Are you eligible for a tax credit?

If you would like to compare Utah health insurance companies and find out if you qualify for a tax credit or subsidy check out the link below. If you are eligible, you could save a significant amount of money on your monthly premium!

SelectHealth

As our most popular statewide carrier in Utah, SelectHealth features the most affordable premiums and in-network coverage with the Intermountain Healthcare facilities. Members can choose from 15 different health plans, and coverage levels often exceed the benchmark standard.

Regence

Regence BCBS offers 4 plans for individuals and families who live in Northern and Central Utah. Although a tax credit from the healthcare marketplace cannot be applied towards these plans, which keeps premiums higher, Regence remains a favorite among consumers.

University of Utah Health Plans benefits from its partnership with the University of Utah Healthcare system, as well as MountainStar Healthcare and other statewide partners. Clients who select U of U Health Plans enjoy competitive rates on 6 well-liked plans and strong local customer service.

Molina Healthcare has re-entered the individual Utah health insurance marketplace after pulling out in 2017. They offer competitively priced silver plans in parts of Utah and contract with Steward and Mountain Star Hospitals. Molina applications must be completed on the healthcare.gov website.

Cigna is a well-established insurance company that is known for their group/business health insurance plans. They have just entered the Utah individual health insurance market for 2020. Their plans are available in Salt Lake, Utah, Davis, and Weber counties.

If you do not qualify for an enrollment period, short-term health plans are available for application at anytime. However, the coverage is less comprehensive than traditional plans. We strongly encourage you to contact our office to discuss short-term plans, as there are considerable differences.

What Do Health Plans Cover?

At a minimum, Utah health care plans must cover at least some of the costs for these categories of 10 essential benefits:

  • Outpatient care
  • Prescription drugs
  • Pediatric services, including dental and vision coverage for children
  • Preventive care
  • Laboratory services
  • Emergency services
  • Hospitalization for surgery, overnight stays, and other conditions
  • Mental health coverage and substance use disorder services
  • Rehabilitative and habilitative services
  • Pregnancy, maternity, and newborn care

Types of Health Coverage in Utah

  • Personal Health Plans

    Personal health plans are paid for in part or entirely by the individuals covered by the plan. Personal plans are purchased on an individual basis. Plans can offer additional benefits beyond the required minimums. Different plans require different monthly premium payments, and individuals must pay plan-specific amounts through co-payments or co-insurance for services. Details about what benefits are included in coverage and how much the healthcare plan will pay can be found in the plan’s policy documents.

    Most personal health plans are either health maintenance organizations (HMO), which only covers care received from a health care provider in the plan’s contracted network of providers, or preferred provider organizations (PPO), which allows more choices in where to get services.

  • Public Health Plans

    Public health plans are subsidized in part or paid for entirely by government funds. These plans have specific eligibility requirements.

    • Medicaid (Managed Care and Fee-for-Service): Medicaid is a federal and state program that covers health care services for low-income individuals and families.
    • Medicare (Medicare Advantage and Original Medicare): Medicare is a federal program available to Americans above the age of 65 and those younger than 65 if they have certain disabilities. Part A hospitalization insurance is free to most, but Part B physician’s services require a monthly premium. Part C is Medicare Advantage, which is offered by private managed care companies and must include at minimum all the benefits in Parts A and B. Part D is optional prescription drug coverage.
    • Medicare Dual Eligible: Some low-income people are eligible for both Medicare and Medicaid. For dually eligible individuals, Medicaid will pay the Medicare monthly premiums on their behalf and cover benefits not covered under Medicare.

When to Purchase Health Care Coverage

If you do not have a employer-sponsored health plan and do not qualify for a public health plan, then you can buy a personal health plan during the annual open enrollment period from November 1 to December 15. In some circumstances, you can purchase private healthcare coverage during a special enrollment period. Qualifying events that allow you the chance to enroll in a health plan outside of the standard open enrollment period fall into the following categories:

  • Involuntary loss of health insurance (includes the loss of employer-based, exhausting COBRA privileges, or individual coverage, losing eligibility for Medicaid or Medicare, and loss of coverage through a family member)
  • Offer of new health benefit (includes becoming newly eligible for a QSEHRA(Qualified Small Employer Health Reimbursement Arrangement) or individual coverage HRA)
  • Changes in household (includes getting married, having or adopting a baby, divorce or legal separation, death)
  • Changes in residence (includes moving to a new zip code or county, coming to the United States from outside the country, relocation related to school, seasonal work, or transitional housing)
  • Other qualifying changes (membership in a tribe, becoming a citizen, leaving incarceration, or AmeriCorps VISTA service)

Questions about Medicaid?

Medicaid and CHIP (Children’s Health Insurance Program) are government-sponsored programs that help some low-income individuals and families pay for medical expenses.

Unfortunately, only employees of The Department of Workforce Services are able to assist with Medicaid or CHIP enrollment. For more questions on Medicaid in the Salt Lake Area- please call The Department of Workforce Services at 801-526-0950 or visit Medicaid.utah.gov.

For questions regarding CHIP please call 877-543-7669.

Still Have Questions?

If you have questions or would like an Altura Benefits team member to help you with a health insurance quote please feel free to call us today!

See our most recent COVID-19 information for Utah employershere