Utah Medicare Advantage plans are health plan options that are part of the Medicare program.  It is another plan choice you have as part of Medicare.  Medicare Advantage Plans are sometimes referred to as “Part C” or “MA Plans” and are offered by private health insurance companies that are approved by Medicare.

Different types of Medicare Advantage plans in Utah

  • Health Maintenance Organization (HMO) Plans
  • HMO Point of Service (HMOPOS) Plans
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNP)

 

If you choose to join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage.  Some plans but not all will also include Part D which is the Medicare Prescription Drug coverage along with it.  Medicare Advantage plans offer all the benefits of Original Medicare but can offer additional benefits that may include:

  • Vision
  • Hearing
  • Dental
  • Gym Memberships / Silver Sneakers
  • Nutritional Supplements

To join one of these Medicare advantage plans, you must be enrolled in Medicare Part A and Part B, live in the plans service area, and not have ESRD (End Stage Renal Disease).  You will have to pay your monthly Medicare Part B premium to Medicare.  In addition, you may or may not have to pay a monthly premium to your Medicare Advantage Plan for the extra benefits they offer.  In Utah, depending on what County you live in there may be some $0 premium plans available.  Some of the Utah Medicare Advantage companies include:

  • Humana
  • United HealthCare (AARP Medicare Complete)
  • Altius
  • Molina
  • Regence Blue Cross Blue Shield

 

When can you sign up for a Medicare Advantage Plan?

You can enroll in a Medicare Advantage Plan (Part C) when you first become eligible for Medicare.  It is a 7 month window that starts 3 months before your 65th birthday, the month of, and 3 months after your birthday month.

 

If you are under 65 and receive Social Security disability, you qualify in the 25th month after you begin receiving your Social Security benefits.


If you are already enrolled in Original Medicare, they you must wait until the next enrollment period to sign up for a Medicare Advantage Plan.  The Annual Enrollment Period (AEP) is from October 15th through December 7th each year and coverage begins on January 1st of the following year.

Generally, once you enroll, you stay enrolled until the next Annual Enrollment Period becomes available.  However, there are some situations that might qualify you to make a change during the rest of the year.  An example of these situations include:

  • You move outside your Medicare Advantage Plans service area
  • You qualify for Extra Help (A program to help you afford prescriptions drugs)
  • Loosing Employer coverage from your company
  • If you move into an institution (such as a nursing home)

 

What is the Medicare Low Income Subsidy?

Eligible individuals who have limited income may qualify for a government program from Medicare.  The Medicare Low Income Subsidy (LIS) program also known as the Medicare Extra Help program, helps pay for the costs of prescription drugs, the monthly Medicare Part B premium, annual deductible, co-pays and coinsurance. Also, individuals enrolled in the Extra Help program do not have a gap in their prescription drug coverage, also known as the Medicare Donut hole.

To qualify for Low Income Subsidy in Utah for 2012 your annual income needs to be less than $16,245 (single) or $21,855 (married).  Your assets also need to be less than $12,510 (single) or $25,010 (married).

If you are unsure if you qualify or your income is slightly higher, you should still go ahead and apply to see if you are eligible.  The worst they can say is no right?  But if you can qualify, it will help pay for a lot of the costs.

To see if you qualify for Low Income Subsidy contact the Social Security Administration at 1-800-772-1213 or apply online at https://secure.ssa.gov/i1020/start

 

Medicare and Medicaid (Special Needs Plans)

If you are an individual that has BOTH Medicare and full Medicaid, Molina has a Special Needs Medicare Advantage Plan available.  It combines the benefits of Medicare and Medicaid all into one easy to use plan provided by Molina.  Some of the benefits that are included in this plan are:

  • Hearing Services:  Routine Exam and Hearing Aid Allowance
  • Vision Services:  Routine Exam and Eye Wear Allowance
  • Over-the-Counter Medication and Supplies
  • Routine Transportation: To and from Medical and Dental Appointments
  • Dental Services: Preventative and Comprehensive Dental Services

 

Click below to view the 2012 Molina Options Plus (HMO) SNP plan benefits at a glance

Molina Options Plus Flyer

 

Medicare Advantage plans are all a little bit different and we’ll do the work for you to find the Right Plan at the Right Price, saving you time and money!  We are a local Utah company and have helped thousands of Medicare beneficiaries here in Utah choose the right plan for their needs.  We even can come to you and do in-home appointments in the comfort of your own home.  Learn, Compare and Save time and money with us!  Call us today… we can help.  1-866-502-7736 or 801-372-4206