Finding Medicare Plans in Utah
With so many options available, it can be pretty daunting to find the Medicare coverage that works best for you. But MedicareMatchup is here to help you consider your options and select your ideal plan.
What is Medicare?
Medicare is a federal healthcare program that provides insurance to people over 65, as well as others with certain conditions.
Who is Eligible for Medicare Plans in Utah?
If you are 65 or older, you may be eligible if:
- You are an American citizen or have been a permanent resident in the US for at least 5 years, and
- You and/or your spouse have worked and paid Medicare taxes for a sufficient amount of time (typically around 10 years).
If you are under 65, you may be eligible if you have:
- Received Social Security Disability Insurance (SSDI) for 2 years, or
- Been diagnosed with End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS).
If you’re unsure whether you qualify or will be turning 65 soon, we can help you get started. You can speak with one of our licensed insurance agents now by calling the number above or browse plans online.
What are the Different Parts of Medicare?
Original Medicare (Parts A and B)
Two components make up Original Medicare: Hospital Insurance (Part A) and Medical Insurance (Part B). As its names suggests, Part A covers hospital services, including lab tests, surgeries, and hospice care. Part B covers certain services and supplies that are “medically necessary,” as well as preventive care.
Medicare Advantage Plans (Part C)
Medicare Advantage Plans, offered by private, Medicare-approved insurance companies, provide an alternative to Original Medicare. These plans must meet or exceed the coverage provided by Original Medicare, often including dental, vision, and prescription drug coverage. Medicare Advantage plans with prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
Premiums for Part C plans can start as low as $0/month and increase as the level of coverage increases. You will, however, still have to pay your Part B premium in addition to your Part C premium.
Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug Plans, offered by Medicare-approved private insurance companies, work alongside Original Medicare to help pay for medications. Neither Original Medicare nor Medigap plans provide this coverage. Prescription Drug Plans use a tier system to assign a certain copay and coinsurance to certain medications. Each plan provides a formulary to help see which drugs are covered as well as the associated copayment and coinsurance.
Medicare Supplement Plans (Medigap)
Medigap plans also work alongside Original Medicare (Parts A and B) to help fill the gaps in coverage. These plans are offered by Medicare-approved private insurance providers and help to reduce certain costs, such as copayments, coinsurance, and deductibles.
When should I enroll in a plan?
Original Medicare (Parts A and B)
Your first chance to sign up for Original Medicare is during your Initial Enrollment Period (IEP). Everyone gets their own IEP, which runs for 7 months total, including:
- 3 months before the month of your 65th birthday
- The month of your 65th birthday
- 3 months after the month of your 65th birthday.
Note: If you miss your IEP, you will have another opportunity to enroll during the General Enrollment Period (GEP). The GEP takes place each year from January 1st to March 31st. You may, however, have to pay a higher premium as a penalty for late enrollment if you miss your IEP.
Medicare Advantage Plans and Prescription Drug Plans
You can first enroll in Advantage Plans and Prescription Drug Plans during the same 7 month period as your IEP.
Note: If you miss this window, you can also enroll or change your coverage during the Annual Election Period (AEP). Also called the Open Enrollment Period, the AEP runs every year from October 15th to December 7th. You may, however, have to pay a higher Part D Premium as a penalty for late enrollment.
Medicare Supplement Plans
Your first chance to enroll in Medigap plans is during your Medigap Open Enrollment Period. This 6-month period starts the month you are both:
- 65 or older
- Enrolled in Medicare Part B
Even if you’re over 65, this period would start the same month as your Part B coverage. Once it starts, your Medigap Open Enrollment Period will last 6 months total.
Note: It’s important to sign up for Medigap plans during your Medigap Open Enrollment Period. If you miss it, you may have to pay a higher premium or be denied coverage altogether.
Special Enrollment Periods
In some situations, you may also make changes to your coverage outside of the aforementioned enrollment periods. If you’ve recently experienced a qualifying life event, you may be eligible for a Special Enrollment Period (SEP). Qualifying events include moving, losing coverage, new coverage becoming available, etc.
How do I select a plan?
Our licensed insurance agents are here to help you sort through your options and find your ideal coverage. You can browse plans online by using the form below or speak with one of our licensed insurance agents by calling the number above. We’re happy to help you compare plans, determine eligibility, or answer any other related questions.
Additional Healthcare Resources in Utah
SHIP operates in every county in Utah and is a national program that offers free one-on-one counseling and assistance to persons with Medicare, and their families.
Utah Medicaid: Medicaid is a source of health care coverage for Utah’s vulnerable populations. Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. To qualify, these individuals must meet income and other eligibility requirements.
Sources: Medicare.gov; https://insurance.utah.gov; https://medicaid.utah.gov/