From its rugged mountains to its mesmerizing ski slopes, Utah is a mix of stunning wilderness and modern metropolitan beauty rolled into one. But no matter whether you’re headed down the open roads or looking to savor the city, it’s important to have reliable, affordable health insurance you can trust.
When it comes to health insurance in Utah, there are plenty of companies to choose from, but finding one that offers you great coverage at a great price can be tricky. At Benzinga, we’ve done the research in comparing and reviewing the best health insurance plans to suit your needs and budget.
The Best Health Insurance in Utah:
What is Health Insurance?
Before you start looking into what it takes and how to get health insurance, it’s important to understand what health insurance actually is and what it covers. Health insurance is designed to cover some of your medical costs in the event that you are sick or injured. You may get health insurance through your employer, through a state exchange or through a private health insurance plan like those profiled here.
As you review your options for affordable health insurance in Utah, you’ll notice different terms that deal with your coverage and what portions of the bills you’re responsible for. It’s a good idea to familiarize yourself with what these terms mean so that you’ll be able to better understand your financial obligations when you get treatment.
- Premium: This is a monthly fee paid to the insurer to keep your policy active.
- Deductible: The money that is paid out of your pocket before the insurance begins to pay is deductible. Insurance plans can have high premiums and low deductibles or vice versa. If you don’t go to the doctor often, you may save more money with a higher deductible plan. If you do see a doctor, you may benefit from a lower deductible, which means that the insurance will start to cover more claims sooner, but you’ll likely pay a higher premium in exchange for this faster coverage.
- Copay: This is a small fee of around $10–$45 that you pay your doctor or specialist when you see them. It isn’t counted toward your deductible.
- Coinsurance: This is a percentage that’s shared between you and the insurance company. You’ll often see it written as 80/20 or 70/30, where the insurance company is responsible for the 1st percentage and you are responsible for the 2nd.
Average Cost of Health Insurance in Utah
Health insurance plans vary and have different coverage levels and costs. Utah residents can expect to pay around $490 per month for health insurance. Although you won’t find the kinds of discounts heaped on your health insurance plan like you would for other types of insurance like homeowners or car insurance, you can save some money if you:
- Lower your body mass index (BMI): A high BMI can lead to a number of chronic health conditions, including heart disease and diabetes. Taking steps to lower your BMI through exercise and eating right could save you money, not just on health insurance but also in treating these chronic conditions.
- Give up tobacco: Utah has one of the lowest smoking rates in the country. Only 9% of residents smoke. If you can stop smoking or avoid tobacco altogether, you’ll pay less for insurance than regular tobacco users.
- Age: Older people tend to have more health problems than those in their 20s or 30s and therefore pay more for their coverage. Although you can’t change your age, you can do your best to live a healthy lifestyle so that you don’t have age-related complications when you’re older.
Types of Health Coverage
There are several kinds of health insurance available in Utah. You’ll want to understand the differences among each type so that you can better decide which is right for your needs and budget.
- Health maintenance organization (HMO): HMOs help patients save money by providing healthcare services through predetermined networks made up of physicians, hospitals and specialists. The majority of your healthcare is managed through a primary care physician (PCP). You’ll need a referral from your physician to see a specialist, and for that specialist’s care to be covered, they must also be part of the HMO network. If you go outside of the network, you’ll likely be responsible for the full amount of the bill.
- Preferred provider organization (PPO): PPOs work like HMOs in that there’s a predefined coverage network, but you don’t need a referral to see a specialist and you can get treatment outside of the network (although you’ll pay more for it). If you do seek treatment outside of the network, you’ll have to file a claim with the PPO to be reimbursed for some of the expenses.
- Point of service (POS) plan: POS plans give you the most freedom to see the doctor or specialist you want, and no referrals are needed. You pay for the cost of care up front, and then file a claim to be reimbursed by the POS provider. There are more steps involved overall with managing your own insurance claims, but if you don’t see the doctor often, this type of plan may save you the most money overall.
What Does Health Insurance Cover?
Every plan is different, but generally speaking, health insurance covers a wide range of treatments, including:
- Wellness checks
- Pediatric care
- Emergency services
- Ambulance services
- Newborn and maternity care
- Prescription drugs
- Rehabilitative services
- Laboratory services
- Mental health care
What Does Health Insurance Not Cover?
Despite the variety of treatments that health insurance covers, there are some things that generally aren’t part of a health insurance plan, including:
- Elective or cosmetic procedures
- Long-term nursing home care
- Infertility treatments
- Alternative therapies
- Dental, vision and hearing
You may be able to get dental and vision coverage separately if it’s offered as part of your insurance plan. These are known as “riders” and may include extra benefits in addition to what’s available from your core insurance plan.
Best Health Insurance Providers in Utah
Finding the most affordable health insurance providers in Utah doesn’t have to be overwhelming. Based on our research, the companies profiled below offer competitive rates and reliable coverage for a variety of healthcare needs.
1. Aetna Health of Utah
Available with both HMO and POS plans, Aetna Health of Utah enjoys some of the highest ratings among health insurers in the state. Quality, consistency and coordination of care all earned Aetna top marks, and the company’s healthy lifestyle apps encourage users to follow healthy lifestyle changes while giving them discounts on wellness products and services, including gym memberships.
Aetna doesn’t always get the best marks for diagnostic screenings, so if you’re concerned about a hereditary illness or you’ve been advised by your doctor to get regular screenings for things like breast cancer, BMI or colorectal cancer, you may need to take more of an initiative in setting appointments and getting care rather than waiting for Aetna to coordinate it all.
SelectHealth offers both HMO and POS plans to customers in Utah and is rated particularly highly among parents of newborns, children and adolescents for its proactive approach toward immunizations, pregnancy and postpartum care.
The company also scored well among patients who need help managing chronic diseases like diabetes, blood pressure and asthma, as SelectHealth offers several options to help make it easier to keep track of medications and what steps to take to better manage the condition. Whether you’re an expectant mother, have young children or looking for a well-rounded plan for your family, it’s a good idea to keep SelectHealth in mind for your coverage needs.
3. Regence BlueCross BlueShield of Utah
Regence is part of the BlueCross BlueShield network of companies and offers PPO plans in Utah. As one of the most well known nationwide health insurance networks, BlueCross BlueShield earns high marks for having a large and growing database of doctors, hospitals and specialists in Utah.
In addition, many patients rated the company well for emergency room utilization and noted that the company was prompt in handling claims services for emergency hospital care. When it comes to sudden and unforeseen hospital visits, it’s good to know that you have an understanding, easy-to-navigate insurance ally in your corner.
UnitedHealthcare is one of the largest nationwide health insurance companies and provides PPO plans in Utah. Older adults with chronic conditions like heart disease and high blood pressure may stand to benefit the most from plans offered by UnitedHealthcare, since the company received top marks with regard to managing cardiovascular disease, BMI assessments and other chronic disease management.
The company also provides helpful articles and videos designed to educate members on important healthcare routines like the use of antibiotics in adults and children, as well as the correct use of opioids for pain management.
AgileHealthInsurance offers a comprehensive and simple-to-use platform for comparing the private health plan options such as short term health insurance and indemnity insurance.
Plans are cheap, at $44 per month, for a 25-year-old female. The most expensive plan runs about $525 per month. Agile pulls plans from Aspen, Companion Life, Everest, Everest Prime, LifeShield, National General and Standard Life in West Virginia. Agile gets an A rating from the BBB and is a consumer-friendly option that offers learning resources so you can make an informed decision.
Finding Comprehensive Health Insurance in the Beehive State
Health insurance companies across Utah each offer a variety of plans with different deductibles, premiums and coverage limits. To get a more customized rate to fit your needs, it’s a good idea to seek out each of these companies and get a direct quote online for free. This allows the insurance company to tailor a quote to your specific needs and budget.
By getting an online quote from each of the providers profiled here, you’ll be able to better understand how to balance coverage and cost so that you can enjoy the best of both worlds when it comes to keeping yourself and your family happy and healthy for years to come.