Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 19, 2022

Established in 1965, Medicare is a program designed to ensure seniors and younger adults with certain disabilities have access to health coverage. For years, Original Medicare was the only option available. Under Original Medicare, beneficiaries receive inpatient care through Medicare Part A and outpatient care through Part B. In 2003, beneficiaries were given an additional option: Medicare Advantage.

The purpose of Medicare Advantage was to give Medicare beneficiaries access to plans offered by private insurance companies, which would help save money by encouraging providers to compete with each other based on price and plan features. Every Medicare Advantage Plan covers almost all the same medically necessary services as Original Medicare, but many providers also offer extra benefits to encourage beneficiaries to sign up for the program. One of the most significant differences between Medicare Advantage and Original Medicare is that an individual enrolled in a Medicare Advantage Plan typically must use doctors and hospitals within that plan’s network. Otherwise, Medicare Advantage may not cover the service, or it may cover it at a lower percentage than it would for in-network care.

In Utah, 432,862 residents are eligible for Medicare, and 44% of them are enrolled in Medicare Advantage, as of 2021. Utah’s Medicare Advantage enrollment rate exceeds the national enrollment rate of 42%.

This guide explains the benefits available under Medicare Advantage, provides information about the top 10 plans available in Utah and offers tips for finding the right Medicare Advantage Plan based on specific medical and financial circumstances.

The Top 10 Medicare Advantage Plans in Utah

Utah’s Medicare Advantage Plans are sold by several insurance companies, and each company typically offers more than one type of plan. There’s more information about these plans in the table below, which lists the top 10 Medicare Advantage plans in the state. To account for the multiple plans offered by each provider, cost data is presented as a price range, instead of an average price. Enrollment numbers for individual plans were also combined to provide the total enrollment for each provider. Information about these plans is current as of April 2022. Seniors who need current cost and enrollment information should visit Medicare.gov.

Name

Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types

UnitedHealthcare

103,245

4

$0

$39

HMO, PPO

SelectHealth

32,825

5

$29

$67

HMO

Humana

17,732

4

$0

$39

HMO, PPO

Aetna Medicare

13,681

3.5

$37

$65

HMO, PPO

Regence BlueCross BlueShield of Utah

11,254

4.5

$31

$179

PPO

Molina Healthcare of Utah & Idaho

10,782

3.5

$0

$0

HMO

Cigna

5,391

3.5

$0

$0

HMO, PPO

Advantage U

1,218

0

$0

$0

PPO

Anthem Blue Cross and Blue Shield

516

0

$0

$0

PPO

Blue Cross Blue Shield of Michigan

83

0

$0

$0

PPO

How Medicare Advantage Plans Work in Utah

Unlike Original Medicare, which is the same for every enrollee, Medicare Advantage makes several types of plans available to Utah residents. These plans have different rules regarding where beneficiaries can receive care and whether an enrollee needs a referral to visit a specialist. Some plans even limit enrollment to Medicare beneficiaries with certain chronic health conditions. The graphic below lists the main types of plans and provides more information about the coverage available under each one.

What Medicare Advantage Plans Cover in Utah

Medicare Advantage Plans cover a wide range of medically necessary services. With the exception of hospice care which remains covered by Medicare Part A, each plan must cover the same services as Original Medicare, such as X-rays, doctor visits and lab tests. Most Medicare Advantage Plans also include prescription benefits, giving enrollees access to medications for high blood pressure, diabetes and other health conditions. One of the main benefits of enrolling in Medicare Advantage is that many plans cover dental care, hearing aids, contact lenses, eye exams and other services that aren’t covered by Original Medicare.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Utah

To qualify for Medicare Advantage, a Utah resident must live in a plan’s service area, have Medicare Part A and Part B coverage and meet the general Medicare eligibility requirements. Medicare is available to residents who are at least 65 years old or have a disability that makes them eligible for Medicare at a younger age. The program is also limited to U.S. citizens and immigrants who have obtained lawful permanent resident status.

When it comes to Medicare enrollment, timing is everything. Both Original Medicare and Medicare Advantage have limited enrollment periods, which are described in the list below. Enrolling as soon as possible can help Medicare-eligible seniors start taking advantage of a wide variety of benefits.

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this is the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Utah

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.




State-Wide Medicare Advantage Resources

State Health Insurance Information Program (SHIP)

The State Health Insurance Information Program (SHIIP) is a nationwide program operating in many states, including Utah. It provides free and impartial one-on-one counseling and assistance to adults 60 or older who are eligible for Medicare, both via telephone and in face-to-face sessions, to help people find the right Medicare and Medicare Advantage plans. It also puts on public Medicare education programs and courses for people of all ages.

Contact Info

The SHIP program in Utah can be reached toll free by calling 1-800-541-7735, or by contacting the Area Agency on Aging serving your area of Utah. 

Visit Website
Take Care Utah

Take Care Utah is an initiative of the Utah Health Policy Project (UHPP), specifically designed to guide people to accurate information about enrollment and coverage in health care plans, with navigating with the health care marketplace and understanding of their options, including plans offered through Medicare and Medicare Advantage. Take Care Utah guides individuals to counseling and information resources, and provides free assistance with applications and enrollment.

Contact Info

More information about Take Care Utah can be obtained from the Utah Health Policy Project by calling 801-433-2299. Services can also be accessed through Take Care Utah’s website

Visit Website
Utah Aging & Disability Resource Center & COVER to COVER 

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. Together, they’re designed to allow seamless access to long-term services and supports for older adults and people with disabilities, creating a “one-stop shop” for anything these individuals may need. The COVER to COVER program is sponsored by the Office of Rural Health and Geriatrics and Extended Care and designed to support access to benefits and programs for rural veterans within their communities, in collaboration with Area Agencies on Aging and other community partners. 

Contact Info

The C2C program can be contacted by email at [email protected]. Further information about the program and a directory of C2C office locations in Utah and their contact details can be found on the ADRC website.

Visit Website Email
Utah Department of Health’s 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. Many of the reports compiled from this data are freely accessible by the public and can be an invaluable resource in evaluating Medicare and Medicare Advantage options. 

Contact Info

The Office of Health Care Statistics can be reached by phone at 801-538-7048 or by e-mail at [email protected]. Reports can be accessed through their online portal.

Visit Website Email
Utah Insurance Department

The mission of the Utah Insurance Department is to make sure that insurance products offered in the state are affordable, reliable and accessible to all on fair terms. It serves and protects consumers residing in the state of Utah through insurance law and regulation, following up on insurance complaints, licensing and certification of cross-border insurers and other initiatives. It also provides general information and counseling about health insurance, including Medicare Advantage plans. 

Contact Info

The department can be reached toll-free within Utah by calling 1-800-439-3805, or on its main line at 801-538-3800. A directory of further contacts, along with directions to department offices, can be found on its website

Visit Website
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 Info

Seniors can contact 2-1-1 Utah through the program’s website or via the downloadable app available there. General inquiries can also be made by calling 801-736-8929.

Visit Website

Local Medicare Advantage Resources

Bear Lake Community Health Center

A group of community health centers that takes a holistic approach to health and wellness, the Bear Lake Community Health Center has 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 Info

BLCHC’s administration offices can be reached by phone at 435-755-6061, or by mail at 517 West 100 North, Suite 210, Providence, Utah 84332. A directory of their clinic locations and contact information can be found on their website.

Visit Website
Goodwill Neighbors Helping Neighbors

Based in the College of Social Work in Salt Lake City’s University of Utah, the Goodwill Neighbors Helping Neighbors program is over two decades old. Its focus is on providing services for seniors and collaborating with community partners in helping older adults adjust to the challenges of aging. NHN mobilizes students to support seniors in learning about preventative health measures, rehabilitative and support services and how to navigate issues with medical insurance coverage. The program provides information and referral support, individual and family counseling and help with applications for a range of public services. These services come with no financial eligibility requirements and are prioritized for those most in need of help.

Contact Info

The NHN program can be contacted by phone at 801-585-9505 or 801-585-9156. More information about the program can be found on its website.