Utah Individual Health Insurance

Health insurance is an essential protection to that guards individuals against illnesses and injuries and the huge costs associated with them. For those considering Utah individual health insurance, the possibilities are endless, as there are often literally hundreds of plans to choose from. Since you are considering private health insurance, you may want to know more about the Utah laws regulating individual health insurance policies.

Eligibility: How Am I Evaluated?

Applicants for Utah individual health insurance are evaluated by their age, family size, health status, and if they are able to get alternative health coverage through an employer or public program. An applicant can be turned down for any reason, unless they fit into one of the following categories:

• They are a newborn born to a person who is already covered under the insurer's policy.
• They are unable to get insurance through their employer and have also been turned down by public programs, such as Medicaid and HIPUtah. In this case, the applicant must be offered a basic coverage plan by the insurer.

In response to HIPPA Group-to-Individual Portability Coverage regulations, Utah requires private insurers to guarantee coverage to HIPPA eligible consumers who meet certain health status qualifications. If they do not, then they will be guaranteed coverage into HIPUtah.

Utah Guaranteed Benefits & Pre-Existing Conditions

Utah does require insurers to offer standardized policies. You have several options when it comes to these standardized policies. First, you can choose between a HMO version and a PPO version. Secondly, you can also choose between a low, medium, or high deductible. These policies cover many basic services and some additional services, such as mental health coverage. Utah health insurance laws also require all plans to cover certain benefits, such as breast reconstruction after a mastectomy and treatment of eating disorders.

In Utah, individual health insurers are allowed to add a pre-existing condition to an elimination rider or attach it to an exclusionary period. With an elimination rider, the condition will never be covered as long as you are with the company. With an exclusionary period, the condition may be covered after 12 months. Insurers are also allowed a 6 month look back period to determine what, if any, conditions should be included. Pregnancy can also be included as a pre-existing condition.

Utah Individual Health Insurance Premiums

Your Utah individual health insurance premium can vary depending on your age, health status, or any other individual factor. Utah laws do limit how much more you can be charged by an insurer due to these factors, but you can still expect to pay a significant amount more than other consumers if you have a serious health condition or are over age 50. Although your insurer cannot raise your rate in the middle of your coverage period, your rate can be raised based on these factors when you renew your policy. However, your policy cannot be cancelled and you are guaranteed the chance to renew it regardless of a change in your health status. This is a way that Utah helps to protect health insurance consumers from being left without coverage if they find themselves in declining health.

Before you buy a health insurance policy, you must read the policy details very carefully. You need to know exactly what is and isn't covered by your policy and how much you will end up paying in your premiums. Contacting a qualified Utah-based broker or agent can help you in selecting the perfect health plan coverage.

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