What are the average healthcare costs in Pennsylvania?
Learn more about healthcare costs in Pennsylvania, including insurance premiums, what medical visits cost, and how these charges compare to nearby states.
Summary
Pennsylvania ranks 46th among the most expensive healthcare states for 2024.
Pennsylvania’s healthcare increases for 2024 are tracking below the medical inflation rates.
The Pennsylvania Insurance Department is working to provide more healthcare options, with several health plans expanding into new counties.
How much are insurance premiums in Pennsylvania?
Although Pennsylvania’s healthcare costs are lower than those of many states, medical care remains one of the highest expenses in a family or individual’s budget.
Pennsylvania residents can access health insurance through employer-sponsored plans, private insurance, or government programs such as Medicaid and Medicare. Pennsylvania also participates in the federal health insurance marketplace, providing additional coverage options.
Pennsylvania healthcare insurance premiums vary significantly according to the type of plan and coverage. Plans come in various price levels, such as Bronze, Silver, Gold, and Platinum. The lower the plan, the cheaper the premium, but this inflates out-of-pocket expenses.
Pennsylvanians can expect to pay around $479 - $653 per person for comprehensive health insurance premiums, although this can vary depending on location, gender, health, and other factors. Family premiums can range from $1,356 to $1,703 per month. These figures also differ depending on age, location, and plan type.
How do healthcare costs compare in Pennsylvania?
Medical expenses come at a price without insurance, regardless of whether you’re in the most affordable or expensive state.
The average ER visit in Pennsylvania costs around $1,800, and a doctor visit ranges between $96 and $147 with no add-ons, like x-rays and blood tests.
The daily rate for a Pennsylvania hospital stay is approximately $2,886 for nonprofit hospitals, $2,112 for for-profit hospitals, and $1,459 for state or local government hospitals.
The cost of prescription drugs keeps rising, draining the budgets of many families. This is one of the many current healthcare policy issues in Pennsylvania that are under review.
However, Pennsylvania offers numerous stand-alone Medicare prescription drug plans (PDPs) that cost around $43 per month. The Inflation Reduction Act (IRA) has capped the yearly out-of-pocket expenses for prescription drugs at $2,000 starting in 2025.
Healthcare costs differ depending on their location within the state, the type of care, and what different providers offer. They also vary from state to state.
Doctor visits
Pennsylvania: $96 - $147
New York: $103 - $157
New Jersey: $109 - 167
ER visits
Pennsylvania: $1,800
New York: $1,825
New Jersey: $3,377
Hospital stays
Pennsylvania: $1,459 - $2,886
New York: $3,533 - $4,006
New Jersey: $1,860 - $3,315
What are the long-term care costs in Pennsylvania?
When considering healthcare plans, it’s also essential to budget for long-term care costs. The price of healthcare skyrockets when someone needs any form of assisted living.
The Pennsylvania Healthcare Association provides care for more than 50,000 seniors and disabled individuals in the state.
In-home care can cost between $4,004 and $5,815 per month. Community and assisted living costs can range between $2,416 for adult day healthcare and $5,550 in an assisted living facility.
Nursing homes offering semi-private rooms could charge around $10,768 per month, while a private room increases the price to approximately $11,558.
What are the healthcare costs for individuals vs. families in Pennsylvania?
On average, individuals in Pennsylvania can expect to spend $400 to $600 per month on premiums with healthcare companies, with additional costs for deductibles, co-pays, and out-of-pocket expenses.
Families may pay between $1,200 and $1,700 every month to cover their medical needs. They have higher overall deductibles and out-of-pocket costs, which are spread across multiple members.
Individuals and families should shop around for cost-effective healthcare in Pennsylvania that fits their needs. Pennie.com is the local insurance marketplace that assists people with this task. It is also a helpful platform for applying for financial assistance.
Individuals can also select plans with high deductibles to minimize their expenses when needing care. Other methods of saving include using in-network providers and doing preventive screening, which can reduce costs in the long run.
What are common medical visits, and what are their costs in Pennsylvania?
To get a true picture of Pennsylvania healthcare costs, we can compare typical expenses to those in neighboring states.
Annual Checkups (including the most common labs and EKG)
Pennsylvania: 430
New York: $458
New Jersey: $487
Dental Cleanings
Pennsylvania: $100 - $200
New York: $100 - $200
New Jersey: $100 - $150
Eye Exams
Pennsylvania: $75 - $125
New York: $150 - $200
New Jersey: $100 - $125
How do you manage healthcare expenses in Pennsylvania?
Here are some tips for maximizing the value and minimizing healthcare expenses in Pennsylvania.
Choose the right health insurance plan by comparing plans, assessing your needs, and checking that your preferred doctors, hospitals, and specialists are in-network to avoid extra costs.
Utilize preventive care by doing annual checkups or making use of free vaccines and screenings.
Use Healthcare Savings Accounts and Flexible Spending Accounts for their tax benefits.
Manage prescription costs by requesting generic medications, using pharmacy discount programs, and mail-order pharmacies, which can be cheaper.
Negotiate costs.
Use in-network providers.
Use telehealth services.
Budget for healthcare expenses.
Check if you qualify for Medicaid, Medicare, or other low-cost or free programs.
Get expert financial advice
Although Pennsylvania healthcare is more affordable than in many other states, medical expenses still have high costs attached. Understanding the various costs, including premiums and day-to-day expenses, will help you plan your monthly budget and your long-term financial planning.
For expert financial advice, let Unbiased match you with a financial advisor who can offer advice that suits your budget and needs.
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