Medicaid Costs and Coverage in Utah

f you have wondered, “How much is Medicaid in Utah?” you know that there are plenty of resources available that give differing numbers and answers. Establishing the answer to the question “How much does Medicaid cost in Utah?” can therefore be relatively tricky if you do not know what kind of factors to take into account. Additionally, while price can be important, learning what services are covered by Medicaid for those who meet Medicaid eligibility requirements is also valuable information to have. If you are a Utah resident from a low-income household, you need to know whether or not the medical costs that you have can potentially be reduced. Therefore, while getting Medicaid cost estimates can be a difficult process, it can also be quite rewarding when you want to pay as little as possible for your medical bills. This article will discuss the different types of Medicaid insurance, as well as the occasional insurance prices that you should be aware of in Utah.

How much does Medicaid cost in Utah?

The Utah Department of Health (UDOH) is responsible for providing Medicaid coverage in the state of Utah, and thus it is also the government body that determines different costs and other pricing options. Medicaid costs in Utah are designed to be quite low or even non-existent. This is because Medicaid insurance coverage is only available to those Utah residents who have low to very-low annual household incomes. These income levels must fall below a certain percentage of the Federal Poverty Level (FPL), which is re-established every year. Therefore, UDOH sets Medicaid cost estimates much lower than other traditional health care providers, in order to provide a cost-efficient way for the state’s most disadvantaged population to pay for their medical bills.

Answering the question “How much is Medicaid in Utah?” is difficult to do, because these costs vary wildly depending on the type of coverage you need and the year in which you apply. Medicaid premiums and deductibles in Utah are established by UDOH every year, but they are also different if you are receiving coverage through traditional Medicaid, the Children’s Health Insurance Program (CHIP) or any of their other special eligibility programs. Therefore, while your Medicaid cost estimates may depend on these different factors each year, are designed to be reasonable and sent to applicants individually in the mail. Learn more about Medicaid copayments, premiums and other costs by downloading our free comprehensive guide.

What services are covered by Medicaid in UT?

If you wish to learn what services are covered by Medicaid in Utah, UDOH has a comprehensive list. Broadly, Medicaid covered services include those that are deemed medically necessary. Some of the most common services include doctor’s appointments, inpatient and outpatient hospital stays, non-emergency ambulance use, prescription drug coverage and specialist appointments. Some other types of Medicaid insurance in Utah include home health care, hospice care, medical supplies, physical therapy, mental health services, speech and hearing pathology services and more.

This Utah Medicaid coverage can also extend to special eligibility groups, such as CHIP recipients. Children enrolled in CHIP coverage can gain access to additional coverage, including regular pediatric care checkups and vaccinations. Other types of Medicaid insurance groups, such as the Aged, Blind and Disabled Medical (ABDM) program and the Medicaid Work Incentive (MWI) program provide specialized resources to seniors, blind or disabled individuals, as well as to Utah residents who are receiving Social Security benefits. While Utah Medicaid plans may not cover the entirety of these health care costs, they will often require low-income Utah residents to pay very little out of pocket. Your UT Medicaid cost estimates will be sent in the mail, along with the complete list of your possible coverage options.

What does Medicaid not cover in Utah?

However, there are also some services that are not covered by Medicaid in Utah, which may or may not be covered by other insurance types. For example, traditional Medicaid coverage through UDOH does not cover dental care, unless you following the application process for a dependent child via the CHIP program. As with many other state-run Medicaid programs across America, UDOH will not cover a number of health-related services that are deemed to be “optional” by the federal government. Answering “what does Medicaid not cover?” is generally more complicated than just providing a list, though, because UDOH will review claims that request a specific service to be covered. While your Utah Medicaid coverage claim may not be accepted, it is still recommended to check with UDOH if you require financial aid with a medical service while under Medicaid benefits in the state.

Other health services Medicaid does not cover include those that are not considered to be medically necessary. Such Medicaid-omitted services include cosmetic surgeries and procedures, experimental treatments that are not sanctioned by your primary care physician, private-duty nursing care provided by a family member and more. Just because a Medicaid coverage service is available in another state does not necessarily mean that it is available in Utah. Therefore, it is always best to check with UDOH directly in order to determine your coverage options.

Additional UT Medicaid Coverage & Cost Factors

Since Utah Medicaid coverage is so inexpensive relative to other health insurance plans, it can be incredibly beneficial to pair it with additional insurance coverage whenever possible. Medicaid insurance benefits can work with programs such as Medicare in order to cover a number of health insurance costs, so that you can often pay very little, if anything, on your medical bills. Although you will still usually have to pay minimal Medicaid costs each month, this scenario is preferable for low-income Utah residents.

You may still qualify for Medicaid coverage in Utah if you do not have another form of primary health insurance, and it is highly recommended to get insured with Medicaid as quickly as possible in such a case. This is because the individual mandate of the Affordable Care Act (ACA) states that all Americans must pay a yearly fine if they have gone uninsured. Although the individual mandate has been repealed, Americans will still face fines until the repeal goes into effect. Learn more about Medicaid coverage in our in-depth Medicaid guide.