Imperial Insurance Companies
Imperial Preferred Gold
Plan ID98113UT0020002
Plan year2027Sold on HealthCare.gov
Plan typeHMOReferral needed for specialists
Metal levelGoldNot HSA-eligible
Sold in2 countiesSalt Lake and Utah
Deductible$1,000$2,000 family
Out-of-pocket max$8,000$16,000 family
Primary care visit$20in network
Generic drugs$5per prescription
1,535 Utah doctors and facilities in this plan's network · Directory updated Oct 22, 2026 · Monthly premiums are not shown: they depend on age, county and income. NPI Profile does not sell insurance; HealthCare.gov lists premiums and handles enrollment.
Find a doctor in this plan
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Listed in Imperial Insurance Companies's provider directory. Directories can be out of date, so call the office to confirm they take this plan.
What you pay with this plan
In-network costs for one person, from the CMS plan files for 2027. "After deductible" means you pay the full cost until you reach the $1,000 deductible.
Doctor visits
- Primary care visit
- $20
- Specialist visit
- $40
- Nurse practitioner or PA visit
- $20
- Preventive care and vaccines
- Free
- Urgent care
- 35% after deductible
Prescription drugs
- Generic drugsLimit: 30 items a month
- $5
- Preferred brand drugsLimit: 30 items a month
- $60
- Non-preferred brand drugsLimit: 30 items a month
- 50% after deductible
- Specialty drugsLimit: 30 items a month
- 50% after deductible
Tests and imaging
- Lab work
- 35% after deductible
- X-rays
- 35% after deductible
- MRI, CT and PET scans
- 35% after deductible
Emergencies and hospital
- Emergency room
- 35% after deductible
- Ambulance
- 35% after deductible
- Hospital stay
- 35% after deductible
- Outpatient surgery (facility)
- 35% after deductible
Mental health
- Therapy and counseling visits
- $20
- Inpatient mental health care
- 35% after deductible
Pregnancy
- Prenatal and postnatal care
- $20
- Delivery and hospital stay
- 35% after deductible
Other care
- Physical and occupational therapyLimit: 20 visits a benefit period
- $20
- Chiropractic care
- Not covered
- Eye exam for childrenLimit: 1 visit a benefit period
- Free
- Glasses for childrenLimit: 1 item a benefit period
- Free
- Adult dental
- Not covered
$4,190Having a baby (CMS example)
$1,320Managing type 2 diabetes for a year
$1,600A simple fracture
Every service in the plan file (70)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | Not covered | |
| Acupuncture | Not covered | |
| Allergy Testing | 35% after deductible | |
| Autism Spectrum Disorders | $20 | |
| Bariatric Surgery | Not covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | Not covered | |
| Chemotherapy | 35% after deductible | |
| Chiropractic Care | Not covered | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | 35% after deductible | |
| Dental Check-Up for Children | Free | 2 procedures a benefit period |
| Diabetes Education | 35% after deductible | |
| Dialysis | 35% after deductible | |
| Durable Medical Equipment | 35% after deductible | |
| Emergency Room Services | 35% after deductible | |
| Emergency Transportation/Ambulance | 35% after deductible | |
| Eye Glasses for Children | Free | 1 item a benefit period |
| Gender Affirming Care | Not covered | |
| Generic Drugs | $5 | 30 items a month |
| Habilitation Services | 35% after deductible | 20 visits a benefit period |
| Hearing Aids | Not covered | |
| Home Health Care Services | 35% after deductible | 30 visits a benefit period |
| Hospice Services | 35% after deductible | 6 months every 3 years |
| Imaging (CT/PET Scans, MRIs) | 35% after deductible | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | 35% after deductible | |
| Inherited Metabolic Disorder - PKU | 35% after deductible | |
| Inpatient Hospital Services (e.g., Hospital Stay) | 35% after deductible | |
| Inpatient Physician and Surgical Services | 35% after deductible | |
| Laboratory Outpatient and Professional Services | 35% after deductible | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | Not covered | |
| Mental/Behavioral Health Inpatient Services | 35% after deductible | |
| Mental/Behavioral Health Outpatient Services | $20 | |
| Non-Preferred Brand Drugs | 50% after deductible | 30 items a month |
| Nutritional Counseling | Not covered | |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | Not covered | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $20 | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 35% after deductible | |
| Outpatient Rehabilitation Services | 35% after deductible | 20 visits a benefit period |
| Outpatient Surgery Physician/Surgical Services | 35% after deductible | |
| Preferred Brand Drugs | $60 | 30 items a month |
| Prenatal and Postnatal Care | $20 | |
| Preventive Care/Screening/Immunization | Free | |
| Primary Care Visit to Treat an Injury or Illness | $20 | |
| Private-Duty Nursing | Not covered | |
| Prosthetic Devices | 20% after deductible | 1 item every 3 years |
| Radiation | 35% after deductible | |
| Reconstructive Surgery | 35% after deductible | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $20 | 20 visits a benefit period |
| Rehabilitative Speech Therapy | $40 | 20 visits a benefit period |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | Free | 1 visit a benefit period |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | 35% after deductible | 30 visits a benefit period |
| Specialist Visit | $40 | |
| Specialty Drugs | 50% after deductible | 30 items a month |
| Substance Abuse Disorder Inpatient Services | 35% after deductible | |
| Substance Abuse Disorder Outpatient Services | $20 | |
| Transplant | 35% after deductible | |
| Treatment for Temporomandibular Joint Disorders | Not covered | |
| Urgent Care Centers or Facilities | 35% after deductible | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Free | |
| X-rays and Diagnostic Imaging | 35% after deductible |
How this plan works
HMO: You pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies.
- Referral for specialists
- Required
- Coinsurance
- 35% after the deductible
- Works with an HSA
- No
- Network
- Imperial Value Common Spirit (UTN001)
- Sold in
- Salt Lake and Utah counties
Insurer's note on referrals: All
Summary of Benefits and Coverage (PDF) Plan brochure Covered drugs (formulary)
Other Imperial Insurance Companies plans on the same network
The same doctors and hospitals, with different costs.
| Plan | Metal | Deductible | Out-of-pocket max |
|---|---|---|---|
| Imperial Classic Gold HMO | Gold | $2,500 | $8,600 |
| Imperial Classic Silver HMO | Silver | $6,400 | $10,300 |
| Imperial Preferred Silver HMO | Silver | $6,500 | $10,500 |
| Imperial Classic Bronze HMO | Expanded Bronze | $7,500 | $12,000 |
| Imperial Preferred Catastrophic HMO | Catastrophic | $12,000 | $12,000 |
Questions about Imperial Preferred Gold
Does Imperial Preferred Gold cover my doctor?
Use "Find a doctor in this plan" on this page: choose the city, then the kind of doctor. The list shows providers Imperial Insurance Companies lists in this plan's network for 2027. Directories can be out of date, so call the office to confirm before your visit.
What kind of plan is Imperial Preferred Gold?
It is an HMO plan: you pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies. It is a Gold plan.
How much is a doctor visit with Imperial Preferred Gold?
A primary care visit costs $20. A specialist visit costs $40. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $1,000 deductible.
Where is Imperial Preferred Gold sold?
It is sold to people who live in Salt Lake and Utah counties, through HealthCare.gov. Imperial Insurance Companies's directory can also list providers outside these counties, such as pharmacies and specialists, but the plan itself is only for people who live in its area.
Why is there no monthly premium on this page?
Premiums depend on your age, county, household size and income, and most people get a subsidy, so a single price would mislead. HealthCare.gov shows the price for your household.
About this data
NPI Profile is not an insurance company, agent or broker, and it does not sell insurance or enroll anyone in a plan. It is a free reference tool built on public files that CMS and insurers publish, to help you compare Marketplace plans and check whether your current or future doctor is in a plan's network. It is not affiliated with CMS, HealthCare.gov, any state exchange or any insurer. Confirm costs and networks with the insurer and the doctor's office, and enroll on HealthCare.gov.
| Source | What it provides here | Source date |
|---|---|---|
| CMS Marketplace public use files (Plan Attributes, Benefits and Cost Sharing, Service Area) | This plan's costs, covered services, coverage examples and the counties where it is sold | Plan year 2027 |
| Imperial Insurance Companies's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Utah are counted. | Updated October 22, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 8, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less.
- Monthly premiums are not shown: they depend on age, county, household and income. HealthCare.gov lists them for your household.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
