Medicare in Utah
- Are you ready to enroll in Medicare? Learn about Medicare coverage options in Utah, including the various plans offered and when you can enroll.
What Utah Medicare Plans Are Available?
Medicare provides financial assistance and coverage for individuals age 65 and up as well as some beneficiaries with disabilities. There are various options available for insurance coverage through the different parts of the Medicare program.
Part A of Medicare is the original component of the program and is funded by the federal government. This initial component is the hospital insurance option, which covers inpatient care in qualifying facilities. Such facilities include hospitals, surgical centers, hospice and skilled nursing care. Part A may also be used for some home health services. Premiums for Part A are based on how much you paid in payroll taxes via employment.
Part B deals with preventative care, covering physician visits, some treatments and screenings and laboratory/diagnostic testing. Premiums for Part B coverage are based on income. You are responsible for copayments and deductibles with Part B coverage.
Medicare Advantage plans (also called Medicare Part C) are required to offer at least the same benefits as Parts A and B. Where this program differs is in the additional services it covers, often including prescription drug coverage and dental and vision benefits.
Within the Medicare Advantage program, which is administered through private insurers, you may have the option to choose between a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service and Special Needs Plans, depending on the plans that are available where you live.
Part D Prescription Drug Plans
Part D is the portion of Medicare specific to prescription drug coverage. You can either opt to purchase Part D as a standalone program to complement Parts A and B coverage. Or you may be able to enroll in a Medicare Advantage plan that includes prescription drug coverage as one of the services provided.
Part D is optional when you first sign up for Parts A and B, but there may be a penalty for those who try to enroll at a later date.
Medicare Supplement Insurance (Medigap)
Medicare Supplement plans (also called Medigap) are supplemental insurance policies that help pay some of the out-of-pocket expenses of health care that are not covered by Parts A and B. Utah residents have their choice of several programs, all of which are provided via private insurers.
This program may help cover the costs of deductibles, coinsurance costs and copays.
Of the Utah population, roughly 12% of residents are enrolled in at least one Medicare program. There are 46 Medigap insurance companies in Utah with roughly 84,000 enrollees.
Who Is Eligible for Utah Medicare?
Upon turning 65, if you have been receiving benefits from the Social Security Administration for four months, you're automatically enrolled in Medicare. If you are part of this group, Medicare will send you information about the various program parts via mail three months prior to your birthday.
If you are not enrolled automatically, there are several other options:
- First-Time Enrollment: If you need to sign up, you are able to do so three months prior to your 65th birthday, your birthday month and the three-month period thereafter.
- Annual Enrollment: Medicare also offers specific annual enrollment periods. The first is between January 1 and March 31; benefits start on July 1. The second is between October 15 and December 7; benefits begin on January 1. You must enroll during this time unless you qualify for one of the special enrollment segments; otherwise, you may incur a fee. The fall enrollment period is the one in which those eligible can change Medicare Advantage plans or choose new Part D coverage.
- Special Enrollment: This applies to those who have recently moved back into the United States or have lost coverage from an employer-sponsored plan. It also applies to individuals who no longer qualify for Medicaid.
How Do I Enroll in Medicare in Utah?
You can sign up for Medicare in Utah through one of the following options:
- Visit the Social Security Administration website to apply.
- Call Social Security at (800) 772-1213.
- Make an appointment to enroll in-person at your local Social Security Administration office.
Contact Information for Utah Medicare, Medicaid and Insurance Help
There are numerous resources to help you with the Medicare sign-up process or in navigating any other forms of insurance.
HelpAdvisor: The HelpAdvisor site provides insight on Utah Medicaid programs, which can be helpful to those who are having financial challenges paying for Medicare.
Utah State Health Insurance Program (SHIP): The Utah SHIP program provides individual counseling to individuals regarding choosing the right Medicare program and enrollment protocols. This program can be reached online or via phone at (800) 541-7735.
Utah Prescription Drug Assistance Program: Utah has several prescription drug assistance programs to help with the cost of medications for Medicare beneficiaries.