cost. We help you check your eligibility for state programs like Pennsylvania Medicaid and CHIP and can assist you with your application. If you don’t qualify for these programs, we’ll help you find an affordable plan on Pennie and maximize your financial assistance to keep your premiums and out-of-pocket costs as low as possible.
What happens if I have been denied Medicaid?
Being denied Medicaid can be a frustrating experience. However, if your household income is over the Medicaid limit, you will likely be eligible for significant subsidies on the ACA marketplace. Our team can help you navigate this transition and ensure you find a quality plan that you can afford.
How do I know what plan is right for me?
Our licensed agents will help you compare plans based on your doctors, prescriptions, and budget. We will explain the differences between different plan types (HMO, PPO, etc.) and metal tiers (Bronze, Silver, Gold) so you can make an informed decision with confidence.
What will my ACA insurance plan in Pennsylvania cover?
All ACA plans, regardless of the carrier, are required to cover ten essential health benefits. These include doctor visits and prescriptions, hospital care, emergency services, maternity and newborn care, mental health services, preventive screenings, pediatric care, and treatment for pre-existing conditions.
Who We Serve
We are dedicated to helping a diverse range of Pennsylvania residents find the right health coverage.
- Families and Individuals: We find affordable plans that cover doctor visits, prescriptions, and emergencies.
- Seniors and People with Disabilities who have Medicare: We provide expert guidance on Medicare plans, ensuring you have the right coverage for your healthcare needs and budget.
- Low-Income Households: We specialize in finding plans with the lowest premiums and out-of-pocket costs, and can assist with applications for Medicaid and CHIP.
- Parents and Children: We help parents understand their options for their children, from comprehensive Medicaid and CHIP coverage to private plans.
Don’t let the confusion of health insurance hold you back. EIMA Health Insurance is here to walk you through every step of the process.
Call (267) 386-7662 or book a free consultation: https://calendly.com/emily-eimahealthinsurance/get-expert-health-insurance-advice
Local Resources:
- Pennie: https://www.pennie.com/
- Pennsylvania Medicaid: https://www.pa.gov/services/dhs/apply-for-medicaid-benefits/
- CHIP: https://www.chipcoverspakids.com/
- PA MEDI (Medicare Counseling): https://www.pa.gov/agencies/aging/aging-programs-and-services/pa-medi-medicare-counseling/
- COMPASS (Online Application Portal): https://www.compass.state.pa.us/