Utah Medicare Advantage Companies for 2021 (Full List of Plans)

There are a lot of Medicare Advantage companies in Utah to choose from, and each has a different selection of plans available. Utah Medicare Advantage plans vary by county and even sometimes by ZIP code. You may be able to get Medicare Advantage coverage in Utah without paying anything more than your original Medicare Part B cost.

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D. Gilson is a writer and author of essays, poetry, and scholarship that explore the relationship between popular culture, literature, sexuality, and memoir. His latest book is Jesus Freak, with Will Stockton, part of Bloomsbury’s 33 1/3 Series. His other books include I Will Say This Exactly One Time and Crush. His first chapbook, Catch & Release, won the 2012 Robin Becker Prize from Seve...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: Sep 23, 2021

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The Highlights

  • You can choose from Utah PPO and HMO Medicare Advantage plans
  • Standalone Medicare Part D Plans in Utah can help cover prescription drugs
  • You’ll still need to pay your Utah original Medicare premium if you choose Medicare Advantage

If you’re shopping for a Medicare Advantage plan in Utah, there are a lot of options to choose from. 14 companies offer Medicare Advantage (Part C) coverage in Utah. Plans vary by county and include HMO, PPO, and POS options.

Finding the best Medicare company can be a challenge. To choose the right UT Medicare company and plan for your needs, compare rates as well as out-of-pocket costs to find the best combination of cost and coverage.

Ready to compare Medicare plans from top companies in Utah? Enter your ZIP code for fast, free Utah Medicare quotes today.

The Complete List of Medicare Advantage Companies in Utah

You have a lot of companies to choose from for Part C Medicare Advantage in UT. Take a look at the complete listing of health insurance companies that offer Medicare Advantage plans in Utah, which counties the plans are offered in, and how many plans each company offers.

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Medicare Advantage Companies in Utah

Company Number of Plans Counties
Advantage U 1 Davis, Weber, Salt Lake, Utah, Tooele
Aetna Medicare 5 Davis, Weber, Washington, Salt Lake, Utah, Iron, Cache, Summit, Wasatch, Tooele, Daggett, Rich, Morgan, Box Elder, Uintah, Carbon, Duchesne, Juab
American Health Plans 1 Weber, Salt Lake, Utah, Box Elder
Cigna 1 Davis, Weber, Salt Lake, Utah
Humana 5 Davis, Weber, Salt Lake, Utah, Washington, Iron
Imperial Insurance Companies 1 Salt Lake
Imperial Insurance Companies, Inc 2 Salt Lake
Lasso Healthcare 2 Millard, Sevier, Wayne, Davis, Weber, Washington, Cache, Uintah, Carbon, Salt Lake, Utah, Summit, Grand, Wasatch, Sanpete, Beaver, Tooele, Daggett, Iron, Rich, Emery, San Juan, Morgan, Duchesne, Kane, Juab, Box Elder, Garfield, Piute
Molina Healthcare 1 Davis, Weber, Washington, Cache, Salt Lake, Utah, Tooele, Iron, Box Elder
Molina Healthcare of Utah & Idaho 1 Davis, Weber, Cache, Salt Lake, Utah, Summit, Tooele, Box Elder
Regence BlueCross BlueShield of Utah 4 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Iron, Morgan, Box Elder
SelectHealth 3 Millard, Sevier, Wayne, Washington, Sanpete, Iron, Juab, Garfield, Piute, Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Rich, Morgan, Box Elder
Steward Health Choice Generations 1 Davis, Weber, Salt Lake, Utah, Tooele
UnitedHealthcare 10 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder, Washington, Iron

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Medicare Advantage Plans by Company in Utah

To compare Medicare Advantage plans by company in Utah, we’ve gathered a list of all the plans available from each UT Medicare company.

Take a look at the UT Medicare plans by company here, and bear in mind that plan availability and details vary by county.

Lasso Healthcare Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Lasso Healthcare Growth Plus (MSA) H1924-004 Millard, Sevier, Wayne, Davis, Weber, Washington, Cache, Uintah, Carbon, Salt Lake, Utah, Summit, Grand, Wasatch, Sanpete, Beaver, Tooele, Daggett, Iron, Rich, Emery, San Juan, Morgan, Duchesne, Kane, Juab, Box Elder, Garfield, Piute MSA * MSAs do not have a monthly premium.
Lasso Healthcare Growth (MSA) H1924-001 Millard, Sevier, Wayne, Davis, Weber, Washington, Cache, Uintah, Carbon, Salt Lake, Utah, Summit, Grand, Wasatch, Sanpete, Beaver, Tooele, Daggett, Iron, Rich, Emery, San Juan, Morgan, Duchesne, Kane, Juab, Box Elder, Garfield, Piute MSA * MSAs do not have a monthly premium.

SelectHealth Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
SelectHealth Advantage (HMO) H1994-002 Millard, Sevier, Wayne, Washington, Sanpete, Iron, Juab, Garfield, Piute Local HMO $34.00
SelectHealth Advantage Enhanced (HMO) H1994-007 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Rich, Morgan, Box Elder Local HMO $61.00
SelectHealth Advantage Essential (HMO) H1994-001 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Rich, Morgan, Box Elder Local HMO $0.00

Advantage U Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Advantage U Signature (PPO) H4304-001 Davis, Weber, Salt Lake, Utah, Tooele Local PPO $0.00

Molina Healthcare Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Molina Medicare Complete Care (HMO D-SNP) H5628-001 Davis, Weber, Washington, Cache, Salt Lake, Utah, Tooele, Iron, Box Elder Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

UnitedHealthcare Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
AARP Medicare Advantage Walgreens (HMO) H4604-018 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local HMO $0.00
AARP Medicare Advantage Plan 1 (HMO) H4604-003 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local HMO $39.00
UnitedHealthcare Medicare Advantage Assist (HMO C-SNP) H4604-017 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local HMO $39.00
AARP Medicare Advantage Plan 2 (HMO) H4604-011 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local HMO $0.00
AARP Medicare Advantage Patriot (HMO) H4604-005 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Iron, Morgan, Box Elder Local HMO * $0.00
UnitedHealthcare Nursing Home Plan (PPO I-SNP) H0710-051 Davis, Weber, Washington, Cache, Salt Lake, Utah, Wasatch, Tooele, Box Elder Local PPO $35.40
AARP Medicare Advantage Choice (PPO) H7404-021 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local PPO $0.00
UnitedHealthcare Medicare Advantage Assure (PPO) H0271-003 Davis, Weber, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Morgan, Box Elder Local PPO $32.60
AARP Medicare Advantage (HMO) H4604-016 Washington, Iron Local HMO $25.00
UnitedHealthcare Medicare Advantage Choice (PPO) H2001-017 Washington Local PPO $38.00

Regence BlueCross BlueShield of Utah Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Regence MedAdvantage + Rx Primary (PPO) H4605-007 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Iron, Morgan, Box Elder Local PPO $0.00
Regence Valiance (PPO) H4605-001 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Iron, Morgan, Box Elder Local PPO * $0.00
Regence MedAdvantage + Rx Enhanced (PPO) H4605-004 Davis, Weber, Salt Lake, Utah Local PPO $178.00
Regence MedAdvantage + Rx Classic (PPO) H4605-002 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Iron, Morgan, Box Elder Local PPO $31.00

Aetna Medicare Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Aetna Medicare Choice Plan (PPO) H5521-101 Davis, Weber, Washington, Salt Lake, Utah, Iron Local PPO $39.00
Aetna Advantra (HMO) H8649-003 Davis, Weber, Washington, Cache, Salt Lake, Utah, Summit, Wasatch, Tooele, Daggett, Iron, Rich, Morgan, Box Elder Local HMO $0.00
Aetna Medicare Elite Plan (PPO) H5521-246 Davis, Weber, Salt Lake, Utah Local PPO $0.00
Aetna Medicare Value Plan (PPO) H5521-197 Cache, Uintah, Carbon, Summit, Wasatch, Tooele, Daggett, Rich, Morgan, Duchesne, Juab, Box Elder Local PPO $59.00
Aetna Advantra Select (HMO) H8649-008 Uintah, Carbon, Duchesne, Juab Local HMO $49.00

Steward Health Choice Generations Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Steward Health Choice Generations (HMO D-SNP) H9455-001 Davis, Weber, Salt Lake, Utah, Tooele Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Cigna Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Cigna True Choice Medicare (PPO) H7849-029 Davis, Weber, Salt Lake, Utah Local PPO $0.00

Molina Healthcare of Utah & Idaho Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Molina Medicare Choice Care (HMO) H5628-007 Davis, Weber, Cache, Salt Lake, Utah, Summit, Tooele, Box Elder Local HMO $0.00

Humana Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Humana Gold Plus H2486-003 (HMO) H2486-003 Davis, Weber, Salt Lake, Utah Local HMO $0.00
Humana Honor (PPO) H5216-046 Davis, Weber, Washington, Salt Lake, Utah, Iron Local PPO * $0.00
HumanaChoice H5216-131 (PPO) H5216-131 Davis, Weber, Salt Lake, Utah Local PPO $0.00
HumanaChoice H5216-189 (PPO) H5216-189 Washington, Iron Local PPO $38.00
HumanaChoice H5216-247 (PPO) H5216-247 Washington, Iron Local PPO $0.00

American Health Plans Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
American Health Advantage of Utah (HMO I-SNP) H4232-001 Weber, Salt Lake, Utah, Box Elder Local HMO $38.80

Imperial Insurance Companies, Inc Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Imperial Insurance Company Traditional (HMO) H2793-003 Salt Lake Local HMO $0.00
Imperial Insurance Traditional Plus (HMO) H2793-007 Salt Lake Local HMO $32.40

Imperial Insurance Companies Medicare Plans in Utah

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Imperial Insurance Value (HMO C-SNP) H2793-005 Salt Lake Local HMO $0.00

Utah Medicare Advantage Plans With No Additional Cost

If you choose to buy Medicare Advantage in Utah, you will still have to pay your original Medicare Part B premium. Several UT Medicare companies offer Advantage plans that don’t have any additional cost beyond your original Medicare costs. Take a look at the options.

Utah Medicare Advantage Plans With No Additional Cost

Plan Name County Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
Lasso Healthcare Growth (MSA) – H1924-001-0 Kane, Iron, Morgan, Daggett, Emery, Garfield, Sanpete, Piute, San Juan, Tooele, Box Elder, Uintah, Duchesne, Rich, Cache, Wasatch, Wayne, Sevier, Utah, Weber, Salt Lake, Millard, Beaver, Grand, Davis, Carbon, Juab, Washington, Summit This Plan does NOT include Prescription Drug coverage. n/a
Lasso Healthcare Growth Plus (MSA) – H1924-004-0 Kane, Iron, Morgan, Daggett, Emery, Garfield, Sanpete, Piute, San Juan, Tooele, Box Elder, Uintah, Duchesne, Rich, Cache, Wasatch, Wayne, Sevier, Utah, Weber, Salt Lake, Millard, Beaver, Grand, Davis, Carbon, Juab, Washington, Summit This Plan does NOT include Prescription Drug coverage. n/a
AARP Medicare Advantage Patriot (HMO) – H4604-005-0 Uintah, Duchesne, Carbon, Juab This Plan does NOT include Prescription Drug coverage. $5,400
Aetna Advantra (HMO) – H8649-003-0 Iron, Morgan, Daggett, Tooele, Box Elder, Rich, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Washington, Summit Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,550
Humana Honor (PPO) – H5216-046-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit This Plan does NOT include Prescription Drug coverage. $5,000
HumanaChoice H5216-247 (PPO) – H5216-247-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit Preferred Generic: $4.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% $7,550
Regence Valiance (PPO) – H4605-001-0 Tooele, Utah, Weber, Salt Lake, Davis This Plan does NOT include Prescription Drug coverage. $5,000
Molina Medicare Complete Care (HMO D-SNP) – H5628-001-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $23.00, Non-Preferred Drug: 41%, Specialty Tier: 25% n/a
AARP Medicare Advantage Choice (PPO) – H7404-021-0 Uintah, Duchesne, Carbon, Juab Preferred Generic: $3.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Drug: $95.00, Specialty Tier: 28% $6,700
AARP Medicare Advantage Plan 2 (HMO) – H4604-011-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit Preferred Generic: $3.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% $5,000
AARP Medicare Advantage Walgreens (HMO) – H4604-018-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $6,700
Regence MedAdvantage + Rx Primary (PPO) – H4605-007-0 Morgan, Tooele, Box Elder, Cache, Wasatch, Utah, Weber, Salt Lake, Davis, Summit Preferred Generic: $3.00, Generic: $13.00, Preferred Brand: $40.00, Non-Preferred Drug: 40%, Specialty Tier: 29% $5,900
SelectHealth Advantage Essential (HMO) – H1994-001-0 Utah, Weber, Salt Lake, Davis Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $45.00, Non-Preferred Brand: $95.00, Specialty Tier: 29% $5,500
Advantage U Signature (PPO) – H4304-001-0 Tooele, Utah, Weber, Salt Lake, Davis Preferred Generic: $3.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $6,900
Molina Medicare Choice Care (HMO) – H5628-007-0 Utah, Weber, Salt Lake, Davis Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $45.00, Non-Preferred Drug: $100.00, Specialty Tier: 33%, Select Care Drugs: $0.00 $5,400
Steward Health Choice Generations (HMO D-SNP) – H9455-001-0 Tooele, Utah, Weber, Salt Lake, Davis Tier 1: 15% n/a
Aetna Medicare Elite Plan (PPO) – H5521-246-0 Utah, Weber, Salt Lake, Davis Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,550
Cigna True Choice Medicare (PPO) – H7849-029-0 Utah, Weber, Salt Lake, Davis Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $5,500
Humana Gold Plus H2486-003 (HMO) – H2486-003-0 Utah, Weber, Salt Lake, Davis Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 31% $5,900
HumanaChoice H5216-131 (PPO) – H5216-131-0 Washington Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% $5,900
Imperial Insurance Company Traditional (HMO) – H2793-003-0 Salt Lake Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $45.00, Non-Preferred Drug: $90.00, Specialty Tier: 33% $2,999
Imperial Insurance Value (HMO C-SNP) – H2793-005-0 Salt Lake Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $45.00, Non-Preferred Drug: $90.00, Specialty Tier: 33%, Select Care Drugs: $3.00 n/a

Standalone Medicare Part D Plans in Utah

If you need to purchase Part D Medicare coverage in Utah as a standalone policy, these plans are available. Remember that plans vary by county, and make sure to check that your UT Medicare Advantage plan doesn’t already include Part D prescription drug coverage.

Standalone Medicare Part D Plans in Utah

Plan Details Tiers
SilverScript SmartRx (PDP)
S5601 – 206 – 0
by Aetna Medicare
Monthly Premium: $7.30
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $19.00
Tier 3: $46.00
Tier 4: 49%
Tier 5: 25%
Clear Spring Health Premier Rx (PDP)
S6946 – 055 – 0
by Clear Spring Health
Monthly Premium: $15.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $40.00
Tier 4: 45%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 200 – 0
by WellCare
Monthly Premium: $15.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $40.00
Tier 4: 46%
Tier 5: 25%
Humana Walmart Value Rx Plan (PDP)
S5884 – 210 – 0
by Humana
Monthly Premium: $17.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: 19%
Tier 4: 35%
Tier 5: 25%
WellCare Value Script (PDP)
S4802 – 162 – 0
by WellCare
Monthly Premium: $17.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 307 – 0
by WellCare
Monthly Premium: $22.80
Annual Deductable: $425
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $47.00
Tier 4: 42%
Tier 5: 25%
Cigna Secure-Essential Rx (PDP)
S5617 – 310 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 18%
Tier 4: 44%
Tier 5: 25%
Express Scripts Medicare – Saver (PDP)
S5660 – 247 – 0
by Express Scripts Medicare
Monthly Premium: $24.30
Annual Deductable: $285
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $35.00
Tier 4: 50%
Tier 5: 28%
Mutual of Omaha Rx Premier (PDP)
S7126 – 100 – 0
by Mutual of Omaha Rx
Monthly Premium: $24.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 23%
Tier 4: 44%
Tier 5: 25%
Clear Spring Health Value Rx (PDP)
S6946 – 026 – 0
by Clear Spring Health
Monthly Premium: $30.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $42.00
Tier 4: 34%
Tier 5: 25%
WellCare Classic (PDP)
S4802 – 021 – 0
by WellCare
Monthly Premium: $33.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 33%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 062 – 0
by Aetna Medicare
Monthly Premium: $34.30
Annual Deductable: $250
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $35.00
Tier 4: 43%
Tier 5: 28%
Express Scripts Medicare – Value (PDP)
S5660 – 133 – 0
by Express Scripts Medicare
Monthly Premium: $34.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $8.00
Tier 3: $34.00
Tier 4: 46%
Tier 5: 25%
Elixir RxPlus (PDP)
S7694 – 031 – 0
by Elixir Insurance
Monthly Premium: $35.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $7.00
Tier 3: 15%
Tier 4: 28%
Tier 5: 25%
AARP MedicareRx Saver Plus (PDP)
S5921 – 375 – 0
by UnitedHealthcare
Monthly Premium: $36.10
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $35.00
Tier 4: 40%
Tier 5: 25%
WellCare Medicare Rx Saver (PDP)
S5810 – 065 – 0
by WellCare
Monthly Premium: $36.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $39.00
Tier 4: 35%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 147 – 0
by Humana
Monthly Premium: $36.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $1.00
Tier 3: 20%
Tier 4: 35%
Tier 5: 25%
Cigna Secure Rx (PDP)
S5617 – 153 – 0
by Cigna
Monthly Premium: $37.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $2.00
Tier 3: $38.00
Tier 4: 50%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 412 – 0
by UnitedHealthcare
Monthly Premium: $39.60
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 276 – 0
by Cigna
Monthly Premium: $48.60
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $4.00
Tier 2: $10.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Humana Premier Rx Plan (PDP)
S5884 – 177 – 0
by Humana
Monthly Premium: $62.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $45.00
Tier 4: 49%
Tier 5: 25%
SilverScript Plus (PDP)
S5601 – 063 – 0
by Aetna Medicare
Monthly Premium: $67.50
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $47.00
Tier 4: 50%
Tier 5: 33%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 154 – 0
by WellCare
Monthly Premium: $76.00
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $47.00
Tier 4: 49%
Tier 5: 33%
Express Scripts Medicare – Choice (PDP)
S5660 – 216 – 0
by Express Scripts Medicare
Monthly Premium: $76.70
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $42.00
Tier 4: 49%
Tier 5: 31%
Mutual of Omaha Rx Plus (PDP)
S7126 – 030 – 0
by Mutual of Omaha Rx
Monthly Premium: $79.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 35%
Tier 5: 25%
Regence Medicare Script Basic (PDP)
S5916 – 001 – 0
by Regence BlueShield of Idaho
Monthly Premium: $93.50
Annual Deductable: $300
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $3.00
Tier 2: $10.00
Tier 3: $40.00
Tier 4: 30%
Tier 5: 27%
AARP MedicareRx Preferred (PDP)
S5820 – 030 – 0
by UnitedHealthcare
Monthly Premium: $95.50
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $10.00
Tier 3: $45.00
Tier 4: 40%
Tier 5: 33%
Regence Medicare Script Enhanced (PDP)
S5916 – 002 – 0
by Regence BlueShield of Idaho
Monthly Premium: $123.50
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $3.00
Tier 2: $10.00
Tier 3: $47.00
Tier 4: 40%
Tier 5: 33%

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Medicare Advantage in Utah
Medicare Advantage in Utah