Purchasing Health Insurance in Utah
You have options for purchasing health insurance in Utah. Read on for an explanation of the best options, the different Utah carriers, and the different ways you can enroll. Reach out to a Compass advisor for any additional questions about health insurance in Utah.
Medicaid and CHIP are state run health plans. 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. For more information about Medicaid visit https://medicaid.utah.gov/.
The Children’s Health Insurance Program, or CHIP, is a state health insurance plan for uninsured Utah kids and teens. Emergency medical costs can quickly break your budget. With CHIP, you’ll have one less thing to worry about. For more information about CHIP visit chip.health.utah.gov/.
Most individuals who do not get health insurance through their workplace start their search on the Obamacare or Affordable Care Act Marketplace. 9 out of 10 families will qualify for the Advanced Premium Tax Credit which makes health insurance incredibly affordable.
Off Market Plans
Non-Obamacare plans work well for people who are healthy and do not qualify for a tax credit through the Marketplace. Reach out to one of our advisors and we can help you decide if one of these plans are the right fit and can compare all the major carriers available in your area.
Utah Health Insurance Carriers
In 2020 there were 6 carriers that filed to sell Qualified/Major Medical “individual” (non-employer) plans in parts of the state for 2021. All carriers have plans on the marketplace which basically means they are willing to accept a tax-credit from the government that’s paid on behalf of the consumer each month, assuming the individual or family qualifies. The odds of qualifying have increased since the ARPA act went into effect which ultimately increased the qualification levels. The carriers that have filed to sell plans in 1 or more counties in Utah and that accept assisted premium tax credits are Select Health, University of Utah Health Plans, Cigna, Molina, Regence, & Bridge Span.
Select Health is without question the power house of the individual market. They have the largest market share and in most cases are also the most cost effective. They are tied in with the Intermountain hospital system, or IHC.
University of Utah
University of Utah Health Plans model closely resembles that of SelectHealth in that they also have a sister company in the medical field with the University of Utah hospital system. However, one key difference is the UofU contracts with hospital systems outside of their own with MountianStar and Steward.
Cigna contracts with the Steward and Mountain Star hospitals. Their niche is with the low income households who have high-cost medications. If this is you, contact one of our agents to learn more and see if their program is a good fit for you.
Molina’s specialties have been in the Medicaid and Medicare markets, however they have a growing presence in the ACA marketplace. They are new to Utah’s market, but they have a highly attractive $0 deductible bronze plan.
Regence/Blue Cross Blue Shield and Bridgespan
Regence and BridgeSpan and sister companies and are generally competitive in particular networks in rural areas.
How to Enroll
Essentially there are 3 basic routes for someone to enroll in a plan in the state of Utah.
1. Directly Through the Health Insurance Carrier
This is probably your least effective method as oftentimes you are having to do the ground work in reaching out to each carrier yourself to obtain quotes, ask benefit questions, check Rx formularies, make sure your doctor is in network, etc.. Early in my insurance career and before I was connected with Compass Insurance Advisors this was how I had to shop quotes for my clients so I know firsthand how gruesome and time consuming it can be.
2. Federal Marketplace/Other Enrollment Platforms
When the ACA was passed, they created a central location that allows consumers to see every plan offered by each insurance company, which sounds nice but can easily be, and is often (even for licensed agents) information overload. The biggest problem is they aren’t clear or have even been incorrect with benefit details beyond deductibles, in-network doctor’s, or rx formularies.
3. Utilizing an Agent/Producer/Advisor
This is easily your most effective method of shopping the market. Most agents (especially Compass agents) sift through all the available plans every year to determine which ones are advantageous or if certain plans were designed to meet a particular niche than the rest.
They will also be aware of each carrier’s network of doctors and hospitals or at the very least know how to research your desired doctor or hospital system among the many networks listed in each carrier’s search engines. Not all networks within an insurance company are created equal. Just because a doctor or facility pulls up in a carrier’s search engine does not mean that the plans offered in the marketplace are accepted by those doctors. Each carrier has a unique name for each network and it’s important to understand this or you may end up being sorely disappointed and very frustrated in finding out your plan doesn’t take your doctor in a time of need.
Working with a Compass advisor does not cost anything extra. Insurance companies cannot raise your rate for using an advisor, so you will pay the same price if you try to figure it out on your own or if you use an advisor.
There’s a ton of value in that there’s no downside, rather there’s complete upside in having an agent help with finding the right plan for your family’s particular needs. It’s like having your cake and eating it too, without all the calories, sugar rush and self-loathing that comes from eating an entire cake all by yourself!!!
Yes, the agent still receives compensation from the insurance company when they enroll clients into a health plan but this has no direct impact on the consumer’s cost. Insurance companies budget an agent’s commission in the premium when negotiating with the Department of Insurance. In essence, if you don’t use an agent, the insurance company has still budgeted the commission into the monthly premium, so all you’ve done is limited your opportunity to make a truly informed, educated decision.
One last underrated value an agent can bring to the table is being aware of alternative plans to the ACA. There are plenty of families who are healthy, don’t qualify for the tax credit, and don’t want to pay the high premiums on the marketplace. For those in this type of situation these non-Obamacare plans are the perfect solution! If you were to shop using one of the first two methods listed above you would likely not be aware of these options, however as long as you utilize a Compass agent you will always be aware of your best options.