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Medicare in Utah

October 6, 2016

Medicare beneficiaries in Utah (as in the other states) can choose to receive their benefits through Original Medicare, Part A and Part B, and enroll in other Medicare plan options to augment their Original Medicare benefits. But did you know you may be able to get your Medicare Part A and Part B benefits through a private, Medicare-approved insurance company, instead of directly through the government? Read on to learn about the coverage choices you may have as a Medicare beneficiary in Utah.

Not every Medicare plan option may be available in every part of Utah. 

Original Medicare for Utah beneficiaries

Under Original Medicare, inpatient hospital care is generally covered under Medicare Part A, while doctor services, preventive care, and durable medical equipment are generally covered by Medicare Part B. Enrollment into the program may happen automatically for many Utah residents about to turn age 65, provided they receive retirement benefits through either the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). You may be eligible for Medicare before age 65 if you receive Social Security Administration (SSA) disability benefits, or certain Railroad Retirement Board (RRB) disability benefits, for 24 straight months.

Utah residents who aren’t enrolled automatically can visit their local SSA office to register.

Alternatively, you can enroll online or over the phone:

  • Call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. Social Security representatives are available Monday through Friday, from 7AM to 7PM.
  • If you worked for a railroad, call the RRB at 1-877-772-5772. TTY users can call 1-312-751-4701. RRB representatives are available Monday through Friday, from 9AM to 3:30PM.

No matter the enrollment method, a “Welcome to Medicare” packet will be mailed out approximately three months before coverage is slated to begin. The packet includes information that you’ll need to get started with Medicare, and it includes your red, white, and blue Medicare card, which lists your Medicare number, the type of coverage you have, and your coverage start date.

Medicare  in Utah

The private Medicare options can vary by location in Utah, but beneficiaries may wish to see which plans are available in their zip code and consider every alternative before making a final decision.

Medicare Part C, also called Medicare Advantage, is a program that lets you get your coverage through a private insurance company that contracts with Medicare to deliver your Medicare Part A and Part B benefits (except hospice care, which Part A still covers directly). If you choose to enroll in a Medicare Advantage plan, it’s important to understand that you are not actually leaving Original Medicare, Part A and Part B. You just get your benefits through the insurance company. If you enroll in a Medicare Advantage plan, you must continue paying your Part B premium, and you will continue paying it for as long as you remain enrolled in the Medicare program.

If you are interested in signing up for a Medicare Advantage plan and would like prescription drug coverage, then make sure the plan you choose includes this benefit. While not every Medicare Advantage plan includes prescription drug coverage, many of them do — these are known as Medicare Advantage Prescription Drug plans.

Medicare Part D is Medicare’s prescription drug coverage program. Stand-alone Medicare Part D Prescription Drug Plans are available from private, Medicare-approved insurance companies. Since Original Medicare includes only limited prescription drug coverage (in most cases, it doesn’t cover medications you take at home), you can enroll in a stand-alone Medicare Prescription Drug Plan to work alongside your Medicare Part A and Part B coverage. You need to be enrolled in Medicare Part A and/or Part B to be eligible for Part D, and you need to live within the plan’s service area.

Medicare Supplement (Medigap) plans in Utah (as in other states) help pay for some of your out-of-pocket costs under Original Medicare, including cost-sharing expenses and emergency overseas travel coverage. Plan benefits are standardized across 10 plan types (labeled letters A through N), and each plan includes different benefits and level of coverage. In 47 states, including North Carolina, Medigap plans offer the same standardized benefits for plans of the same letter type.

These plans can only be used to help with Original Medicare costs, and you’ll need to stay enrolled in Part A and Part B for your hospital and medical coverage. In addition, keep in mind that prescription drug coverage isn’t included in these plans, so if you want help with your medication costs, you should enroll in a stand-alone Medicare Prescription Drug Plan.

Specific plan types and premium amounts may vary depending on where you live in the state.

Utah resources for Medicare beneficiaries

Medicare.gov has compiled a list of available resources to educate you on Utah-based health resources. Medicare-specific resources are included below:

  • State Health Insurance Assistance Program (SHIP): Toll-free number 1-800-541-7735. Local -801-538-4171 Monday through Friday 8:00AM to 5PM ET. Website.
  • National Institute on Aging Information Center: Toll-free number: 1-800-222-2225. Representatives are available Monday through Friday, 8:30AM to 5:00PM ET. Website.

Learn more about how Medicare plans work in Utah including:

The product and service descriptions, if any, provided on these PlanPrescriber Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.