Enrollment in Utah’s New Medicaid Waiver Program Begins July 1
Starting July 1, eligible Utah residents can sign up in the state's new health insurance program, called Primary Care Network, which will offer benefits to about 25,000 residents who do not qualify for Medicaid but cannot afford private insurance, the Deseret News reports. HHS in February approved the program, which will let the state provide primary care benefits through Medicaid to 25,000 uninsured residents by reducing the standard package of Medicaid benefits for some current beneficiaries. About 8% of the state's 143,000 Medicaid beneficiaries will experience limits on some dental, vision, mental health and other benefits; however, benefits will remain the same for children, the physically disabled, the chronically mentally ill, seniors, pregnant women and women with breast or cervical cancer. Further, copayments for doctor visits will increase from $2 to $3 and copays for prescription drugs will increase from $1 to $2. Because benefits are "being reduced and reshuffled," the new plan will not cost the state any additional money (Thalman, Deseret News, 6/24).
New Program Details
People ages 19 to 64 who have been uninsured for at least six months and have annual incomes less than 150% of the federal poverty level are eligible to enroll in the new program (Kaiser Daily Health Policy Report, 5/24). Although the program does not offer coverage for inpatient care and specialty doctors, Utah hospitals have said "they will provide $10 million in care to patients on the plan who are hospitalized" and specialty physicians are forming a network to which patients can be referred. In addition, pharmacies have said they will "provide some expensive medication for chronically ill patients." Rod Betit, executive director of the Utah Department of Health, said, "There's a lot more being provided than just what the waiver is bringing to the table." Officials "hope that improving access to cheaper basic care will reduce the amount of expensive emergency room care" that the uninsured "often seek out but can't pay for" (Deseret News, 6/24).
