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Coverage outside your Medicare Advantage plan's home service area is limited. Emergency care is covered anywhere in the U.S., but routine care outside your area typically is not, unless you have a PPO plan that includes out-of-network benefits.
MOOP stands for Maximum Out-of-Pocket. It is the most you would have to pay in a calendar year for covered medical services under a Medicare Advantage plan, after which the plan pays 100% of covered costs for the rest of the year.
Several Medicare Advantage carriers include University of Utah Health providers in their networks, but coverage depends on the specific plan and whether those providers are in-network or out-of-network. Always verify before enrolling.
No. Intermountain Health has many clinics and facilities across Utah, and not every location accepts every Medicare Advantage plan. You need to verify each specific provider and location.
If your doctor leaves your Medicare Advantage network, you may need to find a new in-network provider or pay higher out-of-pocket costs to keep seeing them. You may qualify for a Special Enrollment Period to switch plans in some cases.
If your doctors stop accepting your plan, you may need to switch plans during an enrollment period, find new doctors within your network, or pay higher out-of-network costs, depending on your plan type.
Peter Abilla is a licensed Utah Medicare agent. He can walk you through this plan's costs, coverage, and whether your doctors are in-network.