Health Insurance for Contractors & Real Estate Agents in Clearfield, Utah
- Self-employed contractors and real estate agents in Clearfield, Utah, can access subsidized health insurance through HealthCare.gov.
- Utah residents with income up to 138% of the Federal Poverty Level (FPL) may qualify for Utah Medicaid, which expanded in 2020.
- In 2026, four carriers offer marketplace plans in Clearfield's Rating Area 3, providing HMO and EPO options.
- Premium tax credits and cost-sharing reductions can significantly lower monthly premiums and out-of-pocket costs for eligible individuals.
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Understanding Your Health Insurance Options in Clearfield
For self-employed individuals in Clearfield, the primary avenue for health insurance is the Affordable Care Act (ACA) marketplace, HealthCare.gov. This platform allows you to compare plans, apply for subsidies, and enroll in coverage that meets the ACA's essential health benefits requirements. Unlike some states, Utah's marketplace offers HMO (Health Maintenance Organization) and EPO (Exclusive Provider Organization) plans. It is important to note that PPO (Preferred Provider Organization) plans are NOT available on-exchange in Utah, so your choice will be between these two network structures.What are HMO and EPO Plans?
- HMO (Health Maintenance Organization): These plans typically require you to choose a primary care provider (PCP) within their network. Your PCP then coordinates all your care and provides referrals to specialists. HMOs often have lower premiums and out-of-pocket costs, but offer less flexibility in choosing providers.
- EPO (Exclusive Provider Organization): EPO plans offer a network of doctors and hospitals, similar to a PPO, but generally will not cover care outside of that network except in emergencies. Unlike HMOs, EPOs usually do not require referrals to see specialists within the network, offering a balance between flexibility and cost.
Financial Assistance for Self-Employed Individuals
Many self-employed contractors and real estate agents in Clearfield qualify for financial assistance, which can make marketplace plans much more affordable.- Premium Tax Credits (Subsidies): These credits reduce your monthly premium payments. Eligibility is based on your household income and family size, with subsidies available to those earning between 100% and 400% of the Federal Poverty Level (FPL).
- Cost-Sharing Reductions (CSRs): If your income is between 100% and 250% FPL, you may also qualify for CSRs, which lower your deductibles, copayments, and out-of-pocket maximums. CSRs are only available with Silver-tier plans.
Utah Medicaid and CHIP Eligibility
Utah expanded Medicaid in 2020, significantly broadening eligibility for low-income residents. If your income is below a certain threshold, you may qualify for free or low-cost health coverage through Utah Medicaid. This is a critical difference from states that have not expanded Medicaid, meaning Clearfield residents do not face a "coverage gap."Adults with household income up to 138% of the Federal Poverty Level (FPL) are eligible for Utah Medicaid. For pregnant women, the income threshold is 144% FPL, providing comprehensive prenatal, delivery, and postpartum care. Uninsured children in households with income up to 200% FPL may qualify for the Children's Health Insurance Program (CHIP). You can apply for these programs directly through Utah's Medicaid portal at medicaid.utah.gov.
Clearfield, with a population of 33,523 and an uninsured rate of 9.6% (per U.S. Census Bureau ACS 2024 5-year estimates), benefits from Utah's expanded Medicaid, ensuring more residents have access to essential care. Davis County, where Clearfield is located, has a lower uninsured rate of 5.7% and a population of 370,924. These programs are vital safety nets for self-employed individuals experiencing fluctuating income or financial hardship.
Health Insurance Carriers in Clearfield
In 2026, four carriers offer marketplace plans in Clearfield, which is part of Utah Rating Area 3. This rating area covers a significant portion of the state, including Davis, Salt Lake, Summit, Tooele, and Wasatch counties. Having multiple carriers ensures competitive pricing and a variety of plan options for self-employed individuals.The confirmed carriers offering plans in Clearfield's Rating Area 3 for the 2026 plan year are:
- BridgeSpan Health Company
- Regence BlueCross BlueShield of Utah
- Select Health
- University of Utah Health Plans
These carriers provide a range of HMO and EPO plans across different metal tiers (Bronze, Silver, Gold), allowing you to choose coverage that best fits your health needs and budget. For example, local hospitals like Holy Cross Hospital-davis in Layton, Lakeview Hospital in Bountiful, Intermountain Health Layton Hospital in Layton, and Western Peaks Specialty Hospital in Bountiful are part of the broader network options available through these plans within Davis County.
Choosing the Right Plan for Your Needs
Selecting the best health insurance plan as a self-employed contractor or real estate agent involves balancing monthly premiums with potential out-of-pocket costs and access to care.| Metal Tier | Key Features | Best For |
|---|---|---|
| Bronze | Lowest monthly premiums, highest deductibles and out-of-pocket maximums. Covers 60% of costs on average. | Healthy individuals who want protection from catastrophic events and can afford high deductibles. |
| Silver | Moderate premiums, moderate deductibles. Covers 70% of costs on average. Only tier eligible for Cost-Sharing Reductions (CSRs). | Individuals and families who qualify for CSRs, or those who expect moderate medical needs and want a balance of premiums and out-of-pocket costs. |
| Gold | Higher monthly premiums, lower deductibles and out-of-pocket maximums. Covers 80% of costs on average. | Individuals who expect significant medical needs, frequently visit doctors, or take expensive prescription drugs and prefer predictable costs. |
Decision Mapping for Self-Employed Individuals
- If your income is below 138% FPL: You likely qualify for Utah Medicaid. Apply through medicaid.utah.gov for comprehensive, low-cost coverage.
- If your income is between 100% and 250% FPL: Focus on Silver plans. You will qualify for both premium tax credits and cost-sharing reductions, significantly reducing your out-of-pocket expenses beyond just premiums.
- If your income is between 250% and 400% FPL: You will qualify for premium tax credits. Compare Bronze, Silver, and Gold plans carefully to find the best balance of monthly premium and expected out-of-pocket costs based on your health needs.
- If your income is above 400% FPL: You will pay full price for marketplace plans but can still benefit from the comprehensive coverage and consumer protections offered by the ACA. Explore all metal tiers to find the most suitable plan.
As a self-employed professional, you can also deduct health insurance premiums from your federal income taxes if you are not eligible for an employer-sponsored plan through a spouse. This deduction can further reduce the effective cost of your coverage.
Frequently Asked Questions
Can I get health insurance if I'm a self-employed contractor or real estate agent in Clearfield?
Yes, self-employed individuals in Clearfield, Utah, can purchase health insurance through HealthCare.gov. You may qualify for significant subsidies based on your household income, making comprehensive coverage affordable. Utah's marketplace offers HMO and EPO plans, with four carriers providing options in Rating Area 3.
What are the income limits for Medicaid in Utah?
Utah expanded Medicaid in 2020. Adults with household income up to 138% of the Federal Poverty Level (FPL) may qualify for Utah Medicaid. For pregnant women, the threshold is 144% FPL, and for children via CHIP, it's 200% FPL. Applications can be submitted through medicaid.utah.gov.
Are PPO plans available on the HealthCare.gov marketplace in Clearfield, Utah?
No, PPO plans are not available on-exchange through HealthCare.gov in Utah. Marketplace shoppers in Clearfield will choose between HMO and EPO network structures. While PPO plans may exist off-marketplace, they do not qualify for premium tax credits or cost-sharing reductions.
How do I choose between an HMO and an EPO plan?
HMO (Health Maintenance Organization) plans typically require you to choose a primary care provider (PCP) within the network and get referrals for specialists. EPO (Exclusive Provider Organization) plans offer a broader network than HMOs and generally don't require out-of-network care except in emergencies. They usually do not require referrals for specialists. Consider your preferred doctors and need for specialist access when choosing.