Nearly 300,000 Utah residents currently receive Medicare benefits. If you are a Utah resident interested in purchasing a Medicare Advantage Plan or Medigap Policy, you must be age 65 or older and registered for or eligible for retirement benefits through Social Security or the Railroad Retirement Board. Utah providers include Altius Healthplans, Humana Medicare, Molina Medicare, Universal Healthcare, and Windsor Sterling. When choosing a plan, consider your current health situation and the benefits you will receive as well as the overall cost, including co-payments and deductibles which may change annually. To learn more about available Medigap plans, rates, and offers, fill out the zip code form to compare plans instantly.
The Medicare Advantage Plan, also known as a Part C or MA plan, covers all your Part A and Part B Medicare benefits by contracting with a private company. Advantage Plans cover about 88,000 people in Utah and include: the Health Maintenance Organization (HMO), Health Maintenance Organization Point-of-Service (HMO-POS), Preferred Provider Organization (PPO), and Private Fee for Service (PFFS). Utah also offers dual eligibility and special needs plans so this may be the best option if you seek spousal coverage or if you are under age 65 and receiving Medicare due to disability.
HMO plans require that you receive care from within-network providers; you must pay for services you elect to receive out of network. The HMO-POS plan, which is frequently chosen by Utah residents, will cover an out-of-network service if you are referred by your primary care physician. A PPO plan is similar to an HMO plan but generally covers a greater percentage of out-of-network expenses. With a PFFS plan, you can see any provider who will accept your plan’s terms.
Most Medicare Advantage Plans in Utah also offer Medicare prescription drug coverage (Part D). To enroll in a Medicare Advantage Plan, you must live in the area serviced by the plan you join, you must have Medicare Part A and Part B, and you must not have End-Stage Renal Disease (ESRD). The average quality rating for Medicare Advantage Plans in Utah is 3.14. Fill out the zip code form to learn more about Medicare Advantage plans and find the best available offers in your area.
Medigap policies are sold by private insurance companies and provide supplemental insurance intended to help pay for “gaps” in Original Medicare coverage (a deductible or copayment, e.g.). A Medigap policy cannot work with a Medicare Advantage Plan and it covers individuals only, not including spouses. To enroll in Medigap, you must have Part A and Part B Medicare benefits. Be aware that the costs of some Medigap policies may increase as you get older, so do review your options every year.
If you decide to join, switch, or disenroll from your Medicare health or drug plan for any reason, the open enrollment period begins on October 15 and ends on December 7 with changes effective on January 1 of the following year. Before you change your Medicare Advantage Plan, be sure that you will retain your prescription drug coverage. Check with your individual provider for specific restrictions and conditions that may apply. Initial enrollment in a Medigap policy is best done during the six-month period after you turn 65.
Medicaid in Utah is administered by the Medical Department of Workforce Services (DWS). Other programs that provide assistance to Medicare recipients include Utah’s Premium Partnership for Health Insurance and the Senior Health Insurance Information Program (SHIP). Fill out the zip code form to compare rates and find the best Medicare supplemental insurance plans in your area.
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