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Medicare Supplement Plans in Utah


Summary: Medicare Supplement plans in Utah are designed to assist in covering the gaps in out-of-pocket costs not covered by Original Medicare. There are a variety of Medigap plans in Utah available to cater to different budgets and healthcare needs. Compare the Medicare Supplement plans available in Utah and choose the one that’s the right fit for you. Estimated Read Time: 11 mins

Table of Contents:

    1. Best Medicare Supplement Plans in Utah
    2. Eligibility for Medigap Plans in Utah
    3. Medicare Supplement Plan Costs in Utah
    4. Companies Offering Medigap Plans in Utah
    5. Medigap Plans in Utah for the Disabled Under 65
    6. Medicare Supplement Plan Rating Methods in Utah
    7. Medigap Guaranteed Issue Protections in Utah
    8. When to Enroll in Medigap Plans in Utah
    9. Does Utah Allow Medicare Excess Charges?
    10. Additional Medicare Coverage Options in Utah

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Medicare Supplement plans in Utah (also called Medigap plans) can help cover out-of-pocket healthcare costs that Original Medicare (Medicare Part A and Part B) leaves behind.

Original Medicare typically only covers 80% of approved outpatient services and medical equipment, leaving you responsible for the remaining 20%. Medigap plans are designed to help fill that 20% coverage gap, so you have fewer out-of-pocket expenses to worry about.

Unlike Original Medicare, which is funded by the federal government, Medicare Supplement plans are provided through private insurance companies. However, any insurance carrier selling Medigap plans must still adhere to strict guidelines.

If you’re a Utah beneficiary, it’s a good idea to review the Medicare Supplement policy options available in your area to determine which plan meets your budget and healthcare needs most.

Here we will discuss Medicare Supplement plans in Utah, their coverage, average costs, and how they can benefit you.

Best Medicare Supplement Plans in Utah

Various private insurance carriers offer up to 12 different Medicare Supplement insurance plans in Utah. Regardless of the insurance company you choose, the benefits of the Medigap plans remain the same. You have the freedom to use your policy with any healthcare provider that accepts Original Medicare, as Medigap plans do not have restrictive networks.

This is because all Medicare Supplement plans in Utah are standardized. For example, if you enroll in Medigap Plan G with Aetna or Humana or any other insurance company offering Medigap plans in Utah, the benefits for Plan G will be identical across all carriers.

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When it comes to budget and healthcare needs, there is no one-size-fits-all best Medicare Supplement plan for everyone. However, Medicare Supplement Plan F, Plan G, or Plan N are popular options for Utah beneficiaries in terms of affordability and comprehensive coverage.

Medicare Supplement Plan F in Utah

Medicare Supplement Plan F in Utah offers the most extensive coverage among the three plans but is only available to select Medicare enrollees. To be eligible for this plan, you must have enrolled in Original Medicare before January 1, 2020.

Medigap Plan F in Utah covers 100% of your out-of-pocket costs after Original Medicare pays its portion. The only cost you need to pay with this plan is the monthly premium.

Medigap Plan F in Utah includes:

  • Part A deductible, coinsurance and hospital costs, and hospice care coinsurance
  • Part B deductible, copays, coinsurance, and any excess charges
  • Blood (first 3 pints)
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency – 80%

Medicare Supplement Plan G in Utah

Medicare Supplement Plan G in Utah is the next best plan and the top choice for those who do not qualify for Medicare Supplement Plan F. With Medicare Supplement Plan G in Utah; you receive 100% coverage for your out-of-pocket costs after meeting the Medicare Part B deductible.

Medigap Plan G in Utah includes

  • Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
  • Part B copays, coinsurance, and any excess charges
  • Blood (first 3 pints)
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency – 80%

Medicare Supplement Plan N in Utah

Lastly, Medicare Supplement Plan N in Utah is your best option if you seek comprehensive coverage with a lower monthly premium. With Plan N, you are responsible for covering the Medicare Part B deductible, a copay for a doctor’s visit or specialist, a copayment for an emergency room visit (if not admitted), and any excess charges, if applicable.

Medigap Plan N in Utah includes:

  • Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
  • Part B copays/coinsurance
  • Blood (first 3 pints)
  • Skilled nursing facility care coinsurance
  • Foreign travel emergency – 80%

Although this plan requires more out-of-pocket responsibility, if you do not frequently visit the doctor, it may be a suitable choice for you.

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Eligibility for Medicare Supplement Plans in Utah

To be eligible for Medicare Supplement plans, Utah residents must meet the eligibility requirements for Original Medicare. These requirements generally include:

  • Being at least 65 years old.
  • Being a United States citizen for at least five years.

There are a few exceptions to these requirements that may allow individuals to qualify for Medicare Supplement insurance at a younger age. These exceptions include:

  • Being diagnosed with end-stage renal disease (ESRD). However, any Medicare coverage won’t start until after a waiting period, which is typically four months of undergoing dialysis.
  • Being diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
  • Receiving Social Security Disability Insurance (SSDI) for at least 24 months.

It’s important to know that if you are currently enrolled in a Medicare Advantage plan (Medicare Part C) and wish to get a Medigap plan, you will need to choose one or the other. It is not possible to have both types of coverage at the same time.

Before applying for a Medigap policy, you must first disenroll from your Medicare Advantage plan, which can only be done during valid election periods. These periods include the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period.

How Much Do Medicare Supplement Plans in Utah Cost?

The cost of your Medigap premiums in Utah will vary depending on the pricing method used by your insurance provider. In Utah, Medicare Supplement carriers often use the attained-age rating method, which means that rates increase as you get older.

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The monthly premiums for a Utah Medicare Supplement plan can be influenced by several factors. Generally, men may expect to pay higher premiums compared to women, as well as individuals who smoke and those who are older than 65. Additionally, if your coverage includes more benefits, you may also have higher premium costs.

Below, we review the cost of Medigap plans for those in Utah. Our example features Medicare Supplement costs for a 65 and 75-year-old male and female in the same Utah ZIP Code. Both are non-smokers.

Female, No Tobacco, Utah ZIP Code 84095
Medigap Plan Monthly Premium Age 65 Monthly Premium Age 75
Medicare Supplement Plan F $115-$408** $147-$408*
Medicare Supplement Plan G $101-$384 $118-$384
Medicare Supplement Plan N $74-$289 $91-$289
Male, No Tobacco, Utah ZIP Code 84095
Medigap Plan Monthly Premium Age 65 Monthly Premium Age 75
Medicare Supplement Plan F $126-$461* $161-$461*
Medicare Supplement Plan G $114-$433 $135-$433
Medicare Supplement Plan N $81-$326 $102-$326

* If on Medicare before 1/1/20

* Sample premium rates sourced from Medicare.gov

It’s important to note that the rates shown here are just averages in Utah. Your actual premium costs could be higher or lower depending on the aforementioned factors and other personal factors.

Medicare Supplement Plan Carriers in Utah

With 10+ Medicare Supplement plans available and various insurance companies nationwide, finding the right carrier is essential. Some of the most popular Medigap plan insurers in Utah include:

  • Aetna
  • Blue Cross Blue Shield
  • Cigna
  • Humana
  • UnitedHealthcare
Compare Utah Medicare Supplement Carriers
Carrier BBB Rating S&P Rating A.M. Best Rating
Aetna A+ BBB A+
Blue Cross Blue Shield F A- A
Cigna No Rating A- A
Humana A+ BBB+ A-
UnitedHealthCare A+ A+ A-

While this is not a comprehensive list of carriers available in Utah, this list does provide some of the highest-rated and highest-enrolled plans in the state. For a complete list of carriers in your area, contact an agent for more details.

Medigap In Utah For Those Under 65 on Disability

If you are under 65 and qualify for Medicare due to disability in Utah, you may be wondering if a Medicare Supplement plan is an option for you. Unfortunately, the state of Utah does not require carriers to provide plans to those under age 65, and if they do, they can drastically increase the cost of the plan’s monthly premium.

However, just because the plans are not required does not mean all carriers will discard them. There are some carriers that allow those under 65 to enroll in at least one of their Medigap plans.

Medicare Supplement Plan Rating Methods in Utah

In Utah, Medicare Supplement insurance plans are rated using three different methods: Attained-Age Rated, Issue-Age Rated, and Community Rated.

The Attained-Age Rated method is commonly used by most Medigap insurers in Utah. This means that your premiums for Medicare supplements are based on your current age. Initially, when you enroll in a Medigap policy, your premiums are typically lower and gradually increase as you get older. These increases in premiums are usually due to the higher healthcare costs associated with aging and the increased utilization of medical services.

Under the Issue-Age Rated method, the premium is based on your age at the time of enrollment. If you enroll in a Medigap plan as soon as you are eligible at 65, you will typically have lower premiums that do not increase solely based on your age. However, the premium may still rise over time due to factors like inflation.

The Community Rated method ensures that all individuals enrolled in the same Medigap plan within a specific geographic location in Utah pay the same premium, regardless of their age. While the premium may increase due to external factors like inflation, it is not directly tied to your age alone.

Medigap Guaranteed Issue Protections in Utah

Utah residents have certain guaranteed issue rights or Medigap protections under federal law. These rights ensure that they can enroll in a Medigap plan without being denied coverage or facing higher premiums due to pre-existing conditions. These protections aim to provide access to Medigap coverage when it is needed.

One important guaranteed issue right is the Medicare Advantage trial period. If someone joins a Medicare Advantage plan when first eligible for Medicare and decides to disenroll within the first year, they have a one-time guaranteed issue right to enroll in a Medigap plan. This allows them to obtain Medigap coverage without undergoing medical underwriting.

Another important protection is available for those who lose coverage. If someone loses employer-based retirement coverage or if their current Medigap plan is terminated or discontinued, they have a guaranteed issue right to enroll in another Medigap plan.

These guaranteed issue rights also apply if someone moves out of state and their Medigap carrier is no longer available. To qualify for this protection, they must apply for a new Medigap plan within 63 days of the termination of their existing plan.

Additionally, there are guaranteed issue rights associated with Medicare Advantage plans. If someone’s Medicare Advantage plan is terminated, they move out of its service area, or they lose coverage due to circumstances beyond their control, they have a guaranteed issue right to enroll in a Medigap plan. To be eligible for this protection, they must apply for a Medigap plan within 63 days of the termination of their Medicare Advantage plan.

When to Enroll in a Medicare Supplement Plan in Utah

You’re eligible for a Medicare Supplement plan in Utah as soon as you enroll in Original Medicare. There is no specific deadline in enrollment for supplemental insurance, but if you apply outside of your Open Enrollment Period you may be subject to underwriting questions about your health.

Your initial enrollment in Medicare Part B triggers a six-month Medigap Open Enrollment Period. You can enroll in a Medigap plan during this period without undergoing medical underwriting. This is the best time to get a Medicare Supplement plan since insurance companies won’t be able to deny you coverage or charge higher premiums based on pre-existing conditions.

If you delay in enrolling in a Medigap plan due to having creditable coverage in addition to Medicare Part B, you can qualify for a Special Enrollment Period. This period grants you guaranteed issue rights that allow you to get a Medigap plan without underwriting.

Does Utah Allow Medicare Excess Charges?

Medicare Part B excess charges are an infrequent additional expense that can occur on top of the Medicare-approved amount for a specific service. These charges are applicable only when your healthcare provider accepts Medicare but chooses not to accept Medicare assignment.

While not all states permit excess charges, most do, and Utah is one of them. In cases where your provider does not accept Medicare assignment, they may bill you for an extra fee of up to 15% for the services rendered. Nevertheless, it’s important to note that most healthcare providers do accept Medicare assignment, making excess charges relatively uncommon.

Additional Medicare Coverage Options in Utah

If you’re exploring other Medicare coverage options in Utah, you have several choices to consider. Whether you prefer a Medigap plan to complement your Original Medicare coverage or simply need prescription drug coverage, Medicare Part D can be beneficial. It helps cover the costs of medications, and you can enroll through an eligible private carrier. However, before enrolling, keep a few key points in mind.

Firstly, Medicare Part D plans operate based on a formulary, which is a list of prescription drugs covered by each plan. Be sure to check that the Part D plan you’re interested in includes coverage for the specific medications you require.

Secondly, be aware of the late enrollment penalty. If you don’t enroll in a Part D plan when you’re first eligible, delaying enrollment can result in higher premiums later on.

If a Medicare Supplement plan doesn’t suit your needs, you can also explore Medicare Advantage plans offered by private insurance companies in Utah. Also known as Medicare Part C, these plans combine the benefits of Medicare Part A and Part B and may include prescription drug coverage as well. However, remember that Medicare Advantage plans often come with high deductibles, regular copayments, limitations on doctor networks, and the requirement for a specialist referral.

Additionally, there are ancillary hearing, dental, and vision plans available. These stand-alone plans can provide you with additional coverage not included in Original Medicare or any Medigap plan without losing the essential benefits of Medicare Supplement insurance along with Medicare Part A and Part B.

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How to Apply for a Medicare Supplement Plan in Utah

Exploring Medicare options in Utah can be difficult, but it can be made simple by calling an agent today! We can help you find the most suitable Medicare Supplement Plan for you.

Working with an licensed insurance agent saves you time and money. Agents know which companies have a lower rate increase. This means you save more today and next year.

Call one of our agents at the number above or fill out an online rate form to discover the easy way to get additional coverage, including Medicare Supplement plans in Utah, today!

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Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. Utah Insurance Department. Accessed July, 2023.
    https://insurance.utah.gov/consumer/seniors/utah-medicare-supplement-medigap-insurance-comparison

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