All Medicaid Programs |
Obsolete Policy |
At the time of application, individuals who are enrolled in and currently receiving benefits through a COBRA health insurance plan that meets the definition or an 'UPP Qualified Health Plan' may be eligible for UPP. (See Section 1003-1 M.)
Individuals who are not enrolled in COBRA health insurance, but who are enrolled in a health insurance plan (see 5) are not eligible for UPP. Individuals covered through the Utah Comprehensive Health Insurance Pool (HIPUtah) are not eligible for UPP.
Individuals are enrolled if they have signed up for the plan and the plan provides medical care as defined in this section.
Individuals are enrolled even if they are subject to a pre-existing condition exclusion period. If the plan has a waiting period before benefits begin, they may still enroll and be eligible for coverage with UPP. However, they cannot receive a reimbursement until the month they pay a health insurance premium.
The following individuals would not be eligible for Utah’s Premium Partnership:
1. Individuals who are enrolled and currently receiving benefits in an employer-sponsored health plan through their employer, their spouse’s employer, or their parent's or legal guardian's employer
2. Individuals who are enrolled in Medicare Part A or Part B.
3. Individuals who are enrolled in health insurance coverage through the Veteran's Administration Health Care System.
4. Individuals who are eligible for a student health insurance plan. It does not matter if they are enrolled or not.
5. Individuals who are enrolled in any other type of group or individual health insurance plan that is not considered limited coverage. (See sec. 1003-1 G)
Exceptions:
For UPP clients moving to Medicaid and back to UPP, see Section 1009-5.
When individuals complete their review within 3 months of review closure, see Section 1008-2.