Utah residents have several Medicare options, including Original Medicare, Medicare Advantage, and Medicare Part D.
Medicare plans in Utah follow all federal guidelines for healthcare coverage for people ages 65 years or older or who have qualifying disabilities or medical conditions.
However, coverage specifications, additional benefits, and plans may vary. It is important to review all the options that are available in Utah.
Glossary of Medicare terms
- Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money someone pays each month for Medicare coverage.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
There are two parts to Original Medicare: Part A and Part B.
- Part A: Part A, or hospital insurance, covers inpatient hospital care, skilled nursing facilities, hospice care, and home healthcare.
- Part B: Part B, or medical insurance, covers outpatient services and treatments, including:
- services from doctors and other healthcare professionals
- preventive services, such as vaccines, screenings, and yearly wellness visits
- durable medical equipment, such as wheelchairs, walkers, and hospital beds
- home healthcare
Read more about Original Medicare.
Medicare Advantage (Part C) is an alternative to Original Medicare that people can purchase through Medicare-approved private insurance companies.
Medicare Advantage plans provide the same coverage as Original Medicare. However, they often also include prescription drug (Part D) coverage and other benefits Original Medicare does not cover, such as:
- vision
- dental
- hearing
Some of the companies that offer Medicare Advantage plans in Utah include:
- Humana
- Cigna
- Aetna
- AARP UnitedHealthcare
- SelectHealth
- Regence Blue Cross Blue Shield of Utah
Not all plans are available in all areas. People can search their ZIP code and find which plans are available in their area using Medicare’s online tool.
Read about Original Medicare vs. Medicare Advantage.
Medicare eligibility
To be eligible for Medicare, a person must meet the following requirements:
- be 65 years old or older or have certain disabilities or medical conditions, such as end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
- be a United States citizen or a legal resident of the United States
Medicare Part D helps cover the cost of prescription medications, and private insurance companies administer these plans.
Many Medicare Advantage plans include prescription drug coverage. Individuals who have Original Medicare can purchase a Part D plan.
Medicare supplement insurance (Medigap) is extra insurance that people can purchase from private insurance companies. A Medigap plan can help cover some of the costs associated with Original Medicare, including:
- deductibles
- coinsurance
- copayments
Medigap is available only to people who are enrolled in Original Medicare.
Various companies offer Medigap plans in Utah, including:
- Cigna
- Aetna
- State Farm
- AARP UnitedHealthcare
- Humana
- USAA
People can use the Medicare online tool to find plans available in their area.
People choosing a Medicare plan in Texas may wish to consider various factors, such as:
- Doctor choice: Many Medicare plans have a network of doctors and other healthcare professionals. Before choosing a plan, a person may wish to check if their current doctor is in the plan’s network.
- Out-of-pocket costs: Monthly premiums are not the only costs to consider when choosing Medicare plans. People are also responsible for copayments, coinsurance, and deductibles.
- Services covered: All Medicare plans must provide the same coverage as Part A and Part B. However, people may want to consider additional benefits that they may consider important, such as gym memberships, vision, and dental.
- Healthcare needs: If a person has certain health conditions, such as diabetes or HIV, they may wish to look into Special Needs Plans, which are bespoke to an individual’s needs.
Learn about Medicare plans.
Individuals can contact Medicare directly by phone at 800-633-4227 or via online chat.
They can also contact the Senior Health Insurance Program (SHIP) to get more information about SHIP assistance in Utah, the Senior Medicare Patrol, and the Senior Community Service Employment Program. People can call SHIP at 800-541-7735.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
People living in Utah have various options for Medicare, including Original Medicare, Medicare Advantage, and Medigap.
Individuals who have queries can contact Medicare directly or their local Senior Health Insurance Program (SHIP) office.