adultBasic Health Insurance for Adult Pennsylvanians

First Priority Health

adultBasic provides low-cost quality health insurance to uninsured adults who meet certain income and other eligibility requirements. adultBasic promotes access to quality health care by providing basic health insurance to Pennsylvania citizens age 19 through 64 who need coverage but cannot afford it. The program is intended to provide transitional health insurance for adults who either have incomes below 200 percent of the Federal Poverty Guidelines, who may have jobs that do not include health benefits or who are between jobs.

The program is administered by the Pennsylvania Insurance Department using funds received from the National Tobacco Settlement. Health care coverage is provided through First Priority Health.

What benefits does adultBasic offer?

• Preventive care such as immunizations and routine checkups
• Doctor services
• Diagnosis and treatment of illness or injury
• Inpatient hospitalization/outpatient services
• Accident and emergency medical care
• Rehabilitation and skilled care (in lieu of extended hospitalization)

What are the qualifications for eligibility?

• At least 19 years of age but less than 65 years of age
• Income within the specified limits. Click here to view the income level eligibility chart
• No other health insurance (including Medicaid or Medicare)
• U.S. citizen or a permanent legal alien
• Lived in Pennsylvania for at least 90 days prior to enrollment
• Did not have coverage in the last three months by a health insurance plan, a self-insurance plan, or a self-funded plan. (Note: This does not include a person who has been terminated from CHIP due to age.)

How much does adultBasic cost?

• While adultBasic is not free, it is affordably priced at $35.00 per month. Modest copays for certain benefits may also be required.

For more information on the program call First Priority Health at 1-800-543-7199 or (TTY) 1-800-413-1112 for the hearing and/or speech impaired weekdays 8 a.m. to 5 p.m.

Waiting List

A person will be placed on a waiting list until an opening becomes available. He or she can choose to pay the full cost of the adultBasic premium to be enrolled while still remaining on the waiting list. Openings will be filled on a first-come, first-served basis regardless of whether the person is waiting or enrolled and paying the full-cost premium.

In the meantime, you may want to consider other health care services and programs. Click here for more information.

This managed care plan may not cover all your health care expenses. Read your contract carefully to determine which health care services are covered. 1-800-KIDS-199.