Pennsylvania Medical Malpractice Insurance

 Pennsylvania Medical Malpractice Insurance Coverage

Coverage Requirements

In the State of Pennsylvania, medical malpractice insurance coverage for physicians is not required by state law.  However, if practitioners want to participate in the state's Mcare Fund, they must maintain a minimal level of medical malpractice insurance. 

When participating in the Mcare Fund, the required minimum limits of coverage are $1M/$3M.  This means that healthcare providers must have medical malpractice insurance with coverage up to $1M per claim, and $3M aggregate.  “Aggregate” means that the policy will pay out up to a total of $3M in one policy year.  (See below for details.) 

What is the Med Mal Climate Like in Pennsylvania?

Pennsylvania is unique in that it has the Mcare Fund.  Mcare stands for the Medical Care Availability and Reduction of Error Fund, and it was signed into law in March of 2002.  As a result, in Pennsylvania, providers are required to have $500,000/$1.5M in private medical malpractice insurance and additional coverage of $500,000/$1.5M through the Mcare Fund for a total of $1M/3M.  Thus, providers get charged two premiums in Pennsylvania for medical malpractice insurance and the Mcare charge must be paid in full when the coverage is bound. 

While most providers must get Mcare coverage in order for their license to be valid, there are situations in which providers may validly opt-out of this coverage.  Some examples of a valid opt-out can include some medical directors, medical school faculty and staff, and retired physicians (eg, if a provider wants to keep their license active, but is not practicing, they don’t have to get Mcare).  That said, providers should never assume that they don’t have to comply with Mcare in Pennsylvania.  They should check with the Mcare program, their institution, and/or their lawyer.     

What Kind of Coverage is Available in Pennsylvania?

Claims-Made and Occurrence-type medical malpractice insurance policies are both available in the state.

Who Can We Get You Malpractice Insurance Coverage with in the State of Pennsylvania?

As a broker, we have access to all of the major carriers in Pennsylvania, including surplus lines/non-admitted carriers.   

Cost of Malpractice Insurance

Due to the requirement of Mcare insurance in addition to traditional med mal insurance in most situations, the cost of Pennsylvania medical malpractice insurance is expensive when compared to other states. 

In general, rates in Pennsylvania for a first year, claims-made medical malpractice insurance policy, for an Internal Medicine physician who is claim free, can range from $3,200-$5,400/year, and Mcare is approximately $3,000-$4,000/year, for a total of $6,200-$9,400/year. 

How to Lower the Cost of Your Medical Malpractice Insurance Coverage

When reaching out to us for coverage, please ask about discounts.  Often, we are able to offer discounts for being New to Practice, Claim Free, and/or having recently completed qualifying risk management CMEs, among others.     

How Can We Help You and Why Should You Choose Us?

Established in 2004, Nexus Insurance is a medical malpractice insurance broker.  As a broker, we can shop the market for you, reaching out to multiple insurance companies simultaneously, with one application, to provide you with a variety of options and to get you the most competitive pricing.  Also, we specialize in med mal insurance and provide coverage for both medical providers and practices of all sizes. 

Finally, do you own a medical practice?  If so, we can also provide general liability and cyber liability coverage for your practice. 

Do you need coverage in Pennsylvania?  If so, click here to request a free quote. 

Additional Resources:

Glossary

Mcare Fund

Pennsylvania Department of State

Pennsylvania Insurance Department

Pennsylvania Medical Society