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PA Insurance and Patients With Pre-Existing Conditions

Posted on Oct 24, 2012

In Pennsylvania there is a state insurance plan that is set up to deal with the requirements of the Health Care Reform Act. The plan is a bridge between the current system and the future requirement that prevents insurance companies from excluding people because of preexisting conditions. If you have been denied insurance because of a preexisting condition you may be eligible for the plan. The plan details are below.


Pre-Existing Condition Insurance Plan: Pennsylvania

Eligible residents of Pennsylvania can apply on-line for coverage through the state’s Pre-Existing Condition Insurance Plan program known as PA Fair Care.
To qualify for coverage

  • You must be a citizen or national of the United States or residing in the United States legally.
  • You must have been uninsured for at least the last six months before you apply.
  • You must have a pre-existing condition or have been denied coverage because of your health condition.
  • PA Fair Care covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs.  All covered benefits are available for you, even if it’s to treat a pre-existing condition.
  • Premium: $283.20 per month
  • Deductible: $1,000 in-network
  • Out of Pocket Limit: $5,000 in-network

If you want to learn more about the program, please call 1-888-767-7015 (TTY: 1-888-767-7018) or visit

Gerard Kramer, Esquire
Schmidt Kramer PC
Injury Attorneys
Harrisburg, PA