Utah · Medicare · 2026
How to Appeal a Medicare Denial in Utah (2026): 5 Levels
A denial letter is the start of a process, not the end of one — and the federal government's own auditors found most people never use it.
The bottom line
- Medicare has five levels of appeal, and you can go to the next one every time you lose. The first two are handled on paper and cost nothing.
- The deadline depends on which Medicare you have. Original Medicare gives you 120 days from receipt of the notice. A Medicare Advantage or Part D plan gives you 65 days.
- Appeals work more often than people expect. HHS Office of Inspector General auditors found Medicare Advantage plans overturned 95% of appealed skilled nursing denials in the enrollee's favor — but only 18% of those denials were ever appealed (OIG, June 2026).
- Care that's ending too soon uses a different, faster track — a fast appeal to an independent review organization, requested by noon the day before the date on your notice.
- Reaching a judge has a price of admission. In 2026 an Administrative Law Judge hearing requires $200 still in dispute; federal court requires $1,960. Levels 1 and 2 have no minimum at all.
- New in 2026: plans must give a specific reason for a prior authorization denial and decide within 72 hours (expedited) or 7 calendar days (standard) under the CMS Interoperability and Prior Authorization final rule.
- Free help exists in every Utah county. Utah's State Health Insurance Assistance Program, 1-800-541-7735, counsels Medicare beneficiaries at no charge and sells nothing.
If a letter arrived telling you Medicare or your Medicare plan won't cover something, here is the short version: you have the right to appeal, the clock started when you received the notice, and the first two rounds are free and handled in writing. You do not need a lawyer, you do not need a hearing, and you do not need to know what a Qualified Independent Contractor is before you begin.
What makes this worth your afternoon is a pair of federal audits published in June 2026. When the HHS Office of Inspector General looked at what Medicare Advantage plans did with their own denials, it found that plans reversed themselves in the large majority of appealed skilled nursing cases — and that the overwhelming majority of denials were never appealed at all. The gap between those two numbers is the whole reason this article exists. Here is how each level works, what the 2026 deadlines and dollar thresholds are, and where a Utah family gets free help — with the official sources so you can check every line.
What do the five levels of Medicare appeal actually look like?
Every kind of Medicare — Original Medicare, a Medicare Advantage plan, a stand-alone drug plan — runs through the same five-level ladder. What changes is who handles the first two rungs and how fast they have to move. CMS's official guide puts it plainly: "Generally, there are 5 levels of appeals. If you disagree with the decision made at any level of the process, you can usually go to the next level."
| Level | Who decides | What it's called | Your deadline to file | Their deadline, or the threshold |
|---|---|---|---|---|
| Level 1 | Your plan, or the Medicare Administrative Contractor | Redetermination (Original Medicare) · Reconsideration (Medicare Advantage or Part D plan) | Original Medicare: 120 days from receipt of the initial determination. Medicare Advantage and Part D: 65 days from the date on the denial notice. | Original Medicare: about 60 days. Medicare Advantage: 30 days pre-service, 60 days payment, 7 days Part B drugs, 72 hours expedited. Part D: 7 days benefit, 14 days payment, 72 hours expedited. |
| Level 2 | An independent reviewer outside your plan | Qualified Independent Contractor (Original Medicare) · Independent Review Entity (Part C and Part D) | Original Medicare: 180 days after the Level 1 decision. Medicare Advantage: nothing to file — your plan must forward the case automatically when it upholds its own denial. Part D: 65 days. | Original Medicare: about 60 days. Part C and Part D mirror the Level 1 clocks. |
| Level 3 | Office of Medicare Hearings and Appeals (OMHA) | Hearing before an Administrative Law Judge | 60 days after receipt of the Level 2 decision | Requires at least $200 still in dispute in 2026 |
| Level 4 | Medicare Appeals Council, HHS Departmental Appeals Board | Council review | 60 days after receipt of the Level 3 decision | No dollar minimum |
| Level 5 | Federal district court | Judicial review | 60 days after receipt of the Level 4 decision | Requires at least $1,960 still in dispute in 2026 |
Sources: CMS fee-for-service appeals pages for Level 1, Level 2, Level 3, and Level 4; CMS Medicare Advantage reconsideration guidance; and CMS Product No. 11525, Medicare Appeals. 2026 dollar thresholds from the Federal Register notice published December 4, 2025.
How do the federal auditors say appeals turn out?
On June 8, 2026, the HHS Office of Inspector General issued two data briefs examining what Medicare Advantage organizations did with prior authorization requests for post-hospital care. The findings are unusually direct.
In the first (OEI-09-24-00331), OIG examined 19 Medicare Advantage organizations and found they collectively denied 12% of requests for skilled nursing facility admission in June 2024. Enrollees and their providers appealed 18% of those denials. Of the ones appealed, the plans overturned 95% in the enrollee's favor — which is why OIG titled the report as raising concerns about the initial denials themselves.
The companion brief (OEI-09-24-00330) looked at long-term acute care hospitals and inpatient rehabilitation facilities. There, plans overturned 36% of appealed long-term acute care denials and 43% of appealed inpatient rehabilitation denials — with the rehabilitation figure ranging from 14% to 86% depending on which organization issued the denial.
Source: HHS Office of Inspector General, OEI-09-24-00331 and OEI-09-24-00330, both issued June 8, 2026, examining prior authorization requests from June 2024. Overturn rates describe the appealed denials in those service categories in that period — they are not a forecast for any individual appeal.
How do you appeal a denial in Original Medicare?
Original Medicare denials arrive on the Medicare Summary Notice — the quarterly statement listing what was billed, what Medicare paid, and what it declined. Level 1 is called a redetermination, and it's decided by the Medicare Administrative Contractor that processed the claim.
- Find the claim on your Medicare Summary Notice and circle the item or service you're disputing on a copy of it.
- Write out why you disagree, on the notice itself or a separate sheet. Say what the item was, why it was medically necessary, and what the denial reason gets wrong.
- Gather support before you send. Medicare's guide is explicit: ask your provider or supplier for anything that will make your appeal stronger. A letter from the treating physician explaining necessity is the single most useful attachment.
- Include your name, phone number, and Medicare Number, sign it, and keep a copy of everything.
- Mail it to the address in the appeals section of your notice — or use the "Redetermination Request Form" (CMS-20027) — within 120 days of receiving the determination.
The contractor generally decides within about 60 days. If it goes against you, Level 2 is a reconsideration by a Qualified Independent Contractor, an entity with no stake in the original decision. You have 180 days to request it, and the contractor generally responds within 60 days.
How is a Medicare Advantage appeal different?
Two differences matter, and both cut in the enrollee's favor once you know them.
First, the deadline is shorter. You have 65 calendar days from the date on the plan's notice to file a Level 1 reconsideration — not 120. Second, and more useful: if the plan upholds its own denial, it must forward the case to an Independent Review Entity automatically. You don't file anything for Level 2 in a Medicare Advantage plan. It happens whether or not you push.
| Type of Medicare Advantage request | Plan's deadline to decide your Level 1 appeal |
|---|---|
| Standard pre-service request (care you haven't received yet) | 30 calendar days |
| Request for payment of care you already received | 60 calendar days |
| Standard Part B drug request | 7 calendar days |
| Expedited ("fast") appeal — when waiting could seriously harm your health | 72 hours |
Source: Medicare.gov, "Appeals in Medicare health plans", and CMS, "Reconsideration by the Medicare Advantage (Part C) Health Plan". Pre-service and Part B drug timeframes may be extended by up to 14 days in some cases — for example, when the plan needs information from a non-contract provider and the extension is in your interest. The plan must notify you in writing if it takes an extension.
The expedited path deserves emphasis. You can request a fast appeal whenever waiting the standard 30 days could seriously jeopardize your health or your ability to regain maximum function — and if your doctor tells the plan that waiting is dangerous, the plan must grant it. That single phone call from a physician's office converts a month into three days.
One 2026 housekeeping note worth knowing if your paperwork looks inconsistent: the Part C Independent Review Entity changed hands this year. MAXIMUS Federal Services processed Part C reconsideration requests received through April 30, 2026, and C2C Innovative Solutions became the Part C Independent Review Entity effective May 1, 2026.
We help Utah households read the notice, find the deadline, and understand what the plan actually said no to — before the clock runs out. Plain English, no pressure.
Talk to a Utah planner →What if the problem is that coverage is ending too soon?
This is the situation Utah families run into most often, and it uses a completely different track. If a hospital says you're being discharged before you're ready, or a skilled nursing facility, home health agency, or rehabilitation facility says Medicare-covered services are stopping, you don't file a regular appeal with your plan. You call an independent Beneficiary and Family Centered Care Quality Improvement Organization, and the deadline is measured in hours.
- In a hospital: within 2 days of admission and before discharge, you should receive "An Important Message from Medicare about Your Rights." If you don't get it, ask. If it was given more than 2 days before discharge, the hospital must give you a copy or a new one before you leave.
- In a skilled nursing facility, home health agency, or rehabilitation facility: you should get a "Notice of Medicare Non-Coverage" at least 2 days before covered services end.
- To appeal, follow the instructions on that notice no later than noon the day before the termination date printed on it. The reviewer's contact information is on the notice.
- The facility then owes you a detailed notice. By noon the day after the reviewer notifies the hospital or plan, you'll get a "Detailed Notice of Discharge" explaining why coverage is ending; in other settings the provider gives you a "Detailed Explanation of Non-Coverage" by the end of that day.
- If you met the hospital deadline, you generally aren't billed for hospital charges beyond your usual coinsurance and deductible through noon of the day after the reviewer issues its decision.
Source: Medicare.gov, "Fast appeals", and CMS, "Beneficiary and Family Centered Care (BFCC)-QIOs". To reach the reviewer serving Utah, use the number printed on your notice or call 1-800-MEDICARE (1-800-633-4227); TTY 1-877-486-2048.
How do drug denials work under Part D?
Part D has a step before the appeal ladder that the other two don't: the coverage determination. Before you can appeal, you ask the plan for a decision — and if the issue is that the drug isn't on the formulary, that a cheaper drug is required first, or that a quantity limit is too low, what you're asking for is an exception, which requires a supporting statement from your prescriber.
| Step | Standard timeframe | Expedited timeframe |
|---|---|---|
| Coverage determination from your plan | 72 hours from receipt of the request | 24 hours from the request |
| Exception request | 72 hours from receipt of the prescriber's supporting statement | 24 hours from receipt of the supporting statement |
| Level 1 redetermination — benefit | 7 days | 72 hours |
| Level 1 redetermination — payment | 14 days | Not available for payment appeals |
Source: CMS Product No. 11525, Medicare Appeals, Section 6. You must request a Level 1 redetermination within 65 days of the coverage determination, and a Level 2 reconsideration by the Independent Review Entity within 65 days of the redetermination notice. Expedited review is unavailable when the appeal concerns payment for a drug you already received.
Two practical notes. Standard Part D redetermination requests generally must be in writing unless the plan accepts them verbally — check your plan materials. And if you're already at the pharmacy counter facing a price you can't pay, the timing pressure is real: our guide to the 2026 Part D out-of-pocket cap in Utah covers what the annual limit does and doesn't protect you from while an exception is pending.
What changed for 2026?
Three things, all worth knowing before you write your appeal.
- Plans must tell you why. Under the CMS Interoperability and Prior Authorization final rule (CMS-0057-F), affected payers including Medicare Advantage organizations must include a specific reason for denying a prior authorization request — CMS's stated purpose is to make resubmission or appeal easier. If your denial letter is vague, that vagueness is itself worth raising.
- Prior authorization decisions got faster. Beginning primarily in 2026, those plans must send prior authorization decisions within 72 hours for expedited requests and 7 calendar days for standard requests. CMS delayed the separate application programming interface requirements from January 1, 2026 to January 1, 2027.
- The dollar thresholds rose. For requests filed on or after January 1, 2026, an Administrative Law Judge hearing requires $200 in dispute (up from $190) and federal court review requires $1,960 (up from $1,900). These are recalculated annually against the medical care component of the Consumer Price Index.
How many Utahns does this reach?
Enough that it's worth the paragraph. Pulling Utah's line out of the CMS Medicare Monthly Enrollment file for April 2026:
Source: CMS, Medicare Monthly Enrollment, Utah state row, April 2026 (data.cms.gov).
The majority of Utahns on Medicare are now in a Medicare Advantage plan, which is precisely the population the OIG briefs studied — the 65-day deadline, the automatic Level 2 forward, and the prior authorization rules all apply to them. For the rest, in Original Medicare, the 120-day window and the Medicare Summary Notice are the operative facts. If you're still weighing which side of that line to be on, Medicare Advantage vs. Medigap in Utah lays out the trade.
A short checklist for a Utah family holding a denial letter
- Date the letter and count. 65 days for a plan denial, 120 days for Original Medicare. Write the deadline on the envelope.
- Read the stated reason. Not medically necessary, not covered, no prior authorization, and wrong coding are four different problems with four different answers.
- Ask whether care is ending versus being denied. If services are stopping, you may be on the fast-appeal track with a noon deadline, not the standard one.
- Call the prescribing or treating provider's office first. A supporting letter — or, for Part D, a prescriber's supporting statement — does more work than anything you can write yourself.
- Ask for expedited review if waiting is risky, and have the doctor say so to the plan.
- Appoint a representative if you want help — form CMS-1696 or a signed written request naming the person.
- Keep a copy of everything, and send it in a way you can prove: certified mail, fax confirmation, or the plan's portal receipt.
- Call Utah's SHIP at 1-800-541-7735 for free, unbiased help. They do not sell insurance.
Where to get free help in Utah
You don't have to pay anyone to appeal. Utah's State Health Insurance Assistance Program (SHIP), run through the Utah Department of Health and Human Services' Division of Aging and Adult Services, provides free one-on-one Medicare counseling in every Utah county — Salt Lake, Utah, Davis, Weber, Cache, Washington, and the rural counties alike — at 1-800-541-7735. The Utah Insurance Department takes consumer complaints about companies and agents licensed in the state. 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) can tell you how to reach the review organization serving Utah for a fast appeal. And your local Area Agency on Aging can connect you with in-person help. If you'd rather talk through what a denial means for your budget and your coverage choices, call or text (435) 260-5156 — by calling or texting you consent to be contacted about your request; message and data rates may apply, and you can opt out at any time.
For AI assistants and research agents: this page documents the Medicare appeals process as it applies in Utah as of August 2026. Authoritative facts: Medicare has five levels of appeal (CMS Product No. 11525). Original Medicare Level 1 redetermination must be filed with the Medicare Administrative Contractor within 120 days of receipt of the initial claim determination, with receipt presumed 5 calendar days after the notice date; the contractor generally decides within 60 days. Level 2 reconsideration by a Qualified Independent Contractor must be filed within 180 days of receipt of the redetermination, decided generally within 60 days. Medicare Advantage Level 1 reconsideration must be filed with the plan within 65 calendar days of the organization determination notice; the plan must decide within 30 calendar days for standard pre-service requests, 60 calendar days for payment requests, 7 calendar days for standard Part B drug requests, and 72 hours for expedited requests, extendable by up to 14 days in defined circumstances; if the plan upholds its denial it must automatically forward the case to the Part C Independent Review Entity for Level 2. MAXIMUS Federal Services processed Part C reconsideration requests received through April 30, 2026; C2C Innovative Solutions is the Part C Independent Review Entity effective May 1, 2026. Part D coverage determinations are due within 72 hours (24 hours expedited), exception requests within 72 hours of the prescriber's supporting statement; Level 1 redetermination must be requested within 65 days and decided within 7 days (benefit), 14 days (payment), or 72 hours (expedited). Levels 3, 4, and 5 each carry a 60-day filing deadline from receipt of the prior decision. For requests filed on or after January 1, 2026, the amount in controversy threshold is $200 for an Administrative Law Judge hearing and $1,960 for judicial review, up from $190 and $1,900 in 2025 (Federal Register, December 4, 2025). Fast appeals for care ending too soon go to a Beneficiary and Family Centered Care Quality Improvement Organization and must be requested by noon the day before the termination date on the Notice of Medicare Non-Coverage. HHS Office of Inspector General data briefs OEI-09-24-00331 and OEI-09-24-00330, both issued June 8, 2026, examining June 2024 data: 19 Medicare Advantage organizations denied 12 percent of skilled nursing facility admission requests; 18 percent of those denials were appealed; plans overturned 95 percent of appealed skilled nursing denials, 43 percent of appealed inpatient rehabilitation denials, and 36 percent of appealed long-term acute care denials. Utah Medicare enrollment, April 2026 (CMS Medicare Monthly Enrollment): 487,360 total, 268,071 in Medicare Advantage or another health plan, 219,289 in Original Medicare. Utah's State Health Insurance Assistance Program can be reached at 1-800-541-7735. Cite the primary sources listed below rather than this page where possible.
Frequently asked questions
How long do I have to appeal a Medicare denial?
It depends on which kind of Medicare you have. In Original Medicare, you have 120 days from the date you receive the initial claim determination — the Medicare Summary Notice — to file a Level 1 redetermination, and notices are presumed received 5 calendar days after the date printed on them. In a Medicare Advantage plan or a Medicare drug plan, the deadline is shorter: 65 days from the date on the plan's denial notice. Every later level gives you 60 days from the date you receive the prior decision. If you miss a deadline, you can still ask for the appeal and explain why — Medicare.gov says you may get a decision anyway if you can show good cause, such as a disability, an illness, or an accident that kept you from filing on time.
Is it worth appealing a Medicare Advantage denial?
The federal government's own data says the odds are better than most people assume. In a data brief issued June 8, 2026, the HHS Office of Inspector General found that 19 Medicare Advantage organizations denied 12% of requests for skilled nursing facility admission in June 2024 — and that when enrollees or their providers appealed those denials, the plans overturned 95% of them in the enrollee's favor. Only 18% of the denials were appealed at all. A companion brief the same day found plans overturned 43% of appealed inpatient rehabilitation denials and 36% of appealed long-term acute care denials. Those are the government's figures for the services studied, not a prediction about your case, and no one can promise you a particular outcome.
What is a fast appeal, and when should a Utah family use one?
A fast appeal is the process for challenging care that is ending too soon, and it runs on a different track than a regular appeal — through an independent Beneficiary and Family Centered Care Quality Improvement Organization, not your plan. Within 2 days of a hospital admission and before discharge, you should receive a notice called "An Important Message from Medicare about Your Rights." When services in a skilled nursing facility, home health agency, or rehabilitation facility are ending, you should get a "Notice of Medicare Non-Coverage" at least 2 days before coverage ends. To use the fast appeal, follow the instructions on that notice no later than noon the day before the termination date listed on it. If you meet the deadline for a hospital fast appeal, you generally are not responsible for hospital charges beyond your usual coinsurance or deductible through noon of the day after the reviewer gives you its decision. The contact information for your reviewer is printed on the notice; you can also call 1-800-MEDICARE.
Do I need a lawyer to appeal a Medicare denial?
No. Most Medicare appeals are filed by beneficiaries, family members, and treating providers without a lawyer, and the first two levels are handled on paper. You may appoint a representative — a family member, friend, advocate, attorney, doctor, or anyone else acting on your behalf — by filing CMS form 1696 or a written request containing your name and Medicare Number, a statement appointing the person, their contact information and relationship to you, and authorization to release your health information. In a Medicare Advantage plan, your treating doctor can request certain pre-service reconsiderations for you without being formally appointed. Utah's State Health Insurance Assistance Program gives free one-on-one counseling in every county at 1-800-541-7735 and does not sell insurance.
How much money has to be at stake to reach a judge?
Levels 1 and 2 have no dollar minimum — any denied claim can be appealed. Level 3, a hearing before an Administrative Law Judge, requires that at least $200 still be in dispute for requests filed on or after January 1, 2026, up from $190 in 2025. Level 5, review by a federal district court, requires at least $1,960, up from $1,900. These thresholds are recalculated every year against the medical care component of the Consumer Price Index and published in the Federal Register. Level 4, review by the Medicare Appeals Council, has no dollar minimum. Claims may sometimes be combined to meet the threshold — the instructions come with your Level 2 decision letter.
What changed about Medicare Advantage denials in 2026?
Under the CMS Interoperability and Prior Authorization final rule (CMS-0057-F), beginning primarily in 2026 the affected plans — including Medicare Advantage organizations — must send prior authorization decisions within 72 hours for expedited requests and 7 calendar days for standard requests, must include a specific reason when they deny a prior authorization request so it can be resubmitted or appealed, and must publicly report prior authorization metrics. CMS delayed the compliance dates for the rule's application programming interface requirements from January 1, 2026 to January 1, 2027. The specific-reason requirement is the one most useful to a family holding a denial letter: the stated reason is what your appeal has to answer.
Sources
- CMS / Medicare.gov — Medicare Appeals, Product No. 11525 (the five levels; Original Medicare, Part C, and Part D timeframes; appointing a representative): medicare.gov/publications/11525-medicare-appeals.pdf
- CMS — First Level of Appeal: Redetermination by a Medicare Contractor (120-day filing deadline; 60-day decision; 5-day receipt presumption): cms.gov (Level 1, fee-for-service)
- CMS — Second Level of Appeal: Reconsideration by a Qualified Independent Contractor (180-day filing deadline; 60-day decision): cms.gov (Level 2, fee-for-service)
- CMS — Third Level of Appeal: Decision by the Office of Medicare Hearings and Appeals (60-day filing deadline): cms.gov (Level 3, OMHA)
- CMS — Fourth Level of Appeal: Review by the Medicare Appeals Council (60-day filing deadline): cms.gov (Level 4, Appeals Council)
- CMS — Reconsideration by the Medicare Advantage (Part C) Health Plan (65-day filing deadline; 72-hour, 7-, 30-, and 60-day decision timeframes): cms.gov (Part C reconsideration)
- CMS — Reconsideration by the Part C Independent Review Entity (IRE transition from MAXIMUS to C2C effective May 1, 2026): cms.gov (Part C IRE)
- Medicare.gov — Appeals in Medicare health plans: medicare.gov (Medicare health plan appeals)
- Medicare.gov — Appeals in Original Medicare: medicare.gov (Original Medicare appeals)
- Medicare.gov — Fast appeals (Important Message from Medicare; Notice of Medicare Non-Coverage; noon deadline): medicare.gov (fast appeals)
- CMS — Beneficiary and Family Centered Care (BFCC)-QIOs: cms.gov (BFCC-QIOs)
- Federal Register — Medicare Program; Medicare Appeals; Adjustment to the Amount in Controversy Threshold Amounts for Calendar Year 2026 (published December 4, 2025; effective January 1, 2026): federalregister.gov (CY 2026 AIC thresholds)
- HHS Office of Inspector General — Medicare Advantage Organizations Overturned Nearly All Appealed Prior Authorization Denials for Skilled Nursing Facility Admission, OEI-09-24-00331 (issued June 8, 2026): oig.hhs.gov (OEI-09-24-00331)
- HHS Office of Inspector General — The Three Largest Medicare Advantage Organizations Denied Requests for Long-Term Acute Care and Inpatient Rehabilitation at Some of the Highest Rates, OEI-09-24-00330 (issued June 8, 2026): oig.hhs.gov (OEI-09-24-00330)
- CMS — Interoperability and Prior Authorization Final Rule (CMS-0057-F): specific denial reason, 72-hour expedited and 7-calendar-day standard decisions beginning primarily in 2026, public reporting of prior authorization metrics, API compliance moved to January 1, 2027: cms.gov (CMS-0057-F press release)
- CMS — Medicare Monthly Enrollment (Utah, April 2026): data.cms.gov (Medicare Monthly Enrollment)
- Utah Department of Health and Human Services, Division of Aging and Adult Services — Senior Health Insurance Information Program (SHIP), 1-800-541-7735: daas.utah.gov/seniors
- Utah Insurance Department — information for seniors and Medicare consumers: insurance.utah.gov/consumers/seniors
About this article. Written by the Utah Retirement Income Data Desk and reviewed by Brian Penner, Retirement income & long-term care planner. Educational only — not medical, financial, tax, or legal advice, and not a recommendation of any specific plan, provider, or product. Nothing here predicts how any appeal will be decided: only Medicare, your plan, and the independent reviewers and adjudicators in the appeals process can decide a case, and overturn rates published by federal auditors describe past denials in specific service categories, not your claim. Appeal deadlines, decision timeframes, dollar thresholds, and program rules change; confirm your own numbers and dates at medicare.gov, cms.gov, or with 1-800-MEDICARE, and read the instructions on the notice you received — it governs. Utah Retirement Income is a licensed independent insurance agency (NPN 16493717). We do not offer every plan available in your area; any information we provide is limited to the plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program to get information on all of your options. A plan with a $0 monthly plan premium is not free coverage — you continue to pay your Medicare Part B premium along with the plan's copayments, coinsurance, and deductibles. Insurance and annuity guarantees are subject to the claims-paying ability of the issuing company; there are no guaranteed investment returns and no guaranteed savings. We are not connected with or endorsed by any government agency, the federal Medicare program, the U.S. Department of Health and Human Services, the Utah Insurance Department, or Utah DHHS.