Utah's Medicare Health Insurance Product Market

Utah's Medicare Product Market

Medicare Supplement and Medicare Advantage policies are specialized health insurance products designed to complement the federal Medicare program. Medicare Supplement policies are sold as a "supplement" to the basic Medicare Part A (Hospital) and Part B (Medical) programs and provide additional coverage beyond the basic Medicare benefits. Medicare Advantage (also known as Medicare Part C) policies, however, are sold as full replacement products. In other words, instead of providing specialized coverage for the "gaps" in Medicare like a supplementary product (with Medicare still bearing most of the insurance risk), Medicare Advantage products replace Medicare completely and the health insurance company bears the full risk of financial loss (with Medicare bearing no financial risk, other than paying the member's portion of the premium to the health insurer).

Another important Medicare product is Medicare Part D. Medicare Part D is a new product that became available during 2006 as a result of changes to the federal Medicare program. Medicare allows commercial health insurers to offer stand-alone pharmacy coverage via specialized insurance products called Medicare Part D drug plans. These plans provide coverage for prescription drugs, a medical benefit that Medicare Part A and B do not normally pay for.

Medicare Supplement and Medicare Advantage products account for over 13 percent of Utah's accident & health insurance market, with approximately 2.9 percent of the market share in Medicare Supplement coverage and over 10 percent of the market share in Medicare Advantage coverage. Approximately 3.8 percent of Utah residents had coverage under a Medicare Supplement or Medicare Advantage product, with about 2.0 percent in Medicare Supplement product and about 1.8 percent in a Medicare Advantage product. Medicare Part D products account for nearly 3 percent of Utah's accident & health insurance market and provide coverage for over 77,000 members, or approximately 2.9 percent of Utah residents.

These estimates only refer to commercial Medicare products offered in the Utah's commercial health insurance market. They do not include other types of Medicare products offered by self-funded employers or government programs. This section summarizes various aspects of the market including state of domicile, age and gender demographics, and plan type.

Coverage by Region:

Resources:

Articles:

'Utah Health Guide Pages:

Links: