Utah · Regence and Select Health, 2026 plan year
Regence vs. Select Health Medicare Advantage in Utah (2026)
Utah's two home-grown insurers file Medicare Advantage plans that look alike from a distance and are built differently. One is all PPO with a monthly premium. The other is all HMO with none. They share 9 counties, split 7 others between them, and leave 13 untouched. This is the 2026 side-by-side from the CMS landscape file: the plans, the counties, the premiums and the out-of-pocket limits.
The bottom line
- Plan type is the dividing line. All 3 Regence plans are PPOs. All 5 Select Health plans are HMOs. Neither carrier files the other type in Utah for 2026.
- Counties: Regence 12, Select Health 13, both in 9. Regence alone in Box Elder, Tooele and Wasatch. Select Health alone in Piute, Sanpete, Sevier and Wayne.
- Premiums: Regence's drug plans are $46.00 and $135.00 a month. Select Health's three are $0. Every one is on top of the $202.90 Part B premium.
- Out-of-pocket limits, in network: Regence $5,000–$6,200; Select Health $5,500–$6,325. The file does not report a PPO's separate limit for out-of-network care.
- Not in Moab or Monticello. Grand and San Juan counties have neither carrier. And 2027 is not in this article: CMS releases that data October 1.
Both companies are local, and that is part of why people compare them. Cambia Health Solutions, Regence's parent, describes Regence BlueCross BlueShield of Utah as "based in Salt Lake City" and "the state's first health insurer, serving Utahns since 1944." Select Health calls itself "a Utah-based nonprofit," and the CMS file lists its parent as Intermountain Health Care, Inc. I have already written the Select Health and UnitedHealthcare comparison and the Select Health county map. This one puts the two Utah carriers next to each other, using the same source for both so the numbers are comparable.
That source is the CMS landscape file, which lists every approved plan in every county. Of Utah's 280 Medicare Advantage drug-plan offerings for 2026, 19 are Regence and 22 are Select Health. Together that is 41, about 15% of the state's shelf. Carriers based outside Utah file the rest.
The plans each carrier files
| Plan (CMS ID) | Type | Monthly premium | Max out-of-pocket, in network | Part D deductible | Utah counties |
|---|---|---|---|---|---|
| Regence MedAdvantage + Rx Classic (PPO) H4605-002 | PPO with drug coverage | $46.00 | $6,200 | $495 | 12 |
| Regence MedAdvantage + Rx Enhanced (PPO) H4605-004 | PPO with drug coverage | $135.00 | $5,000 | $200 | 7 |
| Regence Valiance (PPO) H4605-001 | PPO, no drug coverage | $0.00 | $4,500 | — | 12 |
| Select Health Medicare Essential (HMO) H1994-001 | HMO with drug coverage | $0.00 | $5,500 | $200 | 7 |
| Select Health Medicare + Kroger (HMO) H1994-022 | HMO with drug coverage | $0.00 | $6,325 | $200 | 9 |
| Select Health Medicare Essential (HMO) H1994-017 | HMO with drug coverage | $0.00 | $5,700 | $300 | 6 |
| Select Health Medicare Dual (HMO D-SNP) H1994-015 | HMO Special Needs Plan, dual-eligible | $37.60 | $8,850 | $615 | 6 |
| Select Health Medicare NoRx (HMO) H1994-016 | HMO, no drug coverage | $0.00 | $6,700 | — | 4 |
Source: CMS CY2026 Medicare Advantage / Part D Landscape file, September 2026 release, Utah rows for contracts H4605 and H1994. Premium is the monthly consolidated (Part C plus Part D) premium as filed, or the Part C premium for plans without drug coverage, and is in addition to the Part B premium. The dual-eligible plan's premium is generally covered for members who qualify for Extra Help. Plan names are as registered with CMS.
Regence keeps a short list: one drug plan that reaches all 12 of its counties, a second with a higher premium and a lower out-of-pocket limit in 7, and a plan without drug coverage. Select Health files more plans and divides the state, with one "Essential" plan for the Wasatch Front and Cache Valley and a different plan of the same name for central and southern Utah. Select Health also files a dual-eligible Special Needs Plan. Regence files none.
County by county
Counts below are Medicare Advantage plans with drug coverage only, which is the category most people shop. The last two columns show the county's whole shelf from every carrier.
| County | Regence drug plans | Select Health drug plans | Who is here | All MA drug plans | Carriers |
|---|---|---|---|---|---|
| Box Elder | 1 | 0 | Regence only | 12 | 5 |
| Cache | 1 | 2 | Both | 13 | 5 |
| Davis | 2 | 2 | Both | 24 | 7 |
| Iron | 1 | 2 | Both | 14 | 5 |
| Morgan | 2 | 2 | Both | 18 | 7 |
| Piute | 0 | 1 | Select Health only | 4 | 2 |
| Salt Lake | 2 | 2 | Both | 24 | 7 |
| Sanpete | 0 | 1 | Select Health only | 6 | 2 |
| Sevier | 0 | 1 | Select Health only | 6 | 2 |
| Summit | 2 | 2 | Both | 16 | 6 |
| Tooele | 1 | 0 | Regence only | 15 | 6 |
| Utah | 2 | 2 | Both | 21 | 6 |
| Wasatch | 2 | 0 | Regence only | 13 | 4 |
| Washington | 1 | 2 | Both | 12 | 5 |
| Wayne | 0 | 1 | Select Health only | 1 | 1 |
| Weber | 2 | 2 | Both | 19 | 6 |
Source: CMS CY2026 Landscape, MA-PD category only (Special Needs Plans, plans without drug coverage and stand-alone drug plans excluded), via CMS CY2026 Medicare Advantage / Part D Landscape.
The 9 shared counties are the Wasatch Front, Cache Valley, Summit County and the St. George and Cedar City corridor. That is where a side-by-side comparison is a real choice. The split counties tell you something about each company's map. Regence's three, Box Elder, Tooele and Wasatch, all border the Wasatch Front. Select Health's four, Piute, Sanpete, Sevier and Wayne, are rural central Utah, and in Wayne County its plan is the only Medicare Advantage drug plan filed by anyone.
Regence's footprint has also been steady. In October 2020 the company announced it was "expanding to offer Medicare Advantage plans in eight more counties in Utah; Box Elder, Cache, Iron, Morgan, Summit, Tooele, Wasatch and Washington," bringing the total to 12 for the 2021 plan year. All eight are in the 2026 file, and the total is still 12.
PPO and HMO: what the letters change
This is the difference that shows up when you use the plan. Medicare.gov on PPOs: "You can generally go to out-of-network providers for covered services, but you'll usually pay more." You do not have to choose a primary care doctor, and the answer to "Do I have to get a referral to see a specialist?" is "No." The page adds a caution that is easy to skip: "Before you get services from an out-of-network provider, contact your PPO Plan to ensure the services are medically necessary and covered by your plan."
Medicare.gov on HMOs: "you generally must get your care and services from doctors, other health care providers, and hospitals in the plan's network," with three exceptions, "Emergency care, Out-of-area urgent care, Temporary out-of-area dialysis." In most HMOs you choose a primary care doctor, and "In most cases, you have to get a referral to use a specialist." Outside the network, "you may have to pay the full cost."
Neither design is the right one for everybody. An HMO asks you to stay inside a directory and usually charges less for doing so. A PPO charges for room to step outside it. If every doctor you see is in one plan's directory and you rarely leave the state, the room may be something you pay for and never use. If you split the year between Utah and somewhere else, or you see a specialist who contracts with few plans, it may be the reason you chose the plan. Our Arizona snowbird post works through the travel case.
Live in one of the 9 counties with both and want them read against your own list?
Bring your doctors, hospital and prescriptions by name. From our Moab office or by phone anywhere in Utah, we will check each 2027 directory and formulary against your list once CMS releases the data on October 1, and price a supplement beside them. We do not offer every plan available in your area.
Book a coverage review →Premium against out-of-pocket limit
The two Regence drug plans cost $46.00 and $135.00 a month, which is $552 and $1,620 a year. Select Health's three cost $0 in plan premium. All of them are on top of the $202.90 monthly Part B premium, so no plan in this article is without cost.
What the premium buys is not a simple trade. Regence's higher-premium Enhanced plan has the lowest in-network limit of the five drug plans, $5,000, and a $200 drug deductible. Its Classic plan has a $6,200 limit and a $495 deductible. Select Health's limits run $5,500–$6,325 with deductibles of $200 to $300. So in a year with a hospital stay and ongoing treatment, the most a member pays in network differs by as much as $1,325 between the lowest and highest of these limits, against a premium difference of up to $1,620.
Two cautions on reading those figures. The landscape file reports the in-network limit only. A PPO also has a combined limit that counts out-of-network care, and it is usually higher; ask for it in writing before you rely on the out-of-network benefit. And an out-of-pocket limit covers Part A and Part B services, not prescriptions, which have their own $2,100 cap in 2026. Copays for the care you use most will matter more than the limit in an ordinary year, and those are in each plan's Summary of Benefits, not in this file.
Star ratings, as filed
Every year, Medicare evaluates plans based on a 5-star rating system. In the 2026 file, Regence's contract H4605 carries an overall rating of 3.5 stars and Select Health's contract H1994 carries 4.5. A rating belongs to the contract and the year: it is built from dozens of measures of care, service and drug-plan performance collected in earlier years, and it says nothing about whether your cardiologist is in the directory. CMS publishes the 2027 ratings in October, and they can move in either direction. I would note the number and then go back to the doctor list.
The plans without drug coverage
Each carrier files one plan with no Part D benefit. Regence Valiance reaches all 12 Regence counties, with a $0.00 plan premium and a $4,500 in-network limit. Select Health's NoRx plan reaches 4 counties, Davis, Salt Lake, Utah and Weber, with a $0.00 plan premium and a $6,700 limit. Regence introduced Valiance in 2020 as a plan "for veterans," designed "to complement Veterans Affairs benefits."
These plans suit a narrow group: people who already have drug coverage that Medicare treats as creditable, such as VA or TRICARE. For anyone else they leave a gap, and Medicare.gov is direct about it: "If you join a PPO that doesn't offer drug coverage, you can't join a separate Medicare drug plan." The HMO page says the same. You cannot fix a no-drug Advantage plan by adding a Part D plan to it.
The 13 counties with neither carrier
Beaver, Carbon, Daggett, Duchesne, Emery, Garfield, Grand, Juab, Kane, Millard, Rich, San Juan and Uintah. Most are the thin shelves of eastern and southern Utah, where one to three national carriers file everything there is. Grand and San Juan are in this group: 8 drug plans in Grand County and 4 in San Juan, from Humana and UnitedHealthcare. Medicare.gov's eligibility rule is "Live in the service area of the plan you want to join," and the service area is set by your home address, not by where your specialist practices.
For a Moab reader the useful comparison is a different one. In Grand County, 33.3% of adults live with high blood pressure and 11.2% with diabetes, and most of that care happens locally. The specialty care leaves the county under every plan. So the question is which of the plans filed here covers the trip north, or whether Original Medicare with a supplement, which has no network, is the better fit for someone who expects to make that trip often.
What I would do
If you live in one of the 9 shared counties, start with your doctors and not with the carrier. Look up each physician and your hospital in both 2027 directories by name. If everyone is in the HMO's network and you are comfortable with referrals, the premium difference is real money. If someone important is missing, or you travel, price the PPO with its out-of-network limit in front of you. Then run your prescriptions through both formularies, because the drug deductibles here range from $200 to $495 and the tiers differ. If you live in a Regence-only or Select Health-only county, the comparison is between that carrier and the national ones on your shelf, and the same three checks apply.
And wait for October 1 before deciding anything. Plans, premiums and service areas are refiled every year, and the 2026 figures in this article describe this year only.
How we know all this: the Medicare On Main Data Desk frames every article with public data — here, the CMS CY2026 Medicare Advantage / Part D Landscape file (September 2026 release), filtered to Utah and to contracts H4605 and H1994 for every plan, county, premium, maximum out-of-pocket, deductible and star rating stated; the same file, MA-PD category, for each county's total plans and carriers; Regence's October 20, 2020 news release for its county expansion, quoted as published; Cambia Health Solutions' and Select Health's own pages for each company's description of itself; Medicare.gov's PPO, HMO and joining-a-plan pages, quoted as published; the CMS fact sheet for the 2026 Part B premium; and CDC PLACES county data (2023). Plan facts are the 2026 plan year only; no 2027 plan, premium, county, network or star rating is stated, because CMS publishes the 2027 landscape on October 1. No carrier is endorsed or criticized, and a plan's presence or absence in a county is a filing fact, not a judgment. This is education, not advice; confirm plans, costs and eligibility with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.
Frequently asked questions
What is the difference between Regence and Select Health Medicare Advantage plans?
For 2026 in Utah, the plan type. Every Regence Medicare Advantage plan in the CMS landscape file is a PPO, and every Select Health plan is an HMO. Regence's two drug plans carry monthly premiums of $46.00 and $135.00 with in-network out-of-pocket limits of $5,000–$6,200; Select Health's three carry a $0 plan premium with limits of $5,500–$6,325. Regence files in 12 counties and Select Health in 13, and they share 9. Which one fits depends on your doctors, your prescriptions and how you use care, not on the name.
Is Regence Medicare Advantage a PPO or an HMO?
A PPO, all 3 plans. On a PPO, Medicare.gov says, "You can generally go to out-of-network providers for covered services, but you'll usually pay more," you do not need to choose a primary care doctor, and you do not need a referral to see a specialist. The same page advises contacting the plan before using an out-of-network provider "to ensure the services are medically necessary and covered by your plan."
Which Utah counties have Regence Medicare Advantage plans?
12 counties for 2026: Box Elder, Cache, Davis, Iron, Morgan, Salt Lake, Summit, Tooele, Utah, Wasatch, Washington and Weber. That is the list in the CMS landscape file for contract H4605. The Classic plan and the no-drug Valiance plan reach all 12; the Enhanced plan is filed in 7 of them. The count matches the 12 counties Regence announced in October 2020 for the 2021 plan year.
Which Utah counties have both Regence and Select Health Medicare plans?
9 counties: Cache, Davis, Iron, Morgan, Salt Lake, Summit, Utah, Washington and Weber. Box Elder, Tooele and Wasatch have Regence and not Select Health. Piute, Sanpete, Sevier and Wayne have Select Health and not Regence. The remaining 13 counties, including Grand and San Juan, have neither.
Is Regence or Select Health Medicare available in St. George?
Both. Washington County has 1 Regence drug plan and 2 Select Health drug plans among its 12 Medicare Advantage drug plans for 2026, from 5 carriers. Regence's Enhanced plan is not filed there. Iron County (Cedar City) has the same pairing.
Can I get a Regence or Select Health Medicare plan in Moab?
No. Neither carrier files a Medicare Advantage plan in Grand County or San Juan County for 2026. Grand County's 8 drug plans come from Humana and UnitedHealthcare. Medicare.gov's rule is that you must "Live in the service area of the plan you want to join," so a Moab or Monticello address cannot enroll in either one.
Sources
- CMS CY2026 Medicare Advantage / Part D Landscape file, September 2026 release — contracts H4605 (3 plans, 12 counties) and H1994 (5 plans, 13 counties): plan types, premiums, in-network limits, deductibles, star ratings; county MA-PD totals.
- CMS CY2026 Medicare Advantage / Part D Landscape — the CMS landscape download page.
- Regence newsroom — Regence BlueCross BlueShield of Utah offers Medicare plans in eight more counties (Oct. 20, 2020) — the eight added counties; "12 Utah counties"; the Valiance plans.
- Cambia Health Solutions — Regional health plans — "based in Salt Lake City"; "serving Utahns since 1944."
- Select Health — About — "a Utah-based nonprofit"; "our parent company, Intermountain Health."
- Medicare.gov: Preferred Provider Organization (PPO) plans — out-of-network rule, no referral, no separate drug plan with a no-drug PPO.
- Medicare.gov: Health Maintenance Organization (HMO) plans — the three out-of-network exceptions; referrals; "you may have to pay the full cost."
- Medicare.gov: Joining a Medicare health or drug plan — "Live in the service area of the plan you want to join."
- CMS fact sheet: 2026 Medicare Parts B premiums and deductibles — the $202.90 standard Part B premium.
- Medicare Plan Compare (Medicare.gov) — plan-by-ZIP lookup for the 2027 data from October 1.
- CDC PLACES: Local Data for Better Health, County 2023 — Grand County high blood pressure and diabetes prevalence.
