If you are a person with current Medicaid
eligibility, available insurance, and a serious medical
need, your case may be reviewed for the Buyout Program.
Buyout Program is a Utah Medicaid program that purchases
established health insurance for Medicaid clients. Any Medicaid
(Traditional and Non-Traditional) recipient who has a significant
medical need and available insurance that would cover the
cost of that need may be referred to the Buyout Program.
In order for a client to be enrolled in the Buyout Program,
the Buyout staff must find that enrollment would be cost-effective
for the state. Most insurances are eligible, including but
not limited to employer-based group insurance, individual
plans, student health plans, etc.
primary considerations are eligibility for Medicaid, the
medical need, the coverage offered under the policy, and
the cost-effectiveness of the Buyout purchase. The Buyout
Program should not be confused with other programs such
as UPP, ARRA, or Buy-in (Medicare Premiums Assistance).
policy allows for medical coverage only (unless significant
need is for dental care). Some examples of significant medical
illness such as AIDS, cancer, transplant candidates
of insurance policies Buyout pays for:
group insurance - Current employment of client, spouse,
or parent of a minor (Medicaid reimburses only the portion
of those individuals in the family who are eligible
for the Buyout Program).
(continuation of benefits) after a "qualifying
event" (termination from employment, divorce from
the policyholder, marriage, or reaching the age of majority
of a dependent).
you feel that you may qualify for the Buyout Program, please
notify your Medicaid caseworker.
If you have a specific question for the Buyout staff, send
an e-mail to email@example.com.