Medicare Advantage Plans in Utah

Medicare Advantage in Utah – also known as Medicare Part C – is a form of health insurance that offers beneficiaries an alternative to Original Medicare coverage.

People eligible for Medicare benefits can purchase a Medicare Advantage plan in Utah from private insurance companies. Many Medicare Advantage plans also offer Medicare Part D (prescription drug coverage) and extra benefits all in one plan. Part C plans provide the same benefits as Medicare Part A (hospital insurance) and Medicare Part B (outpatient medical insurance).

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Top-rated Medicare Advantage Providers in Utah

  • Aetna: Aetna accounts for about 9 percent of all Utah MA members. You might look for Aetna’s PPOs with high star ratings for quality.
  • Intermountain Healthcare: This regional provider has about 10 percent of the market for Utah MA plans.
  • Regence Blue Cross: The Utah Blue Cross company offers PPO Medicare Part C plans that have been recognized for quality.
  • Humana: Humana doesn’t appear active at this time.

Popular Medicare Advantage Plans in Utah

Best network freedom: Medicare Advantage PPO

  • PPOs permit Medicare beneficiaries to use a more extensive network of providers for their health care services and supplies.
  • PPOs don’t require enrollees to get referrals from primary care physicians to see specialists.
  • Monthly premiums run between $0 and $100.00.

Best for lower out-of-pocket costs: Medicare Advantage HMO plans

  • Most HMOs have $0 monthly premiums.
  • HMO plan enrollees must get referrals to see specialists.

Best plans for low-income or chronic health conditions: Medicare Advantage D-SNP

  • D-SNPs or Dual Eligible Special Needs Plans, provide coverage for qualified enrollees with limited incomes or chronic illnesses like end-stage renal disease.
  • D-SNP plans are for beneficiaries with both Medicare and Medicaid coverage. The plans help ease the financial burden of medical expenses.

Utah Enrollment Facts:

  • Total number of people enrolled in Medicare Advantage plans in Utah: 164,000
  • The number of people enrolled in Local HMO plans is 112,797
  • The number of people enrolled in Local PPOs is 22,937
  • People enrolled in Regional PPOs: are 0
  • The percentage of Medicare beneficiaries enrolled in Medicare Advantage in Utah is 40 percent.
  • The number of people enrolled in Medicare Advantage nationwide is over 26 million.
  • The rate of Medicare beneficiaries enrolled in Medicare Advantage nationwide is 42 percent.

How much does Medicare Advantage in Utah cost?

Those eligible for Original Medicare in Utah can enroll in a Medicare Advantage HMO plan with a $0 premium as an alternative coverage option. In some states, PPO plans with $0 premiums are also available.

Utah Medicare Advantage plans with prescription drug coverage carry an average monthly premium of $19.15 and average deductibles of 156.89

You can find out more about costs in your Utah service area by asking a licensed insurance agent.

How much do Advantage Plans cost in Utah?

PPO Plan $0.00 to $19.15

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

1. Your Initial Enrollment Period (IEP)

At the age of 65 AND:

  • Receive Social Security retirement or Railroad Retirement Board benefits
  • Your IEP begins three months before your 65th birthday, your birthday month, and three months after your birthday month.

Underage 65 AND:

  • Receive disability benefits from the Social Security Administration or Railroad Retirement Board for the required time.
  • Have an end-stage renal disease or ALS (Lou Gehrig’s disease)
  • In these instances, your IEP begins three months before the 25th month of getting disability, and it ends three months after that month.

2. Open Enrollment Period (OEP) or Annual Election Period (AEP)

During AEP, people can join a new Medicare Advantage plan or switch to a different plan. They can also switch to Original Medicare Parts A and B and enroll in separate prescription drug plans.

AEP runs from October 15 to December 7. Any changes made take effect on January 1.

3. Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period begins every year on January 1 and ends on March 31. During the MA OEP, you can switch coverage back to Original Medicare or sign up for a different Medicare Advantage plan. Any changes you make take effect on the first day of the month that follows your change.

4. Special Enrollment Periods (SEP)

Those who qualify for special enrollment can sign up for a Medicare Advantage or Part D plan.

These are some reasons you may qualify for a special enrollment period:

  • You are leaving your current service area and need coverage at your new location.
  • You are moving back to the U.S. after living abroad
  • You are leaving or moving into a skilled nursing or long-term care facility or institution
  • You are being released from prison
  • Medicare terminates your Medicare Advantage plan or alters its coverage. Or you lose Medicaid coverage or become dually eligible for Medicare and Medicaid.
  • You currently have Original Medicare coverage with a Medicare Supplement plan and switch to a Medicare Advantage plan.

5. Five-star Special Enrollment Period

If a Medicare Advantage plan with a five-star rating becomes available, you can upgrade your coverage.

6. Special Enrollment Period for the “Extra Help” program

Those in the Extra Help program or who have Medicaid coverage can make changes to their coverage during one of these periods:

  • January – March
  • April – June
  • July – September

Medicare beneficiaries may qualify for Extra Help to pay monthly premiums, annual deductibles, and co-payments for Medicare Part D (prescription drug coverage).

Medicare Advantage Highlights:

Here’s a better look at Medicare Advantage in Utah:

  • CMS mandates that Medicare Advantage plans cover, at least, the same benefits as Medicare Part A and Part B.
  • Enrollees must also pay Medicare Part B premiums to maintain Medicare Advantage eligibility.
  • The standard monthly Medicare Part B premium for 2023 is $164.90.
  • The annual Part B deducible for 2023 is $226.
  • Medicare Advantage plans in Utah are quickly gaining popularity as the top coverage options.
  • Most plans and benefits use network providers for medical services and supplies.
  • Medicare Advantage Prescription Drug plans (MAPDs) include prescription drug coverage in the plan with other Medicare benefits.
  • Plans in Utah may contain extra benefits like vision, dental, and hearing care; wellness club memberships like SilverSneakers.

Ready to learn more?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.

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