Utah program
Help paying a health-plan premium (Buyout)
Utah’s Buyout program can help pay an available health-plan premium for someone eligible for Medicaid.
What it is
Utah’s Buyout program can help pay an available health-plan premium for someone eligible for Medicaid.
An insurance premium can remain a large bill after Medicaid starts. Buyout compares the costs of an available employer, individual, student or COBRA plan. The approved payment is not automatically the whole family premium.
Eligibility rules
- A member must currently qualify for Utah Medicaid, have available insurance and significant medical need. Employer, individual, student and COBRA coverage can be considered.
- The cost comparison includes premiums, administration, deductibles and coinsurance.
What you get
- Help paying the eligible member’s approved insurance premium.
- No application charge.
What the help includes
- Buyout pays approved premiums for the eligible member under its cost comparison. The worker confirms the payment recipient and how Medicaid and the other plan work together.
- Buyout is premium assistance for a Medicaid-eligible person, not a reason to assume Medicaid ends. Could the eligibility worker confirm how the other plan, Medicaid benefits and billing protections will work together for your child? Employer, individual, student and COBRA plans can be considered.
If you decide to apply
- Ask your social worker to help request a Buyout referral through the Medicaid eligibility worker.
- Have the available plan’s premium and coverage details, plus the member’s Medicaid notice, ready.
Utah Medicaid Buyout, through your Medicaid eligibility worker · Official page ↗
After you ask
- Buyout staff review the referral and compare costs.
- The referral team can confirm when it has the information it needs, the current decision deadline and how to check its progress.
Good to know
Available insurance does not guarantee premium help. The state’s cost comparison decides which costs it will pay.
Other details
- Your Medicaid eligibility worker and the official Buyout page identify the current referral paperwork and contact.
Federal background: Medicaid premium assistance.
Official sources
“Could Buyout reduce the cost of an available health plan, and how would it work with Medicaid? Could you help compare the benefits and remaining costs before we request a referral?”
Why I’m asking: I want to understand whether premium help could make our available coverage more affordable.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Discuss a referral with the eligibility worker and share the available plan’s costs.
Your social worker
The eligibility worker sends the referral; Buyout staff run the comparison.
The care team
Records and letters when the application asks for them.
- Who decides
- Utah Medicaid Buyout staff decide, after a cost comparison.
- Ask the agency
- “Could you help request a Buyout comparison for an available policy and explain how it works with Medicaid?”
How to apply
First step: Ask your eligibility worker for a Form 19 Buyout referral, or call the line for your surname.
- Ask the eligibility worker for a Form 19 Buyout referral once Medicaid is approved.
- Ask what share of the premium will be paid before you count on it.
Official application / program page ↗
Where it starts: Referral through the Medicaid eligibility worker; the official Buyout page identifies the current contact and paperwork.
What to gather
- Available insurance premium and coverage details
- The Medicaid notice for whoever is covered
How long: Utah publishes no decision clock for Buyout.
What a yes looks like
An approved premium arrangement with the payment recipient and Medicaid coordination explained.
What a no looks like, and the next move
A no is usually the cost comparison. Ask which figures were used and whether a change of plan tier would change it.
Watch out
- It pays the eligible member's share, not automatically the whole family premium.
- The posted process dates from 2014 and no decision clock is published; ask for one in writing.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Utah can pay an eligible member’s approved insurance premium when it saves the state money.
Covers: Approved premium payments under the Buyout cost comparison
What it costs the family: Nothing to apply.
The eligibility facts, as published
- Income
- current Utah Medicaid eligibility is required
- Other
- an available insurance policy, significant medical need, and a favourable cost-effectiveness finding
- Residency
- Utah
- Processing standard
- unknown
Decisions this site cannot make: A state cost-effectiveness finding
Expect friction on: The posted process dates from 2014 and its decision clock is not published
The trap: Utah reimburses the eligible member's portion, which is not automatically the whole family premium. Ask what share will be paid before you rearrange your budget.
Where I read this
- Utah Buyout Program — Utah Department of Health and Human Services, read September 10, 2026
- Medicaid policy 225-6, The Buyout Process — Utah Department of Health and Human Services, read September 10, 2026
- Utah State Plan, Attachment 4.22-C — Utah Department of Health and Human Services, read September 10, 2026
- Medicaid Policy Manual, Table IX — Telephone Numbers — Utah Department of Health and Human Services, read September 10, 2026
- Utah Medicaid General Provider Manual (Section I) — Utah Department of Health and Human Services, read September 10, 2026