Before you start

Pennsylvania residence
Income information for subsidy or Medicaid eligibility
An SSN or ITIN for marketplace applications
A qualifying life event, if enrolling outside the annual window

Step-by-step

1
Enrol in your employer's plan within the new-hire window
Typically 30 days from your start date. Compare the deductible and out-of-pocket maximum, not just the premium.
Via employerWho: YouFirst 30 days of employment
2
Without an employer plan, use Pennie
Pennsylvania runs its own exchange rather than HealthCare.gov, and it typically operates a slightly longer open-enrolment window than federally-run states. Check the current dates on the Pennie site.
OnlineWho: You
3
Check Medicaid eligibility first
Pennsylvania expanded Medicaid, covering adults up to 138% of the federal poverty level with no premium. Newcomers on modest early incomes frequently qualify and never check.
OnlineWho: You
4
Register with a primary care physician
Your PCP gates specialist access in most plans, and in a city with this many academic health systems the practical question is which network your plan actually covers — Penn and Jefferson are not interchangeable. Check before choosing a plan, not after.
OnlineWho: You
5
Learn the urgent care versus emergency room distinction
An ER visit for something a clinic could treat can cost thousands even insured. Urgent care handles fractures, stitches and infections far more cheaply.
In personWho: You
6
Know that Philadelphia has real health disparities by neighbourhood
Life expectancy varies by many years between Philadelphia neighbourhoods, and access to primary care is uneven despite the concentration of hospitals. If you settle outside Center City and University City, check what primary care actually exists nearby rather than assuming the hospital density means access.
In personWho: You

Documents you’ll need

Proof of Pennsylvania residence
Income documentation for subsidies or Medicaid
SSN or ITIN
Immigration documents for marketplace eligibility categories
Evidence of losing prior coverage, if using a special enrolment period

Things most newcomers don’t know

Which hospital network your plan covers matters more here than almost anywhere.

Philadelphia has an unusual concentration of major academic health systems — Penn, Jefferson, Temple, CHOP — and they are separate networks. A plan that covers one may not cover the other, and a specialist referral can turn out to be out-of-network. In a city where the hospitals are the reason to be confident about healthcare, check which one your plan actually buys you.

Source: community-reported

Pennsylvania expanded Medicaid, so there is no coverage gap.

Adults up to 138% of the federal poverty level qualify with no premium. Compared with Texas, Florida and Georgia — all covered elsewhere in this app and none of which took a standard expansion — this removes the band of working people who qualify for neither Medicaid nor subsidies.

Source: Pennsylvania Department of Human Services

The deductible is what will surprise you, not the premium.

US plans commonly require you to pay the first several thousand dollars of care yourself each year. Someone from a national health service reads 'I have insurance' as 'I am covered', then receives a $2,800 bill for a scan.

Source: community-reported

Losing job-based coverage opens a special enrolment window.

You do not have to wait for annual open enrolment if you lose employer coverage, move to Pennsylvania, marry or have a child. Each triggers a limited special enrolment period, typically 60 days.

Source: HealthCare.gov — dates and deadlines

Common mistakes to avoid

Going to HealthCare.gov instead of Pennie.
Choosing a plan without checking which hospital network it actually covers.
Missing the 30-day new-hire enrolment window.
Choosing on premium alone and meeting a five-figure deductible.
Assuming hospital density means primary care access in every neighbourhood.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.

Make it your personal checklist

Globe Quest turns this into a tracked, AI-personalized plan for Philadelphia — timed to your move date, with reminders so nothing slips. Free to start.