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Utah Health Insurance

Health insurance these days comes in two broad categories: individual and group. Those who prefer individual insurance are mostly self-employed, or are employed by a company that does not offer a health plan, or who have a family and who want to purchase individual insurance for their family members. If you buy an individual plan, you are required to pay an annual premium as well as a deductible for each insured dependent, up to a base amount. If you purchase a group policy instead, you have to pay an annual premium, co-payments payable at each medical service, and a deductible payable before insurance begins paying for your valid medical bills.

Utah has some regulations governing individual health insurance that are different from other states. In case you are not eligible for individual insurance through your employment, membership in an association, COBRA, Utah’s continuation coverage, conversion coverage, Medicaid, Medicare, or HIPUtah program, insurance companies are required to provide individual insurance coverage. For all others, insurers can deny individual coverage due to your medical problems. Utah also requires standardized policies that contain specific benefits from all individual insurers, as well as additional policies that they choose to offer. If you have a pre-existing condition, individual insurers may attach an elimination rider to your policy or an exclusion period not exceeding 12 months. Creditable coverage is allowed for individual insurance. Utah treats pregnancy as a pre-existing condition in Utah. For HIPAA eligible people who cannot buy HIPUtah, no exclusion period is needed. Your individual coverage cannot be cancelled due to your illness. Regence Blue Cross Blue Shield administers Utah’s Comprehensive Health Insurance Pool for those who cannot afford to purchase individual health coverage.

In Utah qualified residents cannot be refused group insurance, or be charged more, because of a health problem. A new employer has the right to seek a waiting period before offering group insurance. A new HMO also can impose an affiliation period. In case you have a pre-existing condition, group insurers can require an exclusion period not exceeding one year. Insurers can look back at your medical records for the prior six months before coverage to determine pre-existing conditions. If you had unbroken coverage of more than 63 days, you are protected from exclusion periods with creditable coverage.

Small businesses with two to 50 employees cannot be refused small group health insurance, nor can it be cancelled due to illness within the employee group. Utah requires insurers offer standardized plans. If you want to know about the regulations that cover associations with group coverage, you should contact the Utah Insurance Department. Self-employed persons are not allowed to purchase group insurance in Utah.

Among the programs offering assistance to low income individuals and families in Utah are Medicaid, Children’s Health Insurance Program, and Utah Cancer Control Program.

Choosing the right quotes is never easy, so you should do some homework before making a final decision. However, it is always better to appoint professional health insurance agents and brokers who can be of great help in this regard with their valuable experience and expertise.

Some health insurance providers in Utah are American Medical Security, Assurant Health (formerly Fortis), Fairmont Specialty Group, InterMountain (IHC) Health Plans, Regence BlueCross BlueShield of Utah and Security Life.

 

 

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Useful links and information:

Utah Insurance Department
3110 State Office Building
Salt Lake City, UT 84114
(801)538-3077
http://www.insurance.state.ut.us/

 

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