Medicare Advantage Plans in Utah
Written by: Rachel Nall, MSN, CRNA, APRN
Reviewed by: Kai Martinez, Licensed Insurance Agent
Key Takeaways
All Utah residents had access to a Medicare Advantage plan in 2024.
Medicare Advantage plans are offered by private insurance carriers to substitute for Original Medicare as well as provide additional coverage.
Most Medicare Advantage plans offer Part D prescription drug coverage.
Utah Medicare Advantage Plan Coverage
Medicare Advantage provides your Medicare Part A and Part B benefits through a private insurance company. Most plans also feature prescription drug benefits and .
Parts A and B are collectively called Original Medicare. Part A is commonly referred to as “hospital insurance.” Medicare Part B is commonly referred to as “medical insurance.”
HMOs , which stands for Health Maintenance Organization arethe most common type of Medicare Advantage plan. These plans require you to establish an in-network primary care provider. This provider can make referrals for you when you need specialty services. Typically, if you do not use an in-network provider, your HMO will not cover their services.
A PPO , or Preferred Provider Organization, is different from an HMO in that you may not need a referral for a specialist and you may receive at least a percentage of reimbursement if you see an out-of-network provider. Typically though, your greatest savings in any Medicare Advantage plan will come from utilizing in-network providers.
Medicare Advantage plans can offer more benefits than Original Medicare. According to the Centers for Medicare & Medicaid Services, there were 13 Medicare Advantage plans in Utah that offered innovative benefits like reduced cost sharing and nutrition assistance in 2024.
Find the Medicare Plan that works for you.
Find My Ideal PlanUT Medicare Advantage Plan Costs
On average, a Medicare Advantage enrollee in Utah paid a monthly premium of $13.05 in 2024.
Nearly all Utah residents eligible for Medicare have access to at least one $0 premium Medicare Advantage plan. When considering any plan, it’s important to examine not only the monthly premium, but also the deductible, copayments and coinsurance. Unlike Original Medicare, Medicare Advantage plans provide the protection of an out-of-pocket maximum. The lower your out-of-pocket maximum, the more you could save if you do meet the yearly maximum.
Evaluating your current coverage and assessing what plans are available on an annual basis could potentially save you money, expand your coverage, and help you avoid paying for services you don’t use.
Medicare Advantage Plan Eligibility & Enrollment in Utah
You are eligible for Medicare when you turn age 65. If you have paid Medicare taxes over at least 10 years of work, you are eligible for premium-free Medicare Part A. If you have Medicare Part B, you usually will pay a monthly premium even if you switch to Medicare Advantage.
Some people do qualify for Medicare before age 65. These circumstances include having a qualifying disability, or having end-stage renal disease or Amyotrophic Lateral Sclerosis (also known as Lou Gehrig’s disease).
Even after you are in a Medicare Advantage plan, you have the opportunity to switch your plan at specific times throughout the year. One of the most common times is the Medicare Open Enrollment Period, also known as the Annual Enrollment Period. From October 15 to December 7 on an annual basis, you can enroll in a new plan if you wish. If you do enroll in a new plan, your benefits will start on January 1 of the following year.
There also is a Medicare Advantage Open Enrollment period from January 1 through March 31 each year. At this time, you can change to a different Medicare Advantage plan or go back to Original Medicare. You cannot, however, switch from Original Medicare to Medicare Advantage.
Have questions about your Medicare coverage?
Call TodayAre There Utah Medicare Advantage Plans With Prescription Drug Coverage?
Most Medicare Advantage plans offer prescription drug coverage. You can connect with a GoHealth licensed insurance agent to learn about plans that offer prescription drug coverage as part of a Medicare Advantage plan — some of which have a $0 premium.
Keep in mind that Medicare Advantage plans cover a regional area, so all plans aren’t available to all people in Utah. This means if you move outside the city or major geographic area you live in, you may qualify for a Special Enrollment Period to search for a new plan.
When you choose a Medicare Advantage plan with prescription drug benefits, it’s important to carefully read the plan’s formulary. This is a listing of the prescription drugs the plan covers. Medicare requires that all Medicare Advantage prescription drug plans cover at least two medications in each major category of care. If you have specific medications you are taking related to your health, make sure your new plan covers them. Otherwise, you may have higher medication costs or switch to different medications (with your doctor’s approval) as a cost-saving measure.
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