Utah is also referred as The Mormon State because around 62% residents of the state are members of The Church of Jesus Christ of Latter-day Saints also called Mormons. The state is among the healthiest states in the U.S. and ranked among the top ten states, as far as access to healthcare, quality of healthcare and overall health of the population are concerned. It indicates that the health is preserved and enforced in the state and good healthcare is available all across the state. Utah is also known to have one of the country’s healthiest lifestyles, as it has quite a low percentage of smokers and hospitalizations incidences are lowest in the state. However, the state government still needs to work upon some health issues like an increase in public health funding per capita. Residents of Utah should take pride in their state’s healthiness and should preserve this by continuing the good work. There has been an increase in the enrollment rate in the Utah’s exchange since 2017 and around 201,272 people enrolled in the health plans through the exchange in 2020. Residents of Utah use the federally run exchange, HealthCare.gov to enroll for health insurance plans.
Highlights & Updates
- Residents of Utah utilizes federally run exchange, HealthCare.gov for enrollment in health insurance plans.
- In Utah open enrollment for 2020 health plans has ended and only residents with qualifying events can enroll or make changes in their plans.
- The next open enrollment in Utah will commence from November 1, 2020.
- Unlike most of the states that enrolled through HealthCare.gov, around 201,272 people enrolled in Utah and it is the second consecutive year of increased enrollment.
- Four insurance carriers will be offering health insurance coverage for 2020 in Utah’s exchange.
- Short-term health plans are available for sale in Utah with initial plan terms of up to 363 days and these plans cannot be renewed.
- Despite of not embracing the Obamacare, the uninsured rate in the state has significantly fallen since the law was enacted.
Individual and Family Health Plans in Utah
Utah’s state health marketplace offers highly affordable health insurance plans for the individuals and their families. These plans are required to offer comprehensive benefits and the insurance carriers are not allowed to deny coverage or raise monthly premiums for any individual and even for individuals with pre-existing conditions. The open enrollment period is the best period to enroll in health plans, as individuals regardless of their medical history or income are able to enroll. With so many options available picking the right health insurance can be confusing especially for individuals whose employers do not offer adequate health benefit or those who are self-employed, unemployed, retired or a student. Such individuals can take assistance of experts like InsureMeNow to find the best health insurance coverage for themselves and their families.
Some of the individual and family health insurance plans available in Utah include:
HMO – HMO or Health Maintenance Organization in an individual and family health plan that allows members access to a wide range of healthcare services through a network of healthcare providers or doctors. Members enrolled in this health plan have to pay a monthly or annual fee to receive medical care through a network of doctors or healthcare providers having contract with the HMO. Due to these contracts, premiums of the HMO plans are usually lower than the traditional health insurance. The doctors and medical entities having contracts with the HMO are paid an agreed-upon fee to render healthcare services to the plan’s members. Members of the HMO plans are required to have a primary care provider to obtain healthcare services, who also provide them referral for seeing any specialist. However, members of this plan are limited to receiving care and services from doctors within the HMO network. Though some out-of-network services like emergency care and dialysis are covered under the HMO. Individuals insured under an HMO plan have to live in the plan’s network area in order to be eligible for the coverage. Individuals receiving urgent care out of the HMO network are only covered and for non-emergency services individuals have to pay from their pocket.
PPO – Preferred Provider Organization or PPO is a healthcare plan designed for individuals and their families to provide them healthcare services at reduced rates. PPO is a managed care organization comprising of medical professionals and facilities like primary and specialty physicians, hospitals along with other healthcare professionals. The healthcare professionals contract with the insurance carriers to render healthcare services to the members of the plan at the pre-negotiated rates. The members received medicals services at reduced rates for which they pay annual or monthly fee and have access to the network of providers. Though, members also have the option to avail out-of-network healthcare but it will certainly costs more for the insured. Members of the PPO plans usually have to pay a co-payment per provider visit or they should meet a deductible before start of the coverage.
Fee-for-Service – Indemnity or Fee-for-Service plans are the oldest health insurance plans that combines basic and major medical insurance in one plan leaving few gaps in coverage. Members of this plan are free to choose any doctor and hospital of their choice and require to pay upfront for the received healthcare and can later on file for the reimbursement. Like other individual plans this plan too require members to pay deductibles and co-payments for their medical services. The basic coverage for Fee-for-Service plan includes the cost of visits to the doctor, hospitalization charges, along with surgery and other medical expenses. Besides this plan also pays for major medical bills in case of a lingering illness or serious injury, thereby protecting the insured against the huge medical bills.
Point-of-Service – A Point-of-Service is a managed care health plan whose benefits depend whether the members have used in-network or out-of-network health care providers. This plan comes with the combined features of both HMO and PPO plans. A POS plan like an HMO requires insured members to choose an in-network primary care doctor to receive healthcare and to obtain referral before visiting a specialist. This also have features of PPO plan, as insured have the option to visit out-of-network healthcare service provider but they will comparatively have to pay more. This plan provides nationwide coverage, thereby benefiting people who have to frequently travel. However, the out-of-network deductibles are high for POS plans, which means that insured who use out-of-network services will have to pay the entire healthcare cost from their pocket until they reach the plan’s deductible.
Short-Term Health Insurance in Utah
There are few situations in life when individuals may need temporary health insurance for themselves or their families to stay protected without breaking the bank. Thus, residents of Utah who wish to have this temporary coverage to bridge the gap until they avail permanent health insurance coverage can opt for short-term health insurance plans. Short-term plans are temporary plans designed for a set duration usually less than a year to bridge the gap between long-term plans. Short-term plans are generally required by younger generation who lose their parents’ coverage and need health insurance for a short time until they shop for a longer term health plan or individuals who are in-between jobs and are waiting for their employer health insurance.
Short-term health insurance plans in Utah last only for 364 days or less, and these plans are non-renewable. This further means that the individuals can have a short term plan in Utah for not more than 363 days, as per the state law. However, individuals purchasing a short term health insurance plan in Utah will be considered ineligible for any guaranteed issue like HIPAA Plans, or a COBRA plan if they have recently lost coverage from a group health plan. Short term plans in this state do not provide coverage for pre-existing medical conditions along with many other benefits associated with the comprehensive plans, like minimum essential benefits required for qualified health plans under the Affordable Care Act. Because of such limitations, short-term plans are not considered ideal for everyone and hence are preferred by individuals, who only need minimal coverage and are unable to afford long-term plans. Individuals can buy short-term plans in Utah anytime during the year and these plans are offered by private insurance companies.
Dental Plans in Utah
Dental insurance plans in Utah work just like medical insurance plan. Individuals are required to pay a monthly premium to obtain certain dental benefits like regular checkups, cleanings, x-rays and certain dental care essential to promote general dental health. Some of the dental plans provide broader coverage than others and require financial contribution from insured when dental services are rendered. Some of the dental plans also provide coverage for oral surgery, dental implants, or orthodontia. Dental insurance plans in Utah are categorized as follows:
Dental Preferred Provider Organization – Dental PPO plan is just like PPO health insurance plan, in which insurance company maintain a network of dentists who agree upon to render dental care at a reduced price. Members of the plan will have a lower cost if they choose to visit in-network dentist. Though, PPO plans cover out-of-network dentists too but members will require to pay a higher price. Dental PPO plans are highly popular among the Utah residents but the plan also include some restrictions like waiting period, deductibles, maximum benefit and coinsurance.
Dental Health Management Organization – In DHMO plan, members are require to choose a primary dentist to receive dental treatments. The dental insurance companies make a contract with a group of dentists to provide dental care services to the members of the plan and they pay dentists a predetermined amount each month. The monthly amount paid to the dentists are determined by the number of people enrolled in the plan. Most of the DHMO plans do not have waiting periods, deductibles or annual maximums. The premium of these plans are not expensive and the insured have to pay entire dental care cost from their own pocket if they visit out-of-network dentist.
Vision Plans in Utah
Preventive eye-care is an essential practice even for individuals having a perfect vision to ensure they have perfect vision in the years to come. Thus, having vision insurance in Utah will allow individuals and their family to receive routine eye examination from a qualified eye care professional. Beside this, individuals also receive several other benefits from vision insurance plan. Vision insurance plans features and benefits vary from one insurance carrier to another but some of the common coverage include eye examination, surgical procedures like LASIK, cost of frames and lenses and non-prescription sunglasses.
Insurance Carriers in Utah
In Utah there are four insurance carriers offering health insurance plans through Utah’s exchange in 2020. Following are the four health insurance carriers operating in Utah in 2020:
- Molina Healthcare of Utah
- University of Utah health Insurance Plans