Depends on how rural. The exurban areas have hospitals that are maybe not good enough to a maybe a planned major surgery, but are good for most else. But if you need some heavy duty healthcare I’d say Pittsburgh and probably Philly are your best bets. I’m sure the other major cities in the east and Erie are fine too as honestly there are hospitals in the rather small cities that can handle most things.

Also how well our coverage is? Only other state I have lived in is WV and I can say it’s much better than there. But idk how it compares against ÇA. We do use our federal assistance. So I guess that’s a plus.