Open Enrollment for 2026 State-Based Health Insurance Underway

The enrollment period for 2026 state-based health insurance coverage in Pennsylvania is now open. The program, known as Pennie, replaces the federal marketplace insurance system for state residents.

Pam Laye, supervisor of Outreach and Enrollment at Keystone Health, shared key information for those enrolling or renewing coverage.

Enrollment Dates and Coverage Start

Open enrollment runs from November 1 through January 15. Those enrolling by December 15 will have coverage beginning January 1. Enrollment between December 16 and January 15 will begin February 1.

After January 30, enrollment or plan changes are only available through a special enrollment period for qualifying life events, including marriage, birth, adoption, fostering, or changes in insurance, income, or citizenship.

Eligibility and Plan Options

Anyone living legally in Pennsylvania is eligible to apply through Pennie.

For Franklin County, three providers are offering coverage for 2026:

* Capital Blue Cross

* Highmark

* Geisinger

Each provider offers Preferred Provider Organization (PPO) plans, which allow members to see in-network providers at lower costs.

Highmark also offers an Exclusive Provider Organization (EPO) plan, which does not cover out-of-network care.

Geisinger offers a Health Maintenance Organization (HMO) plan, which requires members to use in-network providers and have an assigned primary care provider.

Deductibles and out-of-pocket costs vary by plan, ranging from $2,000 to $15,800.

Additional Coverage

Some plans include vision and dental coverage. Standalone dental plans are also available.

Cost Assistance

Tax credits and cost-sharing subsidies are available to help lower premiums and out-of-pocket costs such as copayments.

Auto-Enrollment and Penalties

Individuals enrolled in Pennie last year will be automatically re-enrolled unless they make changes.

There is no penalty for being uninsured, but Keystone Health notes that unexpected medical costs—such as $30,000 for a hospital stay or $7,500 for a broken leg—can lead to significant debt without insurance.

Enrollment Assistance

Enrollment can be completed at www.pennie.com, by phone, or through a Certified Application Counselor. Keystone Health's Outreach and Enrollment Department provides free, in-person assistance with certified enrollment navigators.

Appointments can be scheduled by calling (717) 709-7969.

For more information about Pennie, visit www.pennie.com or call 1-844-844-8040. During open enrollment, representatives are available Monday through Friday, 8 a.m. to 7 p.m., and Saturdays from 8 a.m. to 1 p.m.

Photo credits to Keystone Health