University of Utah Health Insurance Plans in Utah County, Utah

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

University of Utah Health Plans is one of 5 carriers offering marketplace plans in Utah County's Rating Area 4 for 2026.
Marketplace plans in Utah County are available as Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) networks, as PPO plans are not offered on-exchange.
Utah expanded Medicaid in 2020, covering adults with incomes up to 138% of the Federal Poverty Level (FPL).
Utah County has a population of 705,400 with an uninsured rate of 7.5%, per U.S. Census Bureau ACS 2024 5-year estimates.

If you're seeking health insurance coverage in Utah County, University of Utah Health Plans offers a range of options through the Affordable Care Act (ACA) marketplace, HealthCare.gov. As a prominent local provider, University of Utah Health Plans provides comprehensive coverage designed to meet the needs of individuals and families across the county. Understanding your choices, including plan types, subsidy eligibility, and local provider networks, is key to selecting the right health plan for 2026. This guide focuses on what University of Utah Health Plans offers specifically for Utah County residents.

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What Types of University of Utah Health Plans Are Available in Utah County?

In Utah County, residents can access University of Utah Health Plans primarily through the HealthCare.gov marketplace. Like all marketplace carriers in Utah, University of Utah Health Plans offers Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans. It's important to note that PPO (Preferred Provider Organization) plans are not available on-exchange in Utah. Here's a brief overview of the plan types you'll encounter:

Health Maintenance Organization (HMO) Plans: These plans typically require you to choose a primary care provider (PCP) within the network and get referrals from your PCP to see specialists. HMOs often have lower monthly premiums and out-of-pocket costs, but offer less flexibility in choosing providers outside the network.
Exclusive Provider Organization (EPO) Plans: EPO plans offer a network of doctors and hospitals, but generally do not require a PCP referral to see a specialist. However, they typically will not cover care received outside of their network, except in emergencies. EPOs offer more flexibility than HMOs within their network.

Both HMO and EPO plans from University of Utah Health Plans will provide essential health benefits as mandated by the ACA, including preventive care, prescription drugs, emergency services, mental health care, and more.

How Do Subsidies and Cost Savings Work in Utah County?

Many Utah County residents qualify for financial assistance to make University of Utah Health Plans more affordable. These subsidies are available through HealthCare.gov and are based on your household income and family size.

Federal Poverty Level (FPL)	Available Assistance
Below 138% FPL	Eligible for Utah Medicaid (if income qualifies after expansion)
100% - 400% FPL	Premium Tax Credits (PTC) available to lower monthly premiums
150% - 250% FPL	Enhanced Cost-Sharing Reductions (CSRs) available on Silver plans, reducing deductibles, copayments, and out-of-pocket maximums
Above 400% FPL	May purchase plans at full price through HealthCare.gov; no subsidies

Utah County, which makes up Rating Area 4, serves a population of 705,400 with a median age of 25.8 years, per U.S. Census Bureau ACS 2024 5-year estimates. The county's uninsured rate stands at 7.5%, indicating a significant portion of the population could benefit from exploring marketplace plans and available subsidies. Understanding your eligibility for these subsidies is crucial for maximizing affordability.

Understanding Utah Medicaid in Utah County

Utah expanded its Medicaid program in 2020 through a ballot initiative, a significant difference from some other states. This means that adults in Utah County with household incomes up to 138% of the Federal Poverty Level (FPL) are now eligible for comprehensive health coverage through Utah Medicaid. This expansion eliminates the "coverage gap" that exists in non-expansion states, ensuring that more low-income residents have access to care. Specific income thresholds for Medicaid in Utah County include:

Adults: Up to 138% FPL
Pregnant Women: Up to 144% FPL. This coverage includes prenatal care, labor and delivery, and postpartum care.
Children (CHIP): Up to 200% FPL

If you believe you might qualify for Utah Medicaid, you can apply directly through Utah's Medicaid portal at medicaid.utah.gov. This program offers extensive benefits with little to no out-of-pocket costs for eligible individuals and families.

Health Insurance Carriers in Utah County

For 2026, residents of Utah County (Rating Area 4) have a selection of carriers offering plans on the HealthCare.gov marketplace. In 2026, 5 carriers offer marketplace plans in Rating Area 4. These include:

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

Each of these carriers provides a variety of plan options across different metal tiers (Bronze, Silver, Gold), allowing you to choose a plan that balances monthly premiums with out-of-pocket costs. University of Utah Health Plans is a key local option, providing integrated care with the University of Utah Health system.

Local Healthcare Providers and Hospitals in Utah County

University of Utah Health Plans often leverages its integrated network of providers and facilities. Utah County is served by 6 acute care hospitals, providing comprehensive medical services to its residents. These hospitals include:

Intermountain Health Utah Valley Hospital (Provo)
Mountain View Hospital (Payson)
American Fork Hospital (American Fork)
Orem Community Hospital (Orem)
Timpanogos Regional Hospital (Orem)
Intermountain Health Spanish Fork Hospital (Spanish Fork)

When selecting a University of Utah Health Plan, it's important to verify that your preferred doctors and any necessary specialists are within the plan's network. This is especially true for HMO and EPO plans, which have more restricted networks than PPOs (which are not available on-exchange in Utah).

Making Your Health Insurance Decision in Utah County

Choosing the right health insurance plan, especially from a carrier like University of Utah Health Plans, involves considering your health needs, budget, and preferred providers.

Assess Your Income: Determine if you qualify for Utah Medicaid (below 138% FPL) or for premium tax credits and cost-sharing reductions (100-400% FPL).
Consider Plan Type: Decide between an HMO or EPO based on your preference for network flexibility and referral requirements.
Review Provider Networks: Ensure that University of Utah Health Plans' network includes your desired doctors and hospitals, such as Intermountain Health Utah Valley Hospital or Timpanogos Regional Hospital.
Compare Metal Tiers: Bronze plans have lower premiums but higher out-of-pocket costs, while Gold plans have higher premiums but lower out-of-pocket costs. Silver plans offer a balance and are the only tier eligible for cost-sharing reductions.

For personalized assistance in navigating the HealthCare.gov marketplace and comparing University of Utah Health Plans with other local options, consider working with a licensed health insurance agent. Their services are typically free to you, and they can provide expert guidance tailored to your specific situation in Utah County.

Frequently Asked Questions

What types of health plans does University of Utah Health offer in Utah County?

In Utah County, University of Utah Health Plans, like other marketplace carriers, offers Health Maintenance Organization (HMO) and Exclusive Provider Organization (EPO) plans on HealthCare.gov. PPO plans are not available on-exchange in Utah.

Can I get a subsidy for University of Utah Health Plans in Utah County?

Yes, if your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits to lower your monthly payments for University of Utah Health Plans purchased through HealthCare.gov. Cost-sharing reductions are also available for those earning up to 250% FPL.

Does Utah Medicaid cover adults in Utah County?

Yes, Utah expanded Medicaid in 2020. Adults in Utah County with household incomes up to 138% of the Federal Poverty Level may qualify for Utah Medicaid, which provides comprehensive, low-cost health coverage. Pregnant women can qualify up to 144% FPL, and children up to 200% FPL for CHIP.

What is the uninsured rate in Utah County?

According to U.S. Census Bureau ACS 2024 5-year estimates, Utah County has an uninsured rate of 7.5%. This is lower than the state's median uninsured rate, but still indicates a need for accessible and affordable health insurance options.

How many hospitals are in Utah County?

Utah County is home to 6 acute care hospitals, including Intermountain Health Utah Valley Hospital in Provo and Timpanogos Regional Hospital in Orem. These facilities are part of the local healthcare network that University of Utah Health Plans members can access.