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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
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
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