A Guide to the ACA Marketplace and Pennie
For those 65 and older not covered by Medicare, finding affordable health insurance is essential. If you don’t have employer-sponsored coverage or other government programs, the health insurance marketplace is a valuable resource.
Here’s what you need to know:
What Is the ACA Marketplace?
The Affordable Care Act (ACA) created health insurance marketplaces to compare and purchase coverage from private insurers. These marketplaces are for those who don’t have coverage through their job or other government programs like Medicare.
Depending on your income and household size, you may qualify for financial assistance to lower your monthly premium.
Pennsylvania’s State-Based Exchange: Pennie
In 2019, Pennsylvania transitioned to its own state-run exchange, Pennie.
This shift gives Pennsylvania more control over customer service, outreach, and reinsurance programs. Since Pennie’s launch in 2020, nearly 500,000 Pennsylvanians enrolled for 2025 coverage—the largest enrollment in state history.
Pennie offers plans from 14 different carriers, covering essential health benefits such as hospital care, mental health services, prescription drugs, and preventive services.
Who Uses Pennie?
Pennie is for anyone needing health insurance but not eligible for Medicare or other government programs. It’s especially helpful for retirees, part-time workers, small business owners, or gig workers.
If your income rises above Medicaid eligibility, you can transition to marketplace coverage with premium tax credits to help lower costs.
Financial Assistance
Around 90% of Pennie customers qualify for premium tax credits, reducing their monthly costs. In 2025, those receiving tax credits saved an average of $541 per month. If your income is lower, you may also qualify for cost-sharing reductions, which lower out-of-pocket costs like deductibles and copays.
Important Considerations for 2026
Enhanced premium tax credits, available since 2021, are set to expire at the end of 2025. The future of these credits depends on federal decisions. Stay informed about any changes that may affect your costs.
How to Enroll
You can enroll during the open enrollment period, or if you experience a qualifying life event like job loss or marriage. Native Americans can enroll year-round.
Visit pennie.com or call 844-844-8040 for help. Free assistance is available from certified enrollment assisters and brokers.
Understanding your health insurance options helps you find the coverage that fits your needs and budget.
