Utah Health Insurance: 2021 Coverage Guide

Fran Majidi
August 20, 2020

Utah Affordable Healthcare Insurance

People in the Beehive State have many options for health insurance plans but everyone should compare rates carefully before selecting a plan. If you’re buying a plan for an individual or family, you can get the coverage you need at the best value by comparing your options with SmartFinancial. Most years, you can only buy health insurance during open enrollment, unless you are eligible for the Special Enrollment Period due to a qualifying event.

When Is Open Enrollment in Utah?

November 1, 2020 - December 15, 2020. Coverage begins January 1, 2021.

How to Get Health Insurance in Utah

Before selecting a health insurance plan, you may want to decide what level of coverage you need first. You can do this by looking at the number of times you sought medical attention or services that were covered by insurance. Look closely at how often you saw a specialist. Is there a particular doctor you need to stick with? There are many questions you should answer before projecting what your healthcare costs will be for 2021.

The most convenient way to get the most competitive health insurance rates is to compare health insurance companies and health insurance quotes. After you submit a form you’ll get several competing health insurance rates to choose from, and we’ll connect you with an agent in your area so you can buy the coverage or ask questions about the plan you’re considering.

What Types of Health Insurance Are Available in Utah?

HMOs, EPOs, PPOs and POS plans are available in Utah. You can even by short-term health coverage. The five different tiers of coverage available in Utah are catastrophic, bronze, expanded bronze, silver and gold. Catastrophic is the most stripped down version and is really not recommended for anyone who sees any medical professionals more than once a year. It is really only intended for emergencies, as the name suggests. After catastrophic coverage, bronze coverage covers the least, about 60% of all costs. Gold plans generally cover about 80%. The average American has a silver plan. As you may imagine, the more coverage, the more you pay each month. But changes are you’ll be paying less out-of-pocket in copays and coinsurance when you see your doctors. You may save money with a higher premium.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

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Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • Lost or quit a job. If you lost a job, changed jobs or even started a business, you can enroll in a health plan outside the open enrollment period.
  • Turned 26. If you were on your parents’ health insurance plan but turned 26 after the enrollment period, you can enroll in an individual health plan.
  • Moved out of an HMO coverage areaYou may have moved but had a health plan that was only valid in one region. You can sign up for a new health plan.
  • Cobra coverage ended.If you extended your healthcare with Cobra and reached the deadline, you can enroll in a new health plan.
  • Divorce. If you were married and shared a health plan, you can enroll in a new individual health plan.
  • Marriage. If you recently married, you may be able to get added onto your spouse’s policy or start an entirely new one together.
  • Birth or adoption of a child.If your baby was born or brought home after the open enrollment date, you can still buy health insurance for that child.
  • Death of spouse or partner. If you were covered under your spouse or partner’s health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
  • Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Utah?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Utah?

The average cost of health insurance in Utah for a 40 year old is about $493 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Utah

The best way to save on health insurance in Utah is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.

Medicare in Utah

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Utah?

12% of the total population of Utah is on Medicare.

How Much Is Medicare in Utah?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Utah

If you are a social security recipient, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Utah?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Utah State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2019 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Utah Health System is listed below:

  • Utah: Overall State Ranking: 11 of 50
  • Utah: Overall Performance: Above Average
  • Utah: Access & Affordability: 34
  • Utah: Prevention & Treatment: 31
  • Utah: Avoidable Hospital Use & Cost: 2
  • Utah: Healthy Lives: 5
  • Utah: Health Care Disparities: 15
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Utah Health Insurance Coverage

The people of Utah have different kinds of health insurance while some Utah residents are not insured at all. See the breakdown below:

  • Private coverage: 54.2%
  • Medicaid: 24%
  • Medicare: 12%
  • Uninsured: 9.8%

Report: America's Health Insurance Plans

Utah Health Insurance Companies

The following carriers offer health insurance and/or medicare in Utah.

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