Are infertility treatments covered on my plan?
Coverage varies according to your plan design. Refer to your member materials on My Health or call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038. Can I find out how much I have paid toward my family deductible?
To find out how much of your family deductible you have met this year, log in to My Health and click "Claims and Coverage" and then "Year-to-Date totals".
Note: Only the subscriber has access to the family's benefit details.
Do I have coverage for a vasectomy?
Your benefits vary according to your plan design. Refer to your member materials on My Health or call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038.
To learn more about the procedure, log in to selecthealth.org/myhealth and click on “Health and Wellness” then “Health Libraries.”
Do I qualify for HIPUtah coverage?
HIPUtah is the state plan for people with serious medical conditions who are unable to obtain health insurance at any price. SelectHealth administers the plan; however, the state of Utah determines the rules and regulations for who qualifies.
Find more information about HIPUtah coverage, or call 801-442-6660 (Salt Lake area) or 800-705-9173.
Do you cover weight loss (bariatric) surgery?LAP-BAND® and gastric bypass surgeries are only covered on some plans. If you are interested in a bariatric procedure, call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038 to see if your plan includes these benefits. Do you offer any discount programs for members?Our health plan members enjoy discounts on various health-related products and services. Visit the member discounts section for more information about discounts for SelectHealth members. Does my plan include vision benefits?We cover one preventive eye exam with a participating provider per calendar year. Glasses and contacts are not covered on your medical health plan but you may receive discounts at several area businesses for being a SelectHealth member. Does SelectHealth cover intrauterine devices? (IUDs)
Coverage varies according to your plan design. Refer to your member materials on My Health or call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038.
To learn more about IUDs and other birth control options, log in to selecthealth.org/myhealth and click on “Health and Wellness” then “Health Libraries.”
How can I better understand my pharmacy benefits?
If your plan includes SelectHealth pharmacy benefits, you will be able to see them when you log in to My Health and click on "Pharmacy Tools."
Logging into My Health will allow you to see what your copay is and if there are cheaper alternatives to what you may be taking.
How can I request an exception for a medication not covered under my pharmacy benefits?In some circumstances, we are able to make exceptions over the telephone based upon information provided by you, your pharmacy or the prescribing provider. If it is determined that an exception cannot be made through this informal process, you or your provider can request an exception through the preauthorization process. A preauthorization request can be initiated by your healthcare provider by submitting a completed preauthorization form or Letter of Medical Necessity. You may also initiate the request by contacting the Pharmacy department by phone, submit a written request or on My Health with secure e-mail. How do I appeal a claim?
SelectHealth is committed to making sure that your insurance concerns or problems are investigated and resolved as soon as possible. Most situations can be resolved informally by contacting Member Services.
If you are not satisfied with the results of working with Member Services, you and/or your authorized representative may file a written formal appeal. To initiate an appeal, you may complete our Appeal Form or write to the Appeals department.
You must file any formal appeal within 180 days from the date you receive notification of any Adverse Benefit Determination or negative outcome of a Preservice Inquiry. Written formal appeals should be sent to:
SelectHealth
Attn: Appeals Department
P.O. Box 30192
Salt Lake City, UT 84130-0192
Appeals may also be sent via fax to the Appeals department at 801-442-0762. You may appeal an Urgent Preservices claim either in writing or orally by calling 801-442-4684. For additional information on appealing a claim, please refer to your Certificate of Coverage.
How do I update my personal information?
You need to complete and submit a Change Form. If you are adding eligible dependents, you need to do so within 31 days of the child's birthday, adoption, or adoption placement.
How much of my individual deductible have I met this year?
To find out how much of your deductible you have met this year, log in to My Health and click "Claims and Coverage" and then "Year-to-date Totals."
Note: Only the subscriber has access to the family's benefit details.
I adopted a child; how do I add him or her to my policy?Placement papers and change forms should be submitted within 31 days of the child’s placement to enroll the newly adopted child on your policy. You must be enrolled in the plan and eligible for benefits on the date the child is placed for adoption.
If you have additional questions about adoption benefits, call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038 or refer to your member materials. I have SelectHealth Dental insurance. How much is my copay?
We cover two oral exams/cleanings per calendar year. However, your copay may differ depending on your particular plan design. For more information about your dental benefits, log in to My Health. What are my maternity benefits?
Your maternity benefits vary according to your plan design. Refer to your member materials on My Health or call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038.
If you are expecting a baby, we invite you to enroll in our free prenatal program, SelectHealth Healthy Beginnings. Healthy Beginnings offers access to a registered nurse care manager, a pregnancy planner, and a free book. Click here for more information.
- Find a participating SelectHealth provider
- Find a participating hospital where you can deliver your baby
- Find Intermountain Healthcare prenatal and Lamaze classes
- Baby Your Baby
What is a Member or Dental Payment Summary or Schedule of Benefits?
A Member Payment Summary (MPS), Dental Payment Summary (DPS), or Schedule of Benefits is an overview of your plan design. It is categorized by service and will show your participating and nonparticipating benefits, out-of-pocket maximums, yearly deductible, and more.
You can access these documents on My Health.
What is a Plus plan?
A Plus plan means you have the option to use nonparticipating providers and facilities or those providers and facilities that are not on your plan's network. To view your particular Member Payment Summary and your potential nonparticipating benefit costs, log in to My Health
Note: If you are on a Plus plan, the logo on your ID Card will include a '+' symbol.
What is COBRA coverage?The Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you the option to continue coverage while you are searching for a new job or coverage. COBRA regulations apply to employers with 20 more employees.
The employer must notify employees about their rights and responsibility for continuation of coverage. For more information about your responsibilities as an employer, contact your broker/agent or visit the Department of Labor Web site. What is the adoption indemnity benefit?The adoption indemnity benefit was created as a result of Utah state legislation. You are eligible for the adoption indemnity benefit when adopting a newborn who is placed with the member within 90 days of the child’s birth. You have one year from the date of placement to submit a claim.
Eligible members on Utah contracts will be reimbursed at a set amount determined by state law. What services require preauthorization?Preauthorization is required for all the following: inpatient services; maternity stays longer than two days for a normal delivery or longer than four days for a cesarean; durable medical equipment; home health nursing services; and pain management/pain clinic services. If you fail to preauthorize these services when using a nonparticipating provider, your benefits are reduced to 50 percent and will not be applied to your out-of-pocket maximum.
If you have additional questions, call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038 or refer to your member materials. What should I do if I’m in an accident?Call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038. To process your claims correctly, we need the details of your accident, including insurance information for the responsible party (e.g., auto or homeowner’s) and any injuries resulting from the accident.
We may need to coordinate benefits with other insurance payers through a process called subrogation. Our Subrogation Specialists will assist you in handling the various aspects of your accident and are experienced in sorting through the many details of settlements and claims payment. For subrogation questions, call 801-442-7415. Where can I find information about SelectHealth career options?We are glad you are interested in joining our company. Click here and learn more about what it is like to work for SelectHealth and search for job openings.Why was my claim denied?
There are many reasons why a claim may be denied, including insufficient information or the use of a nonparticipating provider or facility. If you have more questions, call Member Services at 801-442-5038 (Salt Lake area) or 800-538-5038
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