Curious about health care in the Beehive State? Good news, Utahns. According to a study by US News, Utah has the tenth best health care in the country. That study looks at access, quality, and good public health.
Health insurance options in Utah
According to the Utah Insurance Department, residents have many health insurance options.
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Utah residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 61% | ||
| Individual or family | 9% | ||
| Medicaid | 10% | ||
| Medicare | 10% | ||
| Uninsured | 9% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
9 percent of UT residents are uninsured, equal to the national average. A high percentage of uninsured people raises rates for insured people.
Utah health insurance companies
UT residents have plenty of options when it comes to health care companies in their state. These companies offer both individual and family plans in UT:
- BridgeSpan
- Cigna
- Molina
- SelectHealth
- University of Utah Health Plans
Utah health insurance costs and rate factors
How much should you expect to pay for health care in the Beehive State? UT residents spend an average of $5,982 every year on health care expenditures, well below the national average. Monthly rates vary person to person, based primarily on these factors:
Plan type
Marketplace plans come in metal tiers: bronze, silver, and gold. To get a higher level of coverage, you pay more in monthly premiums.
What should you expect to pay in Utah? These are the average monthly rates for each plan type for a middle-aged UT resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $289 | $479 | $609 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
In Utah, a gold plan costs more than twice as much as a bronze plan. Gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.
You may qualify for a catastrophic plan, the lowest level of coverage available. These plans have low monthly premiums, but a yearly deductible of $8,150. They’re essentially designed to prevent medical bankruptcy. But they’re not ideal for regular, preventative care. Because of that deductible, it may save you money to invest in a bronze or silver plan.
Body mass index
According to the CDC, a high body mass raises your risk for numerous health conditions. That’s why insurance companies analyze your BMI to determine your risk-level. A high BMI leads to higher insurance premiums.
In 2019, UT had a 29 percent obesity rate, the thirteenth lowest in the country. Of the Utah residents who used QuoteWizard to compare health insurance plans, 25 percent have a BMI in the obese range.
Tobacco use
Smokers pay more for health insurance because of the health risks tobacco causes. About 8.9 percent of UT residents are smokers, the lowest rate in the country.
Age
Health care coverage costs up to three times more older people than for younger people. UT residents who used QuoteWizard to shop for health insurance are, on average, 36 years old.
Location
Your location also plays a large role in your insurance rates. That’s because every state has different health care rules, regulations, and providers.
Health insurance rates are also community-rated. So, your insurance prices are partly based on the combined claims that everyone files. If your state files an abnormally high number of claims, your prices could soar.
How health-conscious your state is influences prices. According to America’s Health Rankings, Utah is the fourth healthiest state in the country. That’s a great sign for policyholders. Between smoking and obesity rates, Utah has a healthy populace!
Utah health insurance laws
The Affordable Care Act limits insurance companies from using certain factors to price your policy.
- Pre-existing conditions: The ACA mandates that insurance companies can’t use knowledge of your pre-existing condition to raise your premiums.
- Gender: Insurance companies aren’t allowed to charge women and men different prices for the same plan. That’s good news, especially considering women historically pay more for health insurance.
- Insurance and medical history: Insurance companies also used to analyze your medical and insurance history. Now, they can’t use lapses in insurance or previous medical problems to determine your costs.
There’s a limit to how much you’ll be paying out-of-pocket for a marketplace plan. In 2020, the out-of-pocket maximum is $8,150 for an individual plan and $16,300 for a family plan.
Utah law requires health insurance companies to offer at least some coverage for the following services:
- Maternity minimum stay
- Coverage of mental health conditions
- Prosthetic devices
- Diabetes
- Mastectomy
- Autism spectrum disorders
Required coverage may vary, so be sure to check cms.gov for the full list.
Medicare and Medicaid in Utah
Medicare and Medicaid are both government-funded health care programs. Medicare covers seniors and Medicaid helps low-income families and children.
Medicare
Utah residents 65 and older are eligible for Medicare. There are several coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. Utah residents may also be eligible for these Medicare Savings Programs:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
Medicaid is meant for low-income families and children. These are the state’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Utah Insurance Department
- Website:
- Homepage
- Insurance Commissioner:
- Todd E. Kiser
- Insurance Hotline:
- (800) 439 - 3805
- Office Hours:
- Monday - Friday
8:00 am to 5:00 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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