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Shopping for health insurance in the state of Utah might seem like a daunting task. Thankfully, there are many options open to residents who are uninsured or underinsured. Whether you're healthy or not, this page can provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage, and COBRA. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, HealthPlanOne can help. If not, review the information on this page about Utah Medicaid, CHIP, PCN, UPP, baby Your Baby, and the HIPUtah high risk pool. All of these government programs can help those who are medically uninsurable or who cannot afford private coverage obtain basic health coverage.
What Every Utah Resident Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through HealthPlanOne. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job, look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs, to invest in an individual/family insurance policy through HealthPlanOne.
With individual coverage, you choose the health insurance carrier and benefits you want with the help of HealthPlanOne. We will quote plans for you and your family from all the different carriers available in Utah so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through HealthPlanOne could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Utah each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the HealthPlanOne quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Small Group Plans
If you are self-employed, you can apply for a small group plan. You must have 2 or more eligible employees who each work at least 30 hours per week. Small group plans are medically underwritten by all carriers in Utah. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. HealthPlanOne can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.
Utah Medicaid and Medicare
Medicaid is a federal-state cooperative program which provides comprehensive health coverage to low-income individuals and other high risk groups. One's Medicaid card works in practice much like any other insurance card, and benefits of the program are largely similar to those one would receive from an individual plan. There are several different groups of low-income individuals who are eligible for full or partial Medicaid benefits. These are: families, children, people with disabilities, the elderly, pregnant women, and refugees. For specific eligibility requirements (including income ceilings) for each qualifying group, click here: http://jobs.utah.gov/opencms/customereducation/services/medicaid/index.html For detailed information on the application process and benefits, explore the Medicaid website at http://health.utah.gov/medicaid/ For information on the pharmacy aspect of Medicaid, click here:http://www.health.utah.gov/medicaid/pharmacy/index.php
Click here for information about Utah Medicare plans and pricing.
Utah Children's Health Insurance Program (CHIP)
Utah CHIP is the state's version of the federally mandated SCHIP program which provides basic health coverage to uninsured, low-income children who are ineligible for Medicaid but whose parents' income is insufficient to cover private health insurance for them. If a child qualifies under CHIP requirements, Medicaid benefits will be extended to them. This includes well-child exams, immunizations, doctor visits, hospital and emergency care, prescriptions, hearing and eye exams, mental health services, and dental care. For more information on eligibility requirements, copays, and benefits of the program explore the CHIP website at http://health.utah.gov/chip/
Utah Premium Partnership for Health Insurance (UPP)
Utah's Premium Partnership for Health Insurance (UPP) helps make health insurance more affordable for uninsured working individuals and families. The program will help you pay your monthly premiums when you enroll in your employer's health plan. If you and/or your dependents qualify (based on family size, income, and the plan your employer offers) UPP will reimburse you up to $150 per adult and up to $100 per child every month. For more detailed information, explore the UPP website at http://health.utah.gov/upp/
Primary Care Network of Utah (PCN)
The Primary Care Network (PCN) is a health plan offered through the Utah Department of Health which covers services administered by a primary care provider. Eligibility for the program depends on your family size and income. Income ceilings and other requirements are available here: http://health.utah.gov/pcn/ Applications for PCN are only accepted during specified open enrollment periods which are announced when PCN has the funds to cover more people. Separate enrollment periods may occur for parents of children under 18. Yearly enrollment fees are $50, $25, or $15 depending on your income. Covered services include: visits to a primary care provider, immunizations, birth control, diabetic supplies, emergency medical transportation, some ER visits, routine lab services and x-rays, eye exams, dental services, and 4 prescriptions per month. Hospital stays and visits to a specialist are not covered, as well as some other services such as MRIs. For full details click on the above link.
HIPUtah - Utah's High Risk Pool
HIPUtah is the Utah health insurance high risk pool: the insurer of last resort for many Utah residents. HIPUtah is meant to provide health coverage to residents whose preexisting conditions have rendered them medically uninsurable on the individual market. There are extensive eligibility requirements for enrollees, which are available at the below URL. Coverage under HIPUtah is not guaranteed. The HIPUtah program is administered for the state through SelectHealth.
For a complete list of health services available from the Utah Department of Health click here: http://health.utah.gov/healthservices.htm
Financial help is available on a temporary basis to Utah women who are pregnant and cannot afford proper prenatal care. Through the Baby Your Baby program, women can apply for financial assistance through a form of prenatal Medicaid. All eligibility requirements are available here: http://www.babyyourbaby.org/financial/financial.htm