Individual health insurance in Utah is an emerging solution. In the last decade the market has grown dramatically. LegUp Health predicts the market for individual and family insurance will grow even more in the next decade.
Since the Affordable Care Act took effect in 2014, individual health insurance has changed a lot. Here’s how:
- All individual plans on the Utah Marketplace are ACA-compliant. This means they cover the ten essential health benefits.
- All Individual plans are also “guaranteed issue.” Pre-existing conditions are no longer a factor in your eligibility.
- Individual health insurance is now subsidized by the federal government via premium tax credits. The premium tax credit is a tax credit that offsets your annual health insurance premiums. It’s a way for the government to pay for some or all of your private health insurance costs.
Fewer than 85,000 Utahns enrolled in the Marketplace in 2014. In 2020, there were more than 200,000 enrollees. That’s a record high and a 136 percent increase in just six years. The number will likely increase steadily in the years to come.
Many Utahns are unaware of the opportunity to buy individual health insurance. Here are a few things you should know about health insurance plans in Utah:
- Utah's health insurance marketplace is run by the federal government via healthcare.gov.
- Utah has seven (7) insurance companies offering individual and family plans in 2022.
- There are two places to buy individual plans in Utah: on-marketplace and off-marketplace. If you shop on-marketplace, you go buy coverage via the government-run Utah Health Insurance Marketplace. If you shop off-marketplace, you buy a plan directly from an insurance company. All Utah health insurance companies offer on-marketplace plans, but not all of them off off-marketplace options.
- In Utah, you can buy any individual plan during Annual Open Enrollment. This runs annually from November 1st through January 15th. During this time, you can buy any individual or family health insurance plan available in Utah for the upcoming year. This is the only time you can shop for plans unless you have a qualifying life event. To secure coverage effective January 1st, you must enroll in a plan by December 15th. If you enroll after December 15th, your coverage will take effect on February 1st.
- If you have a qualifying life event, you can shop for plans during a Special Enrollment Period. Life events include getting married, having a baby, losing a job, moving, and more. Depending on your Special Enrollment type, you may have 60 days before or 60 days following the life event to enroll in a new plan. If you miss your Special Enrollment Period you’ll have to wait until the next Annual Open Enrollment Period to enroll.