- SelectHealth Medicare Advantage plans are offered in Utah, Idaho, and Southern Nevada.
- SelectHealth Medicare Advantage plans are HMOs and HMO SNPs.
- SelectHealth HMO SNPs are available to those with heart conditions, lung conditions, and diabetes.
- SelectHealth has affordable plan options, including premium-free plans.
SelectHealth is a nonprofit health insurance company based in Salt Lake City, Utah. It serves Utah, Idaho, and Southern Nevada. The company has partnerships with other local health organizations, such as Intermountain Healthcare and P3 Health Partners, and offers its members a wide range of covered services.
Available Medicare Advantage (Part C) plans include Health Maintenance Organizations (HMOs) at multiple price points and HMO Special Needs Plans (HMO SNPs). The HMO SNPs offer coverage that’s tailored for members with diabetes, heart conditions, or lung conditions.
Keep reading to learn about the Medicare Advantage plans offered by SelectHealth, as well as what they cover and how much they cost.
SelectHealth Medicare Advantage plans are currently available to residents of Utah, Idaho, and Nevada.
Utah is SelectHealth’s home state, and it serves multiple regions within the state, including:
- Central Utah
- Southwest Utah
- Cache Valley
- Wasatch Front
Outside of Utah, regions served include the Treasure Valley and Magic Valley in Idaho, as well as both Clark and Nye counties in Southern Nevada. Plans in Nevada are available through a recent partnership with Nevada-based P3 Health Partners.
An HMO is a very common type of health insurance plan. You might have had an HMO plan through a past employer or the Health Insurance Marketplace.
Basically, HMOs work with a network of providers. The network will include any type of provider you might need to see, such as:
- primary care physicians
- urgent care clinics
- physical, occupational, or speech therapists
Your care will be covered only if you use an in-network provider, except in the case of emergency care — for example, if you need to visit the emergency room but there are no in-network hospitals close by. In this case, your plan will cover your care even though it’s not in network
You can purchase SelectHealth HMO plans at different tier levels and price points. Depending on your plan, you might be able to get coverage without a premium. Higher-tier plans with premiums will cost more per month but will include more covered services.
An HMO SNP is a plan type designed for people with a specific health concern that isn’t covered by a standard plan. Depending on the insurance company, you might find SNPs for people with limited finances, living in nursing facilities, or with chronic conditions.
SelectHealth’s HMO SNPs are for people with the following chronic conditions:
- heart conditions
- lung conditions
SelectHealth’s HMO SNPs help you cover the extra costs of managing a chronic condition.
For example, the SelectHealth Advantage Lung Care plan includes coverage for oxygen supplies and breathing treatments. If you have diabetes or heart conditions, the SelectHealth Advantage Heart and Diabetes Care plan offers $0 copayments on insulin, diabetes medications, and heart medications.
SelectHealth’s Medicare Advantage plans include coverage that’s similar to Part D (prescription drug coverage). SelectHealth does not, however, offer separate Part D plans.
All Medicare Advantage plans are required to offer the same coverage as Medicare Part A (hospital insurance) and Medicare Part B (health insurance). Together, parts A and B are known as original Medicare.
Many Medicare Advantage plans, including those from SelectHealth, also offer additional coverage beyond that of original Medicare.
While some additional coverage options are specific to certain plans, some coverage is standard across SelectHealth Medicare Advantage plans. Covered services include:
- preventive care
- screenings for cancer, diabetes, and other conditions
- part D coverage
- an allowance toward gym membership and classes
- optional dental and vision coverage
- low generic medication copayments
- low doctor’s visit copayments
Plans also include telehealth coverage through Intermountain Healthcare’s ConnectCare program. ConnectCare allows patients to see doctors via appointments on their computers or smartphones. Appointments are available every day of the week, 24 hours per day.
Even more benefits are available to members who select higher-tier plans. These include:
- allowances for over-the-counter medications
- transportation to and from doctor’s appointments
- vision care
- dental care
- hearing aids
- chiropractic care
Your costs will depend on the plan you choose and the area where you live. SelectHealth offers coverage in many regions. Most regions include several counties and cities, and the prices for each offered plan are the same throughout the region.
You can check out prices for selected cities and plans in the table below.
|City||Plan||Premium (monthly)||Deductible (annual)||Primary care visit copay||Specialist visit copay|
|Salt Lake City, Utah||SelectHealth Wasatch Essential Plan||$0||$0||$0||$45|
|St. George, Utah||SelectHealth Southwest and Central Utah Plan||$39||$0||$5||$45|
|Boise, Idaho||SelectHealth Treasure Valley Enhanced Plan||$53||$0||$5||$35|
|Twin Falls, Idaho||SelectHealth Magic Valley Plan||$66||$0||$5||$50|
|Las Vegas, Nevada||SelectHealth Nevada Essentials Plan||$0||$0||$0||$0|
Medicare Advantage is also known as Medicare Part C. Medicare Advantage plans are health insurance plans offered by private companies that have contracts with Medicare.
Medicare Advantage plans need to meet Medicare’s standards and regulations. One critical regulation is that they must offer the same coverage as original Medicare (parts A and B).
This means all Advantage plans must provide coverage for:
- doctor’s visits
- emergency room visits
- hospital stays
- physical, occupational, and speech therapy
- durable medical equipment
- emergency ambulance transportation
The price for your Advantage Plan is in addition to the cost of your Part B premium. In 2020, the standard Part B premium is $144.60. That means you’d pay the premium for your Medicare Advantage plan on top of that $144.60.
So, if a plan has a premium of $0, like the SelectHealth Nevada Essentials Plan, you’d just pay $144.60. But if you choose a plan with a higher premium, like the Treasure Valley Enhanced Plan, you’d pay the $53 premium plus your Part B $144.60, for a total of $197.60.
You can shop for available plans in your area on the Medicare website.
Original Medicare (parts A and B) doesn’t include coverage for most prescription drugs. Medicare beneficiaries can buy a separate Medicare Part D plan to help cover these costs. You can use a Part D plan only as an add-on to original Medicare.
Just like Medicare Advantage (Part C) plans, Part D plans are offered by private insurance companies and have their own premiums you’ll pay on top of your Part B premium.
Part D plans work with a network of pharmacies. You’ll need to use an in-network pharmacy for coverage. Plans also have a list of medications they’ll cover, called a formulary. A formulary includes generic, brand-name, and specialty medications covered by your plan.
If multiple similar medications can treat a condition, a formulary may cover only one or two.
For example, both lisinopril and quinapril are often prescribed to treat high blood pressure. So, your plan’s formulary might include quinapril but not lisinopril.
SelectHealth offers Medicare Advantage plans to residents of Utah, Idaho, and Southern Nevada.
Plans are available as standard HMOs and HMO SNPs. SelectHealth’s HMO SNPs are designed for members managing heart conditions, lung conditions, and diabetes.
You can find a SelectHealth plan at a low cost, with no deductible and low copayments. SelectHealth also offers plans without a premium, making them an affordable option.
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