Utah Health Insurance Marketplace

In Utah, the federal government operates the health insurance Marketplace.

Utah now has its own Marketplace for health insurance, where you can shop for and buy insurance in person, online, or by phone.

Utah Plans, Benefits, and Costs


Utah, Salt Lake City 2015 2016
Monthly Silver Premiums for a 40 Year Old Non-Smoker $215 $244
Average Tax Credit Amount as of March 31, 2016: $211 $187

Last year average total cost for Health Insurance for a 40 Year Old Non-Smoker in your state was $4 per month after tax subsidies. See if you qualify for a free or low cost plan.

Companies can offer four types of plans: bronze, silver, gold, and platinum. These “metal level” plans all cover the same benefits in your state. What differs is how much they pay on average toward the costs of the services the plan covers.

Tobacco Surcharge: Utah allows insurance companies to charge tobacco users 50% more than non-tobacco users.

Who Is Selling Insurance in the Utah Marketplace?

On exchange plans in Utah

Off exchange plans in Utah

  • n/a

What's Covered:

All approved plans in the state must cover the same package of benefits, called essential health benefits. In Utah, the benefits include:

  1. Outpatient services, such as doctor visits or tests done outside a hospital
  2. Emergency services
  3. Hospital stays
  4. Pregnancy and baby care
  5. Mental health and substance abuse services, including behavioral health treatment
  6. Prescription drugs, including generic and certain brand-name drugs
  7. Rehab and habilitative services, those that help people recover from an accident or injury and those that help people with developmental issues. In Utah, this includes speech therapy, physical therapy, and occupational therapy.
  8. Lab services
  9. Preventive and wellness services, along with those that help people manage chronic conditions.
  10. Services for children, including dental and eye care

Some services not included: weight loss programs and surgery, hearing aids, chiropractic, and infertility treatment.

Will These Benefits Be in All Plans?

Although all health insurance policies have to include these benefits, some states may allow insurance companies to substitute a service that has the same value. For example, one type of lab test may be substituted for another. Make sure to read the summary of benefits of the plans you are considering to see if they include the coverage you need.

Financial Aid

You may be eligible for financial aid to help pay for insurance. Here’s what Utah will offer:

Medicaid Expansion: Some states are expanding Medicaid so more people can get health insurance coverage. Although Utah has not yet made a decision on medicaid expansion. (as of July 2015)

Premium Subsidies (also known as Tax Credits ): You may qualify for a subsidy -- money to help pay your health insurance premium each month. The subsidy may be sent directly to your health insurance company and is available on insurance bought in the Marketplace. In general, you'll be eligible if you're single and make about $45,960 or less a year, or if you have a family of four and make about $94,200 or less a year.

Cost-sharing subsidies: Depending on your income, you may also qualify for cost-sharing subsidies that will reduce your costs when you receive medical care. Cost-sharing subsidies are available only with silver-level plans.

Calculator: You can also use our calculator to learn about costs and whether you'll qualify for subsidies or other financial aid.

CHIP: The Children’s Health Insurance Program provides coverage for children of some families who have a low income but are not eligible for Medicaid.

 

Ready to obtain the right health insurance? Check your eligibility for free or low cost health insurance through the marketplace in 4 simple steps...