Valley Hospital Direct 10 Blue Cross Blue Shield

Affordable Pittsburgh health insurance plans are available from Pennsylvania's major companies, including as Highmark Blue Cross Blue Shield, Aetna, UPMC, Humana, Allwell, and AARP-UnitedHealthcare. We help residents of Western Pennsylvania compare multiple carriers, research and apply for the best available individual, family, Senior Medicare, and group medical coverage so they can pay lower rates quality benefits. UnitedHealthcare, Aetna, Humana, and several other carriers offer Group and Senior plan options, but not private single or family medical coverage.

There are no brokerage fees ever associated with our website, and we also assist you in Open Enrollment through the Pennie State Exchange and Marketplace. If you waited too long for Open Enrollment (OE), we will show you low-cost options that will cover you until the next OE period. There are numerous options that will keep premiums substantially below Obamacare plans. Open Enrollment begins on November 1st (October 15th for Senior plans). Special OE periods for pandemics (COVID) are also available.

Senior healthcare coverage in Pittsburgh, Allegheny County, and Western Pennsylvania is offered by many large and small insurers. Medicare Supplements, Advantage (MA), and Part D prescription drug plans are priced very competitively. Popular companies include Cigna-HealthSpring, Advantra (HealthAmerica), Humana, UPMC, Highmark, Keystone, Aetna, AARP (UnitedHealthcare), Geisinger, Allwell, AmeriHealth, and Gateway.

Highmark BCBS

Highmark Blue Cross Blue Shield serves the 29 counties of Western Pa, including the Pittsburgh area. The least expensive private (non-employer-provided) plans (under age 65) in Allegheny County are: Together Blue Major Events EPO 8700, my Direct Blue Major Evfents EPO 8700, my Blue Access Major Events PPO 8700, Together Blue EPO Bronze 3800, Together Blue EPO Bronze 6900 HSA, and my Direct Blue EPO Bronze 3800.

Rates and coverage vary, so we carefully determine which of the Highmark plans (if any) would be the perfect fit for you. Although popular with small business owners and the self-employed, anybody who pays for their own coverage, including students and retired persons, should also consider these options. By utilizing the Blue Cross nationwide network, coverage is offered throughout most of the US.

Senior Medicare Supplement plans offered in Allegheny County include Plans A, N, B, C, F, and F (HD). Two Part D prescription drug plans are also offered. Blue Rx PDP Plus features Tiers 1-4 preferred retail drug copays of $0, $7, 20%, and 40%. The Tiers 1-4 standard mail drug copays are $0, $17.50, 20% and 40%. The monthly premium is $109.10. Blue Rx PDP Complete features Tiers 1-4 preferred retail drug copays of $0, $5, $40, and 35%. The Tiers 1-4 standard mail drug copays are $0, $12.50, $100 and 35%. The monthly premium is $178.30.

The 11 available Advantage plans are Community Blue Medicare HMO Signature, Community Blue PPO Signature, Community Blue PPO Distinct, Security Blue HMO-POS Basic, Security Blue HMO-POS ValueRx, Freedom Blue PPO ValueRx, Freedom Blue PPO Select, Security Blue HMO-POS Standard, Community Blue Medicare HMO Prestige, Security Blue HMO-POS Deluxe, and Freedom Blue PPO Classic.

Highmark also offers dental, travel, special circumstance, and fertility treatment coverage. Group plans for large and small employers, along with federal employee programs are also offered.

Pre-Exchange Highmark Plans No Longer Available

The Highmark DirectBlue PPO and PPOBlue plans, which are no longer available, offered comprehensive coverages including preventive care services, prescription coverage, and complete access to the Highmark Blue Cross Blue Shield networks. Office visits, inpatient hospital services, diagnostic services and maternity care were just a few of the additional benefits of each plan.

The AdvanceBlue was a newer plan that provided a copay on office visits that the other two pans did not offer. It became a very popular plan in the Pittsburgh area for small business owners that wished like to provide inexpensive benefits at a cost that was within their budget. The "Shared Cost Blue" effectively accomplished the same thing as the "AdvanceBlue."

UPMC

UPMC has been steadily adding market share in Allegheny county and nearby counties. They are in direct competition with Highmark and have a vast network of providers. Despite ongoing disputes and litigation with Highmark, UPMC offers very competitive rates, and often features the lowest-cost options for applicants under age 65.

The cheapest offered policy is the Advantage Catastrophic $8,700/$0 plan, which is available to applicants under age 30. Persons that can prove "financial hardship" may also be eligible for coverage. Non-preventative coverage is subject to the deductible although UPMC negotiated network discounts would apply. The Advantage Bronze $6,700/$0 plan offers a lower deductible ($6,700) with copays for generic drugs ($30 and $60 mail order). The policy coinsurance is 40%.

Perhaps the best "bargain" policy is the Advantage Gold $1000/$10 plan. The low $1,000 deductible is very attractive along with the $10 and $70 copays on pcp and specialist office visits. Diagnostic tests receive a $50 copay. Households with incomes between the Federal Poverty Line (FPL) and 250% of the FPL are eligible for "cost-sharing," and may wish to consider the Advantage Silver $3,500/$40 plan. This feature can potentially save thousands of dollars in out-of-pocket expenses by reducing the deductible and copays. Office visit copays are $40 and $75.

Medicare Advantage contracts offered in Allegheny County include the following UPMC For Life plans: Complete Care, HMO Access Rx, HMO Deductible Rx, HMO No Rx, HMO Premier Rx, HMO Rx, HMO Rx Choice, HMO Rx Enhanced, HMO Salute, PPO High Deductible Rx, and PPO Rx Enhanced.

Note: Highmark customers can utilize specialty UPMC hospitals as an "in-network" provider. 10 other hospitals were previously utilized. They include: Most UPMC hospitals in Allegheny County, Horizon in Greenville, Hamot in Erie, and Hillman Cancer Center. The following cancer treatment systems are no longer be in-network: St. Clair Hospital, Washington Hospital, Heritage Valley Health System, Excela Health, and Butler Health System.  UPMC Children's Hospital can also no longer be utilized.

A Health Plan Connect Center in the Westmoreland Mall offers customers free product information and the ability to pay their premiums. Additional information is provided about claims and the provider network. Marketplace and Senior Medicare product information is also offered, along with details about CHIP for lower-income households. Additional Centers are located in Altoona, Williamsport, Erie, Wyomissing, the Ross Park Mall, Monroeville Mall, and South Hills Village.

Aetna And UnitedHealthcare

Two of the nation's largest insurers, Aetna and UnitedHealthcare, also offer extremely competitive Group and Senior rates in the state. Both carriers have nationwide networks, and most physicians and hospitals in the area accept coverage. Older "grandfathered" plans are still in-force for many individuals and families. Marketplace (Exchange) plans are not offered (under age-65 applicants), although selected policy options may return in 2022. UnitedHealthcare offers private temporary coverage for applicants that miss Open Enrollment or need low-cost stop-gap benefits. UHC may offer Pennie Exchange plans in the future since they have returned in many states.

Aetna Options

Aetna Medicare Advantage plans are available in all Pa counties. The plans available in Allegheny County are listed below:

Aetna Medicare Advantra Credit Value – PPO with $0 monthly premium and $250 deductible.

Aetna Medicare Advantra Eagle – HMO with $0 monthly premium and no drug coverage.

Aetna Medicare Advantra Silver – HMO with $0 monthly premium and $0 deductible.

Aetna Medicare Value – PPO with $0 monthly premium and $0 deductible.

Aetna Medicare Advantra Premier – PPO with $20 monthly premium and $0 deductible.

Aetna Medicare Advantra Cares – HMO with $0 monthly premium and $0 deductible.

Aetna Medicare Advantra Gold – HMO with $27 monthly premium and $0 deductible.

Aetna Medicare Advantra Premier Plus – PPO with $28 monthly premium and $0 deductible.

Aetna Medicare Silver – HMO with $65 monthly premium and $0 deductible.

Aetna Medicare Gold Plan – PPO with $170 monthly premium and $0 deductible.

UnitedHealthcare Options

UnitedHealthcare, the nation's largest health insurance company, offers private, Group, and Senior medical plans. Their single and family products are designed for applicants that have missed the Open Enrollment deadline, or prefer a low-cost alternative to conventional coverage. The two available Medicare Advantage plans are Dual Complete and Nursing Home Plan 2. Additional AARP-UHC plans are: Medicare Advantage Choice, Medicare Advantage Patriot, Medicare Advantage Plan 1, and Medicare Advantage Plan 2.

Three available Part D prescription drug plans are AARP MedicareRx Walgreens ($29.30 per month and $310 deductible),  AARP MedicareRx Preferred ($101.00 per month and $0 deductible), and AARP MedicareRx Saver Plus ($38.00 per month and $480 deductible). Supplement plans offered include A, B, C, F, G, K, L, and N.

UnitedHealthcare also features a robust short-term plan portfolio in Allegheny County and other surrounding counties. Available plans include Medical Copay Select, Medical Plus Elite A, Medical Value Select, Medical Copay Select A, Medical Plus Select, Medical Value Select A, Medical Plus Elite, and Medical Plus Select A. Policies can be approved quickly (within 36 hours), and up to $2 million of benefits is available (per person). Enrollment requests are accepted at any time throughout the year. Additional ancillary options are listed below:

Dental – Primary Dental, Primary Preferred Plus Dental, Premier Plus Dental, Primary Preferred Dental, Premier Choice Dental, Premier Max Dental, Primary Plus Dental, and Primary Elite Dental

Vision – Plan A and Plan B

Accident – SafeGuard Plan A, SafeGuard Plan B, and SafeGuard Plan C.

Allegheny County And Western Pa Senior Medicare Coverage

Medigap and Medicare Advantage options are also available throughout the Pittsburgh area. Whether it is AARP, Humana or other smaller carriers, there are many choices that will budget-friendly. An Open Enrollment is available yearly for persons with serious medical issues. Additionally, for children under age 19 in low-income households, CHIP is a very popular plan to utilize.

Medicare Supplement plans pay some (or most) of the out-of-pocket expenses not covered when you submit a claim. Several of the most affordable Allegheny County options are listed below. However, it is important to properly compare, review, and understand all available plans to ensure you are choosing the most appropriate coverage. Prices and plan selection will be different in Washington, Beaver, Butler, Westmoreland, and other surrounding Counties.

Plan A – AARP-UnitedHealthcare, Medico, Cigna, SBLI USA Life, and Accendo.

Plan B – Medico, AARP-UnitedHealthcare, New Era Life, SBLI USA Life, and Cigna.

Plan C – AARP,-UnitedHealthcare,  New Era Life, GPM Health, and Heartland National Life.

Plan D – New Era Life, Central States, Highmark BCBS, GPM Health, and Sentinel Security.

Plan F – AARP-UnitedHealthcare, Central States, Elips Life, Medico, SBLI USA Life, and Cigna.

Plan F (High Deductible) – Medico, Great Southern Life, National Health, New Era Life, and United American.

Plan G – AARP-UnitedHealthcare, Medico, Humana, and Great Southern Life.

Plan K –  AARP-UnitedHealthcare, United States Fire, Cigna, and Medico.

Plan L – AARP-UnitedHealthcare and United States Fire.

Plan N – Medico, SBLI USA Life, Cigna, GPM Health, and AARP-UnitedHealthcare

Medicare Advantage Plans (Part C) provide Parts A and B through a private insurer instead of the Federal Government. Premiums are typically lower than standard Supplement contracts, and also may offer additional benefits. Often, drug coverage (Part D) is included. Illustrated below are several Advantage contracts offered to Allegheny County residents:

AARP Medicare Advantage Plan 1– $0 monthly premium with maximum out-of-pocket expenses of $6,700. Office visit copays are $0 and $40. The ER and Urgent Care copays are $90 and $40. The outpatient hospital copay is $0-$295, and the inpatient hospital copay is $295 for the first 5 days. Rehab therapy services have a $20 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $47, $100, and 33%.

AARP Medicare Advantage Plan 2– $35 monthly premium with maximum out-of-pocket expenses of $5,500. Office visit copays are $0 and $30. The ER and Urgent Care copays are $90 and $40. The outpatient hospital copay is $0-$275 per visit, and the inpatient hospital copay is $260 for the first 5 days. Rehab therapy services have a $20 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $47, $100, and 33%.

AARP Medicare Advantage Choice Plan 1– $35 monthly premium with maximum out-of-pocket expenses of $5,500. Office visit copays are $0 and $30. The ER and Urgent Care copays are $90 and $40. The outpatient hospital copay is $0-$275 per visit, and the inpatient hospital copay is $390. Rehab therapy services have a $20 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $5, $47, $100, and 33%.

AARP Medicare Advantage Choice Plan 2– $0 monthly premium with maximum out-of-pocket expenses of $6,900. Office visit copays are $0 and $35. The ER and Urgent Care copays are $90 and $40. The outpatient hospital copay is $0-$160 per visit, and the inpatient hospital copay is $160 for the first 5 days. Rehab therapy services have a $20 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $47, $100, and 33%.

AARP Medicare Advantage Patriot – $0 monthly premium with maximum out-of-pocket expenses of $5,500. Office visit copays are $0 and $40. The ER and Urgent Care copays are $90 and $40. The outpatient hospital copay is $0-$275 per visit, and the inpatient hospital copay is $275 for the first 6 days. Rehab therapy services have a $20 copay. Prescription drug benefits are not included.

Aetna Medicare Advantra Eagle – $0 monthly premium with maximum out-of-pocket expenses of $4,000. Office visit copays are $0 and $35. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $0-$250 per visit, and the inpatient hospital copay is $275 per stay. Rehab therapy services have a $25 copay. No drug benefits are included.

Aetna Medicare Advantra Credit Value – $0 monthly premium with maximum out-of-pocket expenses of $7,550. Office visit copays are $10 and $50. The ER and Urgent Care copays are $90 and $60. The outpatient hospital copay is 0-20% per visit, and the inpatient hospital copay is $360 for the first 5 days. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $3, $7, $47, $100, and 28%.

Aetna Medicare Advantra Silver – $0 monthly premium with maximum out-of-pocket expenses of $5,900. Office visit copays are $0 and $35. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $0-$225 per visit, and the inpatient hospital copay is $145 for the first 4 days. Rehab therapy services have a $25 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $0, $42, $99, and 33%.

Aetna Medicare Advantra Premier – $20 monthly premium with maximum out-of-pocket expenses of $5,900. Office visit copays are $5 and $35. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $0-$275 per visit, and the inpatient hospital copay is $300. Rehab therapy services have a $35 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $0, $47, $100, and 33%.

Aetna Medicare Gold Plan – $170 monthly premium with maximum out-of-pocket expenses of $7,550. Office visit copays are $10 and $35. The ER and Urgent Care copays are $90 and $10-$50. The outpatient hospital copay is $0-$275 per visit, and the inpatient hospital copay is $400. Rehab therapy services have a $15 copay. The prescription drug 30-day copays for Tiers 1-5 are $2, $5, $47, $100, and 33%.

Community Blue Medicare HMO Signature – $0 monthly premium with maximum out-of-pocket expenses of $7,550. Monthly office visit copays are $0 and $30. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $245 per visit, and the inpatient hospital copay is $295. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $5, $47, $100, and 33%.

Complete Blue PPO Distinct – $25 monthly premium with maximum out-of-pocket expenses of $6,500. Monthly office visit copays are $0 and $25. The ER and Urgent Care copays are $90 and $30. The outpatient hospital copay is $250 per visit, and the inpatient hospital copay is $295. Rehab therapy services have a $30 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $5, $47, $100, and 33%.

Complete Blue PPO Signature – $0 monthly premium with maximum out-of-pocket expenses of $7,550. Monthly office visit copays are $0 and $35. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $150 for the first three days, and the inpatient hospital copay is $295. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $7, $47, $100, and 33%.

Freedom Blue PPO Classic – $281 monthly premium with maximum out-of-pocket expenses of $4,500. Monthly office visit copays are $0 and $25. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $200 per visit, and the inpatient hospital copay is $210. Rehab therapy services have a $25 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $13, $45, $95, and 33%.

Freedom Blue PPO Select – $169 monthly premium with maximum out-of-pocket expenses of $5,000. Monthly office visit copays are $0 and $30. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $225 per visit, and the inpatient hospital copay is $350. Rehab therapy services have a $25 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $13, $45, $95, and 33%.

Freedom Blue PPO ValueRx – $74 monthly premium with maximum out-of-pocket expenses of $5,500. Monthly office visit copays are $0 and $40. The ER and Urgent Care copays are $90 and $50. The outpatient hospital copay is $250 per visit, and the inpatient hospital copay is $220 for first five days. Rehab therapy services have a $25 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $13, $45, $95, and 33%.

HumanaChoice H5525-017 – $0 monthly premium with maximum out-of-pocket expenses of $6,700. The prescription drug 30-day copays for Tiers 1-5 are $7, $17, $47, $100, and 33%.

HumanaChoice H5216-116 – $0 monthly premium with maximum out-of-pocket expenses of $4,500. Monthly office visit copays are $10 and $35. The ER and Urgent Care copays are $80 and $10-$35. The outpatient hospital copay is $295 per visit, and the inpatient hospital copay is $295 for the first 6 days. Rehab therapy services have a $10-$40 copay. Prescription drug benefits are not included.

HumanaChoice R0923-001 – $0 monthly premium with maximum out-of-pocket expenses of $4,500. Monthly office visit copays are $10 and $35. The ER and Urgent Care copays are $80 and $10-$35. The outpatient hospital copay is $350 per visit, and the inpatient hospital copay is $350 for the first 6 days. Rehab therapy services have a $10-$40 copay. Prescription drug benefits are not included.

Humana Value Plus – $27.40 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit coinsurance is 20%. The ER and Urgent Care copays are $80 and 20%. The outpatient hospital coinsurance is 20%, and the inpatient hospital copay is $600 for the first 3 days. Rehab therapy services are subject to 20% coinsurance. The prescription drug 30-day copays for Tiers 1-5 are $0, $14, $37, $100, and 26%.

Lasso Healthcare – $0 monthly premium with maximum out-of-pocket expenses of $6,700. This is an MSA plan, so 100% of covered benefits are paid after deductible is reached.  Prescription drug benefits are not included.

Security Blue HMO Basic – $58 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $5 and $30. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $200 per visit, and the inpatient hospital copay is $350 per visit. Rehab therapy services have a $30 copay. Prescription drug benefits are not included.

Security Blue HMO ValueRx – $67 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $10 and $40. The ER and Urgent Care copays are $80 and $50. The outpatient hospital copay is $250 per visit, and the inpatient hospital copay is $225 for first 5 days. Rehab therapy services have a $30 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $15, $42, $90, and 33%.

UPMC For Life – $0 monthly premium with maximum out-of-pocket expenses of $3,400. Monthly office visit copays are $5 and $45. The ER and Urgent Care copays are $50 and $100. The outpatient hospital copay is $225 per visit, and the inpatient hospital copay is $350 per visit. Rehab therapy services have a $40 copay. Prescription drug benefits are not included.

UPMC For Life HMO Premier Rx – $0 monthly premium with maximum out-of-pocket expenses of $6,700. Monthly office visit copays are $0 and $45. The ER and Urgent Care copays are $50 and $80. The outpatient hospital copay is $350 per visit, and the inpatient hospital copay is $300 for the first 5 days. Rehab therapy services have a $40 copay. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $42, 45%, and 35%.

UPMC For Life PPO High Deductible With Rx – $35 monthly premium with maximum out-of-pocket expenses of $6,700. The prescription drug 30-day copays for Tiers 1-5 are $0, $10, $42, $95, and 33%.

VA Pittsburgh Healthcare System

VAPHS provides benefits to veterans in Pennsylvania, Ohio, and West Virginia. A total of seven facilities (outpatient cliniucs and clinical care) are available. Additional facilities include centers for dialysis, renal and liver transplant, cardiac surgery, and oncology and bariatric referrals. Research is also performed, with help from the University of Pittsburgh Medical School.

The Heinz campus features a recovery facility and psychiatric rehab treatment. More than 250 beds are available for outpatient, rehab, dental, and initial care treatment. Located on Patriot Way in O'Hara Township, the facility provides treatment for dementia, hospice care, and transitional care. A Recovery Center can treat approximately 100 patients, and an ambulatory care center includes many outpatient services.

The University Drive location is an acute care facility located in Oakland on Allequippa Street. Several of the specialized services include sleep studies, dermatology, audiology, urology, gastroenterology, and endocrinology. The Women's renal dialysis has been nationally recognized for outstanding performance. Visitors to patients having surgeries can also stay at the "Fisher House."

Major Hospitals In Allegheny County

To determine if these facilities are in your network, please contact us.

Allegheny Valley

Allegheny General

Children's Home

Children's Institute

Forbes

HealthSouth Harmarville Rehabilitation

HealthSouth Rehabilitation Sewickley

Heritage Valley Sewickley

Jefferson

Kindred

LifeCare Behavioral Health

LifeCare

New LifeCare Hospitals Alle-Kiski

Ohio Valley

Select Specialty McKeesport

Select Specialty Pittsburgh UPMC

Southwood Psychiatric

St. Clair

UPMC Children's

UPMC East

UPMC Magee-Women's

UPMS McKeesport

UPMC Mercy

UPMC Passavant

UPMC Presbyterian

UPMC St. Margaret

Veterans Affairs Pittsburgh Healthcare System

West Penn

To compare Pittsburgh health insurance quotes, please provide your zip code at the top of the page, or you can get an "instant quote." You can also call, and we'll be happy to review your options. The enrollment process typically takes less than 15 minutes. Once your policy is approved, our award-winning customer service will still be available.

News From The Past:

About 400,000 Pa residents (many reside in the Pittsburgh area) will not lose federal subsidies. The US Supreme Court ruling in King Vs. Burwell (6-3) allows states that use the Federal Exchange to continue to offer subsidized coverage. With Open Enrollment beginning in four months, once again, many low-cost policies will be available.

Hiighmark's BlueCard policyholders may have been affected by a security breach at Excellus BlueCross BlueShield which serves Rocherster (New York) and the surrounding area. Names, social security numbers, dates of birth, and financial information may have been compromised. The online attack happened in early August and may have impacted more than 10 million persons.

This security incident is not the first for Highmark, who in recent years has been attacked. As a result, free identity-theft and credit-monitoring services have been provided to help protection against future problems.

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Source: https://www.pahealthinsurancecoverage.com/latest-news/pittsburgh-health-insurance-quotes-upmc-highmark-bcbs-and-more-a21.html

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