What Intermountain Health offers and who can use it

Intermountain Health is a nonprofit health system based in Utah that operates hospitals, clinics, and urgent care centers across Utah, Idaho, and Nevada. It also runs its own insurance plans — Intermountain Health Plans — which cover medical, dental, and vision services. You can receive care at Intermountain facilities whether or not you have one of their insurance plans, but the insurance plans are designed to work most smoothly with their own network of providers.

Intermountain Health operates as both a provider (the doctors, hospitals, and clinics) and an insurer (the company that pays for care). This means if you choose an Intermountain insurance plan, your premiums and out-of-pocket costs stay within the same organization. If you use an outside provider or insurer, you are working across separate organizations, which can mean higher costs and more paperwork.

The system serves people with employer-sponsored coverage, individual plans purchased directly, Medicare coverage, and Medicaid coverage in the states where Intermountain operates. Each path has different rules about which providers you can see, what you pay, and what the plan covers.

Key Takeaways

  • Intermountain Health is both a provider network and an insurance company, so their plans work most efficiently if you use Intermountain doctors and hospitals.
  • You can receive care at Intermountain facilities through employer plans, individual plans, Medicare, or Medicaid, but coverage rules and costs differ by plan type.
  • Intermountain Health Plans include medical, dental, and vision coverage, though what is covered and what you pay depends on which specific plan you choose.
  • If you use providers outside the Intermountain network, you will typically pay higher out-of-pocket costs and may need to handle billing yourself.
  • Intermountain operates in Utah, Idaho, and Nevada, so coverage and provider availability vary by state and location.

Employer-sponsored plans through Intermountain Health

If your employer offers health insurance through Intermountain Health Plans, you receive coverage as part of your job benefits. Your employer pays part of the premium, and you pay the rest through payroll deduction. The specific coverage — what doctors you can see, what procedures are covered, and how much you pay at the doctor's office — depends on which plan your employer selected.

Intermountain offers several plan types for employers: HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and HDHP (High Deductible Health Plan paired with a Health Savings Account). An HMO typically has lower premiums but requires you to choose a primary care doctor and get referrals for specialists. A PPO gives you more freedom to see any doctor but charges more if you go outside the network. An HDHP has a lower premium but a higher deductible, and it pairs with a Health Savings Account that lets you set aside pretax money for medical expenses.

When you enroll through your employer, you receive plan documents that list which hospitals and doctors are in-network, what your copay is for a doctor visit, and what your deductible is. Keep these documents handy — they are the source of truth for what your plan covers and what you owe.

Individual and family plans purchased directly

You can buy an Intermountain Health Plan directly without going through an employer. These plans are available year-round through Intermountain's website, though the main enrollment period for coverage starting January 1 is typically November 1 through December 15. If you experience a may have access to life event — such as losing employer coverage, getting married, or having a child — you may be able to enroll outside the main period.

Individual plans come in different metal levels: Bronze, Silver, Gold, and Platinum. Bronze plans have the lowest premium but the highest out-of-pocket costs. Platinum plans have the highest premium but the lowest out-of-pocket costs. Silver and Gold fall in between. The metal level you choose determines both what you pay monthly and what you pay when you use care.

If your household income falls below a certain threshold, you may be able to receive subsidies that lower your monthly premium or reduce your out-of-pocket costs. These subsidies come from the federal government, not from Intermountain. To see whether you may have access to, you would need to check through the federal Health Insurance Marketplace (Healthcare.gov) or your state's marketplace, which can compare plans from multiple insurers and show you what subsidies you might receive.

Medicare and Medicaid coverage through Intermountain

Intermountain Health offers Medicare Advantage plans (also called Part C plans) for people age 65 and older or those who may have access to for Medicare due to disability. A Medicare Advantage plan is an alternative to Original Medicare (Parts A and B). It covers hospital and doctor visits through a private insurer — in this case, Intermountain — rather than through the federal government. Medicare Advantage plans often include prescription drug coverage and dental or vision benefits that Original Medicare does not.

Intermountain also participates in Medicaid programs in Utah, Idaho, and Nevada. Medicaid is a joint federal and state program for people with low income. The specific plans available, what they cover, and who qualifies varies by state. In Utah, Intermountain offers Medicaid plans through the state's Medicaid program. If you think you might may have access to for Medicaid, you would explore through your state's Medicaid office, not through Intermountain directly.

Both Medicare Advantage and Medicaid plans have their own provider networks, deductibles, and copays. The documents you receive when you enroll will spell out these details. If you are considering switching from Original Medicare to a Medicare Advantage plan, you have a specific enrollment window each year (typically October 15 through December 7), and switching back to Original Medicare is also limited to certain times of year.

In-network versus out-of-network care and costs

Intermountain Health's insurance plans charge you less when you use doctors, hospitals, and other providers that are part of their network. In-network providers have agreed to accept Intermountain's negotiated rates, which are usually lower than what they would charge an uninsured person or someone with a different insurance plan.

If you see a provider outside the Intermountain network, you will typically pay a higher copay, coinsurance, or deductible. Some plans may not cover out-of-network care at all except in emergencies. Before scheduling a procedure or specialist visit, it is worth checking whether the provider is in-network. You can do this by calling Intermountain's customer service number (found on your insurance card) or by logging into your online account if you have one.

Emergency care is usually covered regardless of whether the provider is in-network, though you may still owe a copay. If you are having a medical emergency, go to the nearest emergency room and sort out the billing later. After the emergency is resolved, you can contact the hospital's billing department or Intermountain's customer service to understand what you owe.

Dental and vision coverage

Intermountain Health Plans include dental and vision coverage as part of most medical plans, though the level of coverage depends on which plan you chose. Dental coverage typically includes preventive care (cleanings and exams) at no cost, but fillings, crowns, and other procedures require you to pay a percentage of the cost after you meet a deductible. Vision coverage usually covers an eye exam and a portion of the cost of glasses or contact lenses, though there are often limits on how much the plan will pay.

Some plans separate dental and vision into different coverage tiers, meaning you might have a different deductible and copay for dental than for medical. Check your plan documents to see what is included. If you need extensive dental or vision work, it is worth understanding your coverage limits before you schedule the appointment, because some procedures may not be covered at all or may be covered only partially.

How to find Intermountain providers and check coverage

Intermountain Health maintains a provider directory on its website where you can search for doctors, hospitals, and clinics by location and specialty. You can also call Intermountain's customer service line (the number is on your insurance card) to ask whether a specific provider is in-network or to get a referral to a doctor in your area.

Before you schedule an appointment, especially for a specialist or procedure, confirm three things: that the provider is in-network, that your plan covers the service, and whether you need a referral. Some plans require a referral from your primary care doctor before you can see a specialist. If you do not get a referral when one is required, you may end up paying the full cost yourself.

If you have questions about what your specific plan covers, your insurance card has a customer service number. You can also log into your online account (if your plan offers one) to see your deductible, copays, and coverage details. Having this information before you need care saves time and prevents surprise bills.

Frequently Asked Questions

Can I use Intermountain Health insurance outside of Utah, Idaho, and Nevada?

Intermountain Health Plans are designed for use within their service area in Utah, Idaho, and Nevada. If you travel or move outside this area, you would likely need to use out-of-network providers, which means higher costs. If you are moving permanently outside the service area, you would need to switch to a different insurance plan.

What happens if I go to an Intermountain hospital but see a doctor who is not part of Intermountain Health?

You can receive care from any doctor, even if they do not work for Intermountain Health. However, if the doctor is out-of-network, you will pay higher out-of-pocket costs. The hospital facility itself may be in-network, but the individual provider's bill is separate. Always check whether your doctor is in-network before scheduling.

Do I need to choose a primary care doctor with an Intermountain HMO plan?

Yes, HMO plans require you to select a primary care doctor who coordinates your care and provides referrals to specialists. PPO plans do not require this. If you have an HMO and see a specialist without a referral, you may have to pay the full cost yourself.

How do I know if I may have access to for a subsidy on an individual Intermountain plan?

Subsidies are based on your household income and are determined through the federal Health Insurance Marketplace or your state's marketplace, not by Intermountain directly. You would need to enter your income information on Healthcare.gov or your state's site to see what subsidies you might receive.

Can I switch from an Intermountain Medicare Advantage plan back to Original Medicare?

Yes, but only during specific enrollment periods. The main period is January 1 through February 14 each year. If you miss this window, you generally cannot switch until the next annual enrollment period (October 15 through December 7). Switching back to Original Medicare is a permanent decision for that year, so understand the differences before you make the change.