Utah Health Insurance

Overview

If you live in Utah and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:

  • Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
  • Compare private health plans using U.S. News & World Report's health insurance ratings for Utah

From now until November 15, the start of the next open enrollment, you cannot get new yearly insurance unless you have a qualifying life event. See below for those options for coverage and how to avoid the penalty.

Do I Qualify for a Tax Break on Health Insurance?

Use the tool at right to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.

If You Qualify: Plans That Cost Less

Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Utah. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage. 

Note: you had until March 31 to enroll for coverage for the rest of 2014 (enrolling on March 31 would cover you starting May 1). If you missed this date, with few exceptions, you will pay a penalty.

If You Don't Qualify: Private Plans

If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Utah’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage.  What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.

Do I Have To Buy Health Insurance?

You may have heard that everyone in Utah must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per adult plus $47.50 per child (up to $285 per family) or 1 percent of your family’s income, whichever is more. 

U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.

Where To Buy Health Insurance

Utah's Official Marketplace

Health Insurance Marketplace is Utah’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Health Insurance Marketplace, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:

  • Social security numbers for everyone in your household
  • Your employer’s name and address
  • Your most-recent pay stub or recent records of your wages
  • Information about other types of income you receive, such as alimony, unemployment benefits or a pension

 

Insurance Companies and Brokers

Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Health Insurance Marketplace website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.

U.S. News & World Report has teamed up with GetInsured, an online broker licensed to sell health insurance, to help you buy the subsidized health plan you want. The GetInsured customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.

Qualified Plans on Health Insurance Marketplace

Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.

You should also look at a Health Insurance Marketplace plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Health Insurance Marketplace plan makes sense given your income. Use the "Shop for Health Insurance Now" section on the top right of this page.

Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.

Participating Companies

Altius Health Plans. Altius Health is affliated with Coventry Health Care, a subsidiary of Aetna. The Coventry network includes over 5,600 hospitals, 585,000 doctors and over 62,000 pharmacies. Coventry offers a free online tool, directprovider.com, to look up provider information on the go. Altius offers HMO and PoS exchange plans in Catastrophic through Gold tiers.

Arches Mutual Insurance. With an $85 million federal loan, this new, nonprofit, member-governed, co-op offers HMO exchange plans in Bronze through Gold tiers. Arches has relationships with hospitals in all of Utah’s twenty-nine counties, reports The Salt Lake Tribune.

BridgeSpan Health. BridgeSpan, established by Regence BlueCross BlueShield, is affiliated with Cambia Health Solutions, a nonprofit health services company. In addition to Utah, the company offers health plans in Idaho, Oregon and Washington. BridgeSpan offers PPO exchange plans in Catastrophic through Gold tiers.

Humana Medical Plan of Utah. Established in 1974 in Louisville, Ky., Humana is one of the largest U.S. health insurance companies with over 11.5 million members. Its network includes over 350,000 doctors, 3,000 hospitals and 50,000 pharmacies. Utah residents who buy a Humana exchange plan may not have access to the entire network of doctors and hospitals. Humana offers HMO exchange plans in every tier.

Molina Healthcare. Established in 1980 in California, Molina is a multi-state health care organization with a focus on providing government-sponsored health services to over 5 million Americans in 15 states, according to the company. Molina offers HMO exchange plans in Bronze through Gold tiers.

SelectHealth. Established in 1983, Select Health has approximately 530,000 members in Utah and Idaho, according to eHealth. SelectHealth offers HMO and HSA High Deductible Health Plans exchange plans through the following three networks: Select:Value (10 hospitals, 1,300+ doctors), Select:Med (34 hospitals, 3,900+ doctors) and Select: Care (43 hospitals, 5,000+ doctors). An overview of SelectHealth plans sold on Utah’s exchange is available. SelectHealth offers HMO exchange plans in Catastrophic through Gold tiers. 

Need More Help?

The Utah Insurance Department exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 801-538-3077 or emailed at health.uid@utah.gov. Residents can file an insurance complaint form online.

Health Insurance Guide

U.S. News offers information on how to buy health insurance and publishes plan ratings for every state. If you’re over 65, see the guide to Medicare plans. Otherwise, start by looking up the Health Insurance Guide for your state.

ADVERTISEMENT
For a licensed GetInsured insurance broker, call (866) 813-5460
Loading...
2014-08-01