Best Medicare Advantage Plans in Utah for 2019
Original Medicare provides coverage for many medical treatments. At the same time, Part A and Part B of Medicare also have lots of gaps in the form of deductibles, coinsurance, and copays. An increasing number of people have turned to some of the best Medicare Advantage plans in Utah for 2019 because they can help reduce out-of-pocket costs and usually have modest or even $0 premium rates. The Medicare Part B premium does still have to be paid with these plans, but many people find that their health care costs go down significantly after signing up for one of these plans. Take a moment to compare Original Medicare to Utah Medicare Advantage plans.
Best Time to Enroll in Medicare Advantage Plans in Utah for 2019
First, you’ve got to be enrolled in Medicare Part A and Part B in order to enroll in a Medicare Advantage plan in Utah. Otherwise, the only health question that you need to answer for Medicare Part C in Utah is about End Stage Renal Disease ESRD. If you have ESRD, you need to enroll in a special plan and not a typical Medicare Advantage plan.
Besides these basic requirements, Medicare Part C plans in Utah only allows enrollment during certain times:
- Initial Coverage Election Period: When you’re first enrolled in Medicare Part A and Part B at age 65, you get your first chance to choose a Medicare Advantage plan.
- Annual Election Period: In the autumn, you get a chance to check out and sign up for new Medicare Advantage plans for the coming year.
- Special Election Periods: Specific circumstances, like moving away from your plan’s network area, might trigger a Special Election Period.
- Medicare Advantage Disenrollment Period: At the start of each year, you have a few weeks to drop your Medicare Advantage plan and simply resume Medicare Part A and Part B. You can also join a Part D plan during this time if you also dropped your drug benefits.
Once you join a Medicare Advantage plan in Utah for 2019, your new insurance company will send you an insurance ID card that you will usually show to healthcare providers instead of the Original Medicare card.
Best Types of Medicare Advantage Plans in Utah for 2019
Original Medicare is standardized all across the country. Unlike Medicare Part A and B, various Medicare Advantage plans may deliver healthcare very differently. Various plans also have different premiums and benefits. As with any health insurance, you will need to compare local options to find one that suits your budget, preferences, and healthcare needs the best.
Learn about the most popular choices for a Medicare Advantage plan in Utah for 0219:
Health Maintenance Organization HMO plans:
An HMO may offer you a modest or $0 premium. In return for lower rates and costs, you have to follow strict network rules. About 83 percent of Utah Medicare Advantage members choose an HMO.
Preferred Provider Organization PPO plans:
You can enjoy the freedom to get covered services at out-of-network providers, but you will probably pay more for this freedom with a PPO. About 14 percent of MA plan members in Utah picked a PPO.
Special Needs Plans SNPs:
An insurance company may offer you a Special Needs Plans if you have to manage certain medical conditions, such as institutional conditions or chronic health conditions.
Dual-Eligible Medicare Advantage plans in Utah help people who have Original Medicare and Medicaid, such as those who are on a fixed income through Social Security.
Private Fee-for-Service PFFS plans:
These are some of the least common plans, but they are still available in many areas. These are cost-sharing plans. Coverage is set by the insurance company, though, and not Medicare.
MAPD: This actually refers to any of the best Medicare Advantage plans in Utah for 2019 that includes prescription drug coverage. Prescription drug coverage comes with various types of Advantage plans.
Enrollment Statistics for Medicare Advantage Plans in Utah
These are some enrollment figures for Utah Medicare Advantage plans:
- Percent of Utah beneficiaries: 35 percent
- Number enrolled in a Utah Medicare Advantage plan: 127,850
These are the biggest Utah counties by population. You’ll typically find the most plan options in these bigger and more populated counties. However, you can still find the best stand-alone Medicare plan with a reasonable monthly premium in any of the counties across the state.
- Salt Lake County, Utah: 1,135,649
- Utah County, Utah: 606,425
- Davis County, Utah: 347,637
- Weber County, Utah: 251,769
- Washington County, Utah: 165,662
Do Medicare Advantage Plans in Utah Cover Prescriptions Drugs?
Medicare Part A and Part B only offer limited prescription drug coverage. Meanwhile, most of the best Medicare Part C plans in Utah include Medicare Advantage Prescription Drug plans that a beneficiary can use as their Part D plan. That’s one reason so many Utah beneficiaries prefer a Medicare Advantage plan in Utah over just relying upon Medicare Part A and Part B.
In fact, even those who sign up for a Medicare Supplement insurance plan to supplement their Medicare coverage aren’t able to enjoy a Medicare prescription drug plan unless they sign up for — and pay for — Medicare Part D separately. This is why some of the people who are under the Medicare program choose Advantage health plans instead of Medigap/Medicare Supplement plans.
In order to compare different drug options, it’s important to consider a couple of factors. One is the formulary or list of drugs covered by the insurance company. Insurers will also have Prescription Drug Tiers that specify different benefit levels for generic vs. brand-name medicine. A beneficiary should compare these to their own prescription needs to find the best solution. If needs change, beneficiaries can also switch their plans every year during the Annual Election Period so that they can find a plan that features Part D prescription drug coverage that will suit their needs and help them save even more on health care costs.
Network Rules for Medicare Advantage Plans in Utah
Almost all Medicare Advantage plans in Utah use networks to help control costs. Since Medicare Part A and Part B don’t use networks, this is something that’s important for people to understand. Most American medical providers will accept Medicare Part A and Part B, but that may not be true for some Medicare Advantage plans.
With an HMO, members should count on getting covered services from in-network providers. An HMO may cover out-of-network emergencies, but otherwise, it’s important to stick to a network doctor and hospital unless the insurer gave approval for an exception in advance. The may make exceptions, for instance, in the rare event they do not have a medically necessary, in-network medical service. Also, members have to choose a PCP who must give patients referrals to see a specialist or get certain kinds of medical services.
A PPO may cover out-of-network healthcare services, but the member will have to pay more of the cost. In addition, some of the best PPOs don’t require referrals from a primary care doctor for specialists. Some PPO plans even have statewide or national networks, so they may offer a better choice for people who want to travel without worrying that cannot find a network hospital or doctor.
If you do move away from your plan’s main network area, you can ask for a Special Election Period. This gives you 62 days to select another Medicare Advantage plan from your new hometown. Then, you can look for a plan with a service area that works in your new area.
Top Providers for Medicare Advantage Plans in Utah for 2019
To help you compare Medicare Part C plans in Utah for 2019, it might help to glance at an overview of some of the state’s leading providers:
- Aetna: Aetna accounts for about 9 percent of all Utah MA members. You might look for Aetna’s PPOs with high star ratings for quality.
- Intermountain Healthcare: This regional provider has about 10 percent of the market for Utah MA plans.
- Regence Blue Cross: The Utah Blue Cross company offers PPO Medicare Part C plans that have been recognized for quality.
- Humana: Humana doesn’t appear active at this time.
Medicare compiles the best information about every plan in every county, and they use that data to create star ratings. There weren’t any Medicare Advantage plans in Utah listed with a 5-star rating at the time of publication, but that could change as new information gets published for 2019. Some plans had star ratings over 4 stars, and insurance companies hope to get a 5-star rating to help them attract more Medicare Advantage plan members and earn government incentives.
Utah Medicare Resources
These are some local resources for Utah Medicare beneficiaries:
- Utah Extra Help With Medicare
- Utah Aging Services
- CMS: Centers for Medicare and Medicaid Services
An experienced insurance agent from our company can help you out over the phone and talk to you about what each Medicare Advantage plan in Utah will and will not cover. They can also help guide you in choosing an insurance company with a top star rating so that you can find coverage that will help with doctor’s office visits, hospital stays, care in a skilled nursing facility, skilled temporary care in a nursing home and more.