What types of Select Health plans are available in Orem?

In Orem, Select Health, along with other carriers, primarily offers Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans on HealthCare.gov. PPO plans are not available on-exchange in Utah. These plans provide comprehensive coverage for medical services through defined networks.

Can I get financial assistance for a Select Health plan in Orem?

Yes, Orem residents may qualify for subsidies (Premium Tax Credits and Cost-Sharing Reductions) to lower their monthly premiums and out-of-pocket costs for plans purchased through HealthCare.gov, including those offered by Select Health. Eligibility is based on household income relative to the Federal Poverty Level (FPL).

Are Orem hospitals like Orem Community Hospital covered by Select Health plans?

Select Health plans typically contract with a broad network of providers. To confirm if Orem Community Hospital or other specific facilities like Timpanogos Regional Hospital are in-network for a particular Select Health plan, it is essential to check the plan's provider directory before enrolling. This ensures your preferred doctors and hospitals are covered.

Updated July 2026 · UtahPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Select Health Insurance Plans in Orem, Utah

In 2026, Select Health is one of 5 carriers offering marketplace health insurance plans in Orem, Utah.
Orem residents can access financial subsidies on HealthCare.gov to reduce premiums, with eligibility based on household income relative to the Federal Poverty Level.
Utah expanded Medicaid in 2020, covering adults with incomes up to 138% FPL, and pregnant women up to 144% FPL.
Marketplace plans in Orem are primarily structured as Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) networks; PPO plans are not available on-exchange.

Navigating health insurance options in Orem, Utah, involves understanding the plans available through HealthCare.gov and local carriers like Select Health. For 2026, residents of Orem, part of Utah Rating Area 4, have access to a competitive marketplace with multiple providers. Select Health offers a range of plans designed to meet diverse needs, typically structured as Health Maintenance Organization (HMO) or Exclusive Provider Organization (EPO) networks. Financial assistance in the form of Premium Tax Credits and Cost-Sharing Reductions is available to eligible individuals and families, significantly lowering the cost of coverage.

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What Health Insurance Options Does Select Health Offer in Orem?

Select Health is a prominent health insurance carrier providing coverage in Orem, Utah, through the federal marketplace, HealthCare.gov. Like other carriers in Utah, Select Health primarily offers plans with Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) network structures. These plans are designed to provide comprehensive medical benefits, including preventive care, doctor visits, hospital stays, and prescription drugs, within a defined network of healthcare providers. HMO plans generally require you to choose a primary care provider (PCP) who coordinates your care and provides referrals to specialists. EPO plans offer more flexibility than HMOs, as you typically don't need a referral to see a specialist, but you must stay within the plan's network for services to be covered, except in emergencies. It is important to note that PPO (Preferred Provider Organization) plans are not available on-exchange in Utah for subsidized coverage, meaning Orem shoppers will select between HMO and EPO options when applying for financial assistance.

Understanding HealthCare.gov and Subsidies in Orem

Orem residents purchase health insurance plans, including those from Select Health, through HealthCare.gov, the federal marketplace for Utah. This platform allows individuals and families to compare plans, apply for financial assistance, and enroll in coverage. The availability of subsidies is a critical factor for many Orem residents in making health insurance affordable. Subsidies come in two main forms:

Premium Tax Credits (PTC): These reduce your monthly premium payment. Eligibility for PTCs is based on your household income relative to the Federal Poverty Level (FPL). Many Orem residents with incomes between 100% and 400% FPL qualify for significant premium assistance.
Cost-Sharing Reductions (CSRs): These lower your out-of-pocket costs, such as deductibles, copayments, and coinsurance. CSRs are available to individuals and families with incomes up to 250% FPL who enroll in a Silver-tier plan.

For example, a single individual in Orem earning $35,000 per year (approximately 250% FPL) would likely qualify for both Premium Tax Credits and Cost-Sharing Reductions, making a Silver plan much more affordable. The U.S. Census Bureau ACS 2024 5-year estimates indicate Orem's median household income is $83,342, and the city's uninsured rate is 10.1%, highlighting the importance of these affordable options.

Utah Medicaid and CHIP Eligibility in Orem

Utah has expanded its Medicaid program, which is a crucial resource for many Orem residents. Unlike states that have not expanded Medicaid, Utah offers coverage to adults with household incomes up to 138% of the Federal Poverty Level (FPL). This means that if your income falls within this range, you may qualify for Utah Medicaid, which provides comprehensive health benefits with little to no cost. Specific income thresholds for other groups in Utah include:

Pregnant Women: Utah Medicaid covers pregnant women with incomes up to 144% FPL. This includes comprehensive prenatal care, labor and delivery, and postpartum care.
Children (CHIP): The Children's Health Insurance Program (CHIP) in Utah covers uninsured children in households with incomes up to 200% FPL.

These programs ensure that vulnerable populations in Orem have access to essential healthcare services. Applications for Utah Medicaid can be submitted through the state's Medicaid portal at medicaid.utah.gov.

Health Insurance Carriers in Orem

In 2026, 5 carriers offer marketplace plans in Rating Area 4, which includes Orem, Utah. These carriers provide a range of health plans through HealthCare.gov, giving Orem residents several options to choose from. The confirmed local carriers for this rating area are:

BridgeSpan Health Company
Imperial Health Plan of Utah
Regence BlueCross BlueShield of Utah
Select Health
University of Utah Health Plans

When comparing plans, it's important to consider not only the monthly premium but also the deductible, copayments, coinsurance, and the plan's network of doctors and hospitals. Each carrier offers different plans across the Bronze, Silver, Gold, and Platinum tiers, with varying levels of cost-sharing and coverage. Utah County, home to Orem, has a population of 705,400 per U.S. Census Bureau ACS 2024 5-year estimates. The county's 6 acute care hospitals, including Orem Community Hospital and Timpanogos Regional Hospital in Orem, and Intermountain Health Utah Valley Hospital in Provo, serve the community. Select Health, along with other carriers, contracts with many of these local facilities and providers.

Choosing the Right Select Health Plan in Orem

Selecting the ideal health plan requires careful consideration of your healthcare needs, budget, and preferred providers. Here are key steps for Orem residents:

Assess Your Needs: Consider how often you expect to use healthcare services. If you anticipate frequent doctor visits or have chronic conditions, a Gold plan with lower out-of-pocket costs after the deductible might be more cost-effective, even with a higher premium. If you are generally healthy and primarily want coverage for emergencies, a Bronze plan with a lower premium but higher deductible could be suitable.
Check Provider Networks: If you have specific doctors or hospitals you prefer, verify that they are in-network with the Select Health plan you are considering. For Orem residents, checking if facilities like Orem Community Hospital or Timpanogos Regional Hospital are included in the network is essential.
Understand Costs: Look beyond the monthly premium. Compare deductibles, copayments for doctor visits and prescriptions, and the out-of-pocket maximum. Remember that Cost-Sharing Reductions can significantly lower these costs if you qualify for a Silver plan.
Utilize Subsidies: Apply for coverage through HealthCare.gov to determine your eligibility for Premium Tax Credits and Cost-Sharing Reductions. These financial aids can make a substantial difference in the affordability of your plan.
Consider Plan Type: Decide between an HMO or EPO plan based on your preference for primary care physician referrals and network flexibility. PPO plans are not available on-exchange in Utah.

For personalized guidance, a licensed health insurance producer can help you compare Select Health plans and other options available in Orem, ensuring you choose coverage that aligns with your specific situation.

Frequently Asked Questions

What is the average cost of health insurance in Orem, Utah?

The cost of health insurance in Orem varies significantly based on factors like age, plan tier (Bronze, Silver, Gold), and whether you qualify for subsidies. Without subsidies, a Bronze plan might cost several hundred dollars per month for an individual, while a Gold plan would be more. However, many Orem residents qualify for Premium Tax Credits through HealthCare.gov, which can drastically reduce these monthly premiums.

Can I enroll in a Select Health plan outside of the Open Enrollment Period in Orem?

Generally, you can only enroll in a health insurance plan during the annual Open Enrollment Period. However, certain Qualifying Life Events (QLEs) trigger a Special Enrollment Period (SEP), allowing you to enroll outside of this window. Common QLEs include losing other health coverage, getting married, having a baby, or moving to a new area like Orem.

Are PPO plans available on HealthCare.gov in Orem?

No, PPO (Preferred Provider Organization) plans are not available on-exchange for subsidized coverage in Orem, Utah. Marketplace shoppers in Utah Rating Area 4 will find Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans offered by carriers like Select Health. PPOs may be available off-exchange, but without federal subsidies.

What is Utah Rating Area 4?

Utah Rating Area 4 is a specific geographic region used by health insurance carriers to set premium rates. Orem is located within Utah Rating Area 4, which is a single-county rating area covering all of Utah County. This means that health insurance premiums for a given plan are generally the same for all residents within this rating area, regardless of their specific city within the county.