Medicare plays a key role in providing health and financial security to beneficiaries residing in Utah. With more than 409,600 Utah beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Utah. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Utah?

Medicare covers most Utah residents who are 65 or older, and it also covers disabled Utah residents. In general, Medicare enrollment in Utah works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Utah Medicare Enrollments

245,388

Original Medicare Plans
(Part A and B)

164,218

Medicare Advantage & Other Health Plans

139,324

Stand-alone Medicare
Part D (Drug plans)

409,606

Total Medicare Beneficiaries
in Utah

Utah Medicare Advantage Plans (Part C)

More than 37% of Utah Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Utah who are already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare instead.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 164,218 beneficiaries enrolled in Medicare Advantage and other plans in Utah. More than 37% of Utah Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

As of 2020, 32 Medicare Advantage plans are available in Utah. The average monthly Medicare Advantage premium changed from $23.99 in 2019 to $23.45 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Utah. Although Medicare Advantage plans are currently available throughout the state, some counties only have one plan available for purchase. Residents in counties such as Davis, Salt Lake, Utah, and Weber have 21 Medicare Advantage plans to choose from.

Utah Medicare Supplement (Medigap) Insurance Plans

Utah doesn’t have rules in place that ensure disabled beneficiaries have at least some access to Medigap plans.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

Often, Medigap plans in Utah can be more expensive if you don’t enroll during your Initial Enrollment Period and wait for an Annual Open Enrollment Period. 

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. There are currently 23 insurers licensed to sell Medigap plans throughout Utah. Utah doesn’t have rules in place that ensure disabled beneficiaries have at least some access to Medigap plans.

Utah Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, There are 139,324 Medicare beneficiaries in Utah enrolled in stand-alone Part D prescription drug plans and 157,248 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28 stand-alone Part D plans available in Utah, with premiums ranging from about $16 to $110 per month. About 18% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Utah

  • State Health Insurance Information Program (SHIIP) is a national program that offers one-on-one counseling and assistance to people with Medicare and their families. SHIPs provide free Medicare counseling and assistance via telephone and face-to-face interactive sessions.
    Contact: Call 1-800-541-7735 or contact the Area Agency on Aging serving your area of Utah.

  • Take Care Utah, a Utah Health Policy Project initiative, is a network of nonprofit organizations focused on helping people with health insurance. It consists of about 50 enrollment specialists all across Utah.
    Contact: Call 801-433-2299

  • Utah’s ADRC and C2C initiatives are a collaboration between the Centers for Medicare and Medicaid Services, the Veterans Health Administration, and the U.S. Administration on Community Living. ADRC and C2C streamline access to long-term services and support for older adults, people with disabilities, and their families. ADRCs seek to create a coordinated and streamlined system providing clients a “one-stop-shop” experience.
    Contact: Email [email protected]

  • Office of Health Care Statistics: The Utah Department of Health provides a number of services through its Office of Health Care Statistics that can be helpful with Medicare enrollment and navigation, such as public access to data comparing Utah health plans and hospital costs, answers to common questions about health care in the state and guidelines to using and interpreting the data on their site.
    Contact: Call 801-538-7048 or e-mail [email protected]. Reports can be accessed through their online portal.

  • 2-1-1 Utah: An initiative of the United Way of Utah, 2-1-1 Utah is a comprehensive information portal to find a wide range of services in the state, including health insurance counseling. The service can be accessed by phone or via a smartphone app. The 2-1-1 Utah resource is directly tied to Take Care Utah, which is similarly dedicated to helping people navigate health insurance options.
    Contact: 2-1-1 Utah through the program’s website or via the downloadable app available there. Call 801-736-8929.

  • Bear Lake Community Health Center: The mission of Bear Lake Community Health Center is to provide access to quality, primary, and urgent health care regardless of ability to pay. The center will take a holistic approach to maintain a healthy community through education, prevention, and a community networking system. There are Utah locations in Garden City, Providence, North Logan, and Brigham City, as well as several sites out of state. In addition to providing access to quality primary and urgent medical care regardless of ability to pay, the center provides information services that help seniors with navigating health care coverage options, including Medicare and Medicaid, and finding economically efficient choices.
    Contact: Call 435-755-6061 or by mail at 517 West 100 North, Suite 210, Providence, Utah 84332

  • Goodwill Neighbors Helping Neighbors (NHN) program was developed in response to the challenges community-dwelling older adults face in navigating multiple systems to meet their health needs, plan for the future, and generally negotiate daily life. NHN is dedicated to providing free, high quality, comprehensive support to Utah’s community-dwelling older adults and their families. Through the program, older adults can call or meet with knowledgeable and experienced College staff to discuss any support needs they might have.
    Contact: Call 801-585-9505 or 801-585-9156

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Utah. Our process makes it easier for you to access your Medicare eligibility in Utah so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 382-1192 anytime to get a free quote or to ask any questions.

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