Written by a parent, not a doctor. Nothing here is medical advice.

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Pennsylvania program

Buy a plan after losing coverage (Pennie, the state Marketplace)

Pennsylvania's health insurance marketplace, where you can buy a plan after losing coverage. Income may reduce the monthly premium.

What it is

Pennsylvania's health insurance marketplace, where you can buy a plan after losing coverage. Income may reduce the monthly premium.

Pennie offers individual and family coverage after a qualifying loss of insurance. Leaving a job can open this route whether you quit or were dismissed. The premium, treatment network and start date all matter when comparing it with continued work coverage.

Eligibility rules
  • For 2026, premium tax credit income eligibility generally runs from 100% to 400% of poverty, with other federal conditions.
  • Loss of qualifying job coverage ordinarily allows enrollment during the 60 days before or after it ends, including after a quit or firing. The date coverage actually ends matters, not simply the last workday.
  • Losing Medical Assistance or CHIP also opens a window to buy a Pennie plan, usually 60 days and sometimes 90. The date on your notice decides it, so show the notice to a Pennie assister.
What you get
  • A choice of individual and family health plans.
  • Income-based tax credits can reduce the monthly premium.
  • A special enrollment window after qualifying coverage ends.
What the help includes
  • You pay the premium after any tax credit. The tax credit depends on expected annual income rather than only the month pay fell.
  • No 2026 premium tax credit is available above 400% of poverty under the stated income rule.
  • Pennsylvania has no extra state premium help of its own right now; the help shown in your Pennie application is the federal tax credit.
  • The tax credit is based on what you expect to earn for the whole year. If you end up earning more than you estimated, you may have to pay some of it back at tax time, so tell Pennie when income changes.
If you decide to apply
  1. Ask a Pennie assister to compare plans using the coverage end date and expected income for the year.
  2. Bring this month's income and, if a work plan ended, the employer's coverage-loss letter, plus the oncology team's accepted-plan list.
  3. Check the exact hospital, medicines, first premium and start date before choosing a plan.

1-844-844-8040 · Official page ↗

After you ask
  • Enrollment confirmation and the first premium invoice follow plan selection. Coverage begins on the plan's confirmed start date.
  • A missed special enrollment window can mean waiting for open enrollment unless another enrollment right applies. MA applications do not have that annual enrollment window.
Good to know

Job-loss enrollment generally spans the 60 days before and after coverage ends. The larger federal premium credits ended December 31, 2025.

Other details
  • A plan sold by the same insurer as your old work plan can have a different network and drug list.
  • Continuation coverage and Pennie have different premiums and timing rules. The comparison should include the costs of ongoing treatment.

Federal background: Marketplace special enrollment.

Official sources
Ask your social worker

“Would Pennie or keeping the work plan leave us better covered after a coverage loss? Could you compare the total cost and oncology network and help us choose before the enrollment window closes?”

Why I’m asking: I want to avoid a gap in treatment coverage when a work plan ends.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Apply on pennie.com within 60 days of the day coverage ended and pick a plan whose network has the oncology group.

Your social worker

The social worker checks the oncology network of the plans you are comparing.

The care team

Records and letters when the application asks for them.

Who decides
Pennie
Ask your social worker
“Our job coverage ends on [date]. Which Pennie plans have the oncology group and the hospital in network?”

How to apply

First step: Go to pennie.com or call 1-844-844-8040 within 60 days of the coverage end date.

  1. Apply on pennie.com within 60 days of the coverage end date.
  2. Compare the plan's oncology network with the hospital before choosing.

Official application / program page ↗

Where it starts: pennie.com or 1-844-844-8040

What to gather

  • The coverage end date and the employer's letter
  • Expected income for the year
  • The oncology group's plan list

How long: Enrollment is immediate once you pick a plan; coverage starts on the plan's start date.

Clock: 60 days from the day job coverage ends to enroll on Pennie

Clock: Pennie printed 90 days for the July 2024 renewal cohort; its consumer page says 60. Act within 60.

What a yes looks like

An enrollment confirmation and the first premium invoice.

What a no looks like, and the next move

Missed the 60 days: wait for open enrollment, or check Medical Assistance for the parent, which has no deadline.

Watch out

  • The deadline is 60 days from the day coverage ends, quit or fired alike.
  • No 2026 tax credit above 400% of the poverty line; the bigger credits ended December 31, 2025.
  • After a Medical Assistance loss, act within 60 days even though a 2024 notice mentioned 90.

Dates that change this

2025-12-31: The bigger premium tax credits ended December 31, 2025; the 400% limit is back for 2026.

2024-07-01: Pennie's June 2024 newsletter gave a 90-day sign-up after Medical Assistance loss from July 2024; its current consumer page says 60 days. The two were not reconciled. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 9, 2026.

What it is worth

A Marketplace plan with tax credits based on income, bought within 60 days of losing job coverage. No 2026 tax credit above 400% of the poverty line.

  • $60 — Special enrollment window after losing job-based coverage
  • $400 — Premium tax credit income ceiling for 2026

Covers: Individual and family plans · Income-based premium tax credits (100% to 400% of poverty for 2026)

What it costs the family: The plan premium less any tax credit.

The eligibility facts, as published

Sep job loss
60 days after coverage loss, including after quitting or being fired
Sep medicaid loss
consumer page 60 days; June 2024 newsletter 90 days for the renewal cohort from July 2024; unreconciled
Ptc
100-400% FPL for 2026

The trap: The bigger premium tax credits ended December 31, 2025. For 2026, income above 400% of the poverty line generally gets no tax credit. Pennie's own affordability program is not funded.

Where I read this

← Back to your options