Original Medicare does not have an annual out-of-pocket limit, which is why most beneficiaries choose to supplement their coverage in some way. Medicare Supplement plans in Utah help pay a variety of healthcare costs, including coinsurance and deductibles. Commonly known as Medigap, some plans cover nearly every out-of-pocket cost you have while others mainly protect you against exorbitant hospital bills. The right choice for you depends on your personal needs.
What is Medigap in Utah?
There are 10 standard Medicare Supplement plans available in Utah (A, B, C, D, F, G, K, L, M, and N). However, not every Medigap insurer offers all 10 plans. Some insurers also provide high-deductible versions of one or more plans.
Each Medigap plan is standardized, meaning that you get the same benefits with that plan no matter where you buy it – even if you move. While benefits are standardized, though, costs may vary widely, as Medigap insurers may set their own premiums. However, they must follow state and federal guidelines.
Unlike Original Medicare, you can be denied a Medigap policy, even if you're 65. Unless you have guaranteed issue rights, your application goes through medical underwriting. Your answers to a series of health-related questions determine whether you'll be offered a policy and at what rate.
What does Medigap cover?
Medicare Supplement benefits vary according to which plan you choose. At a minimum, every Medigap plan covers the Medicare Part A coinsurance and gives you an additional 365 lifetime reserve days for inpatient care.
The following table details which benefits each Medigap plan includes:
Medicare Supplement Insurance plans only cover services provided by Original Medicare. This includes Part A, hospital care, and Part B, medical services. It does not include prescription drug coverage. These benefits are available with a Medicare Part D prescription drug plan.
Medigap Plan C and Medigap Plan F in Utah
Thanks to a new federal law that prohibits Supplement plans that pay the Medicare Part B deductible, Medigap Plan C and Medigap Plan F are no longer available to new Medicare beneficiaries.
You can sign up for Medigap Plan D or Medigap Plan G instead. These plans offer the same benefits as Plans C and F, respectively, minus the Part B deductible.
Who qualifies for Medicare Supplement Insurance in Utah?
At the federal level, you qualify for Medicare Supplement Insurance in Utah as soon as you're aged 65 or older AND enrolled in Original Medicare. Most states also require Medigap insurers to offer plans to beneficiaries who aren't yet 65 but qualify for Medicare due to a disability. Utah, unfortunately, is not one of them.
When is the best time to join a Medicare Supplement plan in Utah?
The best time to join a Utah Medicare Supplement plan is during your 6-month Medigap Open Enrollment Period (OEP). It begins the day you enroll in both parts of Original Medicare and are age 65 or older.
During your Medigap OEP, you cannot be denied a Supplement policy or charged a higher premium for any reason.
If you have Medicare due to a disability, you also qualify for a Medigap OEP once you turn 65. Your application will be treated as if you were brand-new to Medicare.
How to choose a Medigap plan in Utah
Start by deciding how much coverage you want. To avoid medical underwriting later, we recommend a plan with the most comprehensive benefits you can afford.
The insurance company's pricing method helps you estimate long-term costs. Most Medigap insurers use one of three pricing methods:
- Attained-age rated: Premiums start out low but go up as you age. These policies usually cost the most over time.
- Community rated: Premiums are not based on age. Over time, these plans cost the least, although you usually pay more in the beginning.
- Issue-age rated: Premiums are based on your age when you join the plan but don't go up just because you get older. Rates may rise over time due to inflation, though.
Most Utah Medigap insurers use attained-age and issue-age pricing.
Our Find a Plan tool makes it easy to compare Medigap plans in Utah. Simply enter your location information to review Medicare plan options in your area.