adultBasic

Frequently Asked Questions (FAQs)

Q. What income documentation do I need to send with the application?
A. You will need to provide copies of the following, if applicable:

• Paycheck stubs—one month's worth for all wage earners in the family—if you get paid every week, send four; if you get paid every other week, send us two; and if you get paid monthly, send one stub. Please note: if your wages are the same every pay period, you may send in one stub and indicate that this is the regular wages you receive every time you are paid. These paycheck stubs should reflect your average pay, and should have been received within the last 60 days.
• Alimony
• Child support (only if received in the last 60 days)—send award letter
• Pension (check stubs)
• Social Security or survivor benefits (award letter or check stubs)
• Unemployment compensation (notice of compensation payable or check stubs)
• The most recent federal income tax form with all schedules for all filers in the household.
• If you have recently changed jobs, you can have your employer write a letter stating your gross earnings and average hours you work each month. This must be on company letterhead and be signed by your employer.
• Document any special circumstances that cause your annual income to fluctuate (for example, if you're a seasonal worker, or you rarely work overtime hours).

Q. Does adultBasic have a grace period if my premium payment is late?
A. No, payments must be received by the 15th of the month so that coverage can continue. There is no grace period for a late payment. Your coverage will be cancelled and you will need to complete a new application. You will be placed at the end of the waiting list.

Q. Is there a waiting list for adultBasic?
A. Due to the overwhelming response to enroll in the adultBasic program and the funding available, the Pennsylvania Insurance Department found it necessary to implement a waiting list. It is still important for individuals to apply for the program and if eligible, secure a place on the waiting list.

Q. Can I get coverage while I am on the waiting list?
A. When you receive the notice that you are eligible, you will have the option to purchase the adultBasic coverage at the Insurance Department’s cost per month (coverage can be purchased at-cost for $344.95 a month while on the waiting list). The benefits you will receive are the same as those offered through the program. In addition, whether or not you choose to purchase coverage does not affect your place on the waiting list.

Q. Should I apply for adultBasic even if there is a waiting list?
A. Absolutely!  Once you apply and are determined eligible, your name is placed on a statewide list to be served on a "first come, first served" basis as openings become available.  It's critical that you complete all questions on the application, sign and date the application and submit it along with verifications of your household income.  Your place on the waiting list will be determined by the date your completed application is received.

Q. How will I know if I am enrolled, or on the waiting list?
A. You will receive a notice from Highmark. 

Q. How long will I be on the waiting list?
A. You will remain on the list until a space is available. Unfortunately, we cannot make a time estimate as it depends on the number of adults who leave the program and the amount of funding available.

Q. What happens when space becomes available in the low cost adultBasic coverage?
A. When space becomes available, you will receive a notification (again, using the "first come, first serve" formula) telling you that you have the opportunity to enroll in adultBasic. You will need to confirm that your income is still the same and you are without insurance (with the exception that you may have purchased adultBasic coverage while on the waiting list). You also will be asked to submit two months' of premium. Once your payment is received you will be notified of your effective date of coverage.

Q. What happens if I don't respond to the offer when space becomes available?
A. We understand that circumstances may change while you are on the waiting list. If you are no longer eligible, or you fail to respond within 30 days, your name will be removed from the waiting list and a new application would need to be submitted to enroll in the program.

Q. Is there a waiting list for the Children's Health Insurance Program (CHIP)?
A. No. Applications and benefits for CHIP are not effected in any way by the waiting list for adultBasic.