Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 19, 2022

Medicare is a federal program providing health care for Iowans aged 65 or older and for some younger residents with qualifying disabilities. They also have the option of enhancing their health coverage through Medicare Advantage, sometimes called Medicare Part C. Medicare Advantage (MA) plans work similarly to Original Medicare, but often provide more comprehensive coverage. Private insurance companies under contract with Medicare and Medicaid Services and regulated by the government administer Medicare Advantage plans. 

Medicare Advantage provides hospital and medical insurance through Medicare Part A (hospitalization) and Part B (general health care), just like traditional Medicare. But Original Medicare doesn’t include Part D prescription drug coverage, so beneficiaries must purchase this coverage separately. Most Medicare Advantage plans include drug coverage as part of their benefits. MA plans may also provide dental and vision plans and other services that recipients won’t get with traditional Medicare. 

Medicare recipients in Iowa who also choose Medicare Advantage are a smaller group than the national average. In 2020, about 24% of Iowa’s Medicare recipients chose MA plans, compared to 38% on average nationwide. By 2021, the number of beneficiaries participating in MA plans had risen to 27%. Nearly 645,000 residents were enrolled in Medicare in Iowa in 2022, with 61 Medicare Advantage plans available to 97% of those enrolled.

The Top 10 Medicare Advantage Plans in Iowa

Medicare Advantage has multiple plan types available throughout most of the state. However, plan offerings vary by county, so beneficiaries should confirm what types are offered in their area. Below is an overview of the top 10 Medicare Advantage providers in Iowa based on their total enrollment. The enrollment numbers on all plans were combined to create the overall total by provider. The table also offers a cost range for each provider based on the plan with the lowest and highest costs. The information for each plan was accurate as of April 2022, but costs can fluctuate. Seniors can go to Medicare.gov to get the most current information on the plans available.

Name

Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types

UnitedHealthcare

86,385

4

$0

$36

HMO, PPO

Aetna Medicare

58,400

4

$0

$0

HMO, PPO

Humana

29,298

4

$0

$96

HMO, PPO, PFFS

HealthPartners UnityPoint Health

5,573

5

$0

$49

PPO

Wellmark Advantage Health Plan

3,100

0

$0

$49

HMO, PPO

Health Alliance Medicare

770

4

$0

$165

HMO

MediGold

395

4.5

$0

$29

HMO, PPO

Quartz Medicare Advantage

326

5

$0

$144

HMO

Highmark Inc.

96

0

$0

$0

PPO

Medica

70

0

$0

$16

HMO, PPO

How Medicare Advantage Plans Work in Iowa

Seniors switching to Medicare Advantage plans may have lower out-of-pocket costs compared to Original Medicare, but they typically have to use the doctors and health care providers within a plan’s network. Beneficiaries have many different types of Medicare Advantage plans from various insurance providers to compare. The two primary types of Medicare Advantage plans in Iowa include Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans.

Beneficiaries also may find some Private-Fee-For-Service (PFFS) plans and Special Needs Plans (SNP) in some parts of the state. The descriptions below help seniors understand their options better.

What Medicare Advantage Plans Cover in Iowa

MA plans can vary greatly in price and in coverage options, providing beneficiaries with greater flexibility. Because they tend to be an all-in-one solution, Medicare Advantage plans offer the same level of Medicare Part A hospital insurance and Medicare Part B medical insurance coverage as Original Medicare, plus other types of coverage it doesn’t provide.

Most MA plans include prescription drug coverage, which isn’t an option under Original Medicare. They also frequently offer various additional benefits, such as vision care, hearing aids, wellness programs and dental care.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Iowa

Seniors in Iowa who want to enroll in a Medicare Advantage plan must be enrolled in Medicare Part A and Part B before making the switch. They cannot be enrolled in Medigap (Medicare Supplement coverage), which can’t be used in conjunction with MA plans.

Standard eligibility requirements of traditional Medicare still apply with Medicare Advantage. Thus, applicants must be aged 65 or older or have a qualifying disability if they’re younger. All applicants must be United States citizens or authorized immigrants. 

Eligibility may vary based on plan type. While HMOs and PPOs don’t generally have any special requirements beyond the regular prerequisites, SNPs always have additional conditions that must be met, as they are meant for beneficiaries with specific special needs.

All plans will require the beneficiary to reside within the area served by a particular plan. Service areas often vary by county. Beneficiaries also must enroll at designated times of the year during open enrollments, a schedule for which can be found below. There are also some special enrollment periods for which individuals may qualify.

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Iowa

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.




State-Wide Medicare Advantage Resources

Senior Health Insurance Information Program (SHIIP) – Senior Medicare Patrol (SMP)

Senior Health Insurance Information Program (SHIIP) – Senior Medicare Patrol (SMP) is Iowa’s state-run State Health Insurance Program, offering dedicated information to seniors seeking assistance about Medicare and other health insurance topics. One major facet of what SHIIP-SMP offers is counseling for seniors considering their Medicare options. This program allows seniors to ask questions, receive information and compare Medicare Advantage and Original Medicare plans with the help of a highly trained and unbiased professional health care counselor. The website also contains valuable information seniors can use when making Medicare decisions, including Medicare misconceptions and testimonials about how the SHIIP-SMP program has helped others. In-person Welcome to Medicare seminars are also hosted periodically throughout the state. All seniors using Medicare and those soon to turn 65 who want information about their Medicare options can take advantage of the services SHIIP-SMP has to offer.

Contact Info

Seniors can contact the SHIIP-SMP program at 800-351-4664 to ask questions or schedule a counseling session.

Iowa Department on Aging

The Iowa Department on Aging is the branch of the state government that supports the needs of all aging Iowa residents. Here, seniors can find information, services and events that pertain to aging resources throughout the state. This includes Medicare support and assistance seniors can use to make educated decisions. The Department of Aging also sponsors LifeLong Links, a program that connects seniors with resources in their local area, including the five Area Agencies on Aging operating throughout the state. These organizations provide access to local resources as well as state-level programs and services. 

Contact Info

Seniors can contact the Iowa Department on Aging toll-free at 800-532-3213 or locally at 515-725-3333.

Local Medicare Advantage Resources

Aging Resources of Central Iowa

Aging Resources of Central Iowa is a senior-specific agency serving Boone, Dallas, Jasper, Madison, Marion, Polk, Story and Warren counties. Seniors living in the region can access a wealth of free resources through this organization, including an Information and Assistance hotline. Highly trained benefits experts are available Monday through Friday from 8:00 a.m. to 4:30 p.m via the hotline to answer questions about Medicare, as well as other health and aging-related services available in Central Iowa. All seniors and their families or caregivers living within the agency’s service area have free access to the services provided by Aging Resources of Central Iowa.

Contact Info

Seniors can contact Aging Resources of Central Iowa at 515-255-1310 or 800-747-5352. The Information and Assistance hotline can be reached by calling 515-255-1310 or via email at [email protected].

Email
Milestones

Milestones is an Area Agency on Aging located in Eastern Iowa that serves seniors in Appanoose, Clinton, Davis, Des Moines, Henry, Jefferson, Keokuk, Lee, Louisa, Lucas, Mahaska, Monroe, Muscatine, Scott, Van Buren, Wapello and Wayne counties. Through Milestones, seniors have access to a wealth of resources related to health care and more. This includes access to comprehensive information about Medicare plans and policies, both via phone counseling and in-person appointments at the Davenport and Ottumwa offices. Free and confidential, this support service allows seniors to receive answers to their Medicare questions, compare plans and make educated decisions. Seniors in Eastern Iowa have full access to all Milestones programming. Seniors living outside of the local area can access select assistance opportunities.

Contact Info

Milestones can be reached by calling 855-410-6222 or 319-752-5433 for the Burlington office, 563-324-9085 for the Davenport office and 641-682-2270 for the Ottumwa office. Emails can be sent through the agency website’s contact page.

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Northeast Iowa Area Agency on Aging

The Northeast Iowa Area Agency on Aging, or NEI3A, serves Allamakee, Black Hawk, Bremer, Buchanan, Butler, Chickasaw, Clayton, Delaware, Dubuque, Fayette, Grundy, Hardin, Howard, Jackson, Marshall, Poweshiek, Tama and Winneshiek counties. With support for independent seniors, caregivers and persons with disabilities, NEI3A can connect eligible individuals with a wide variety of resources across the region. This includes Medicare counseling for seniors who qualify, offering free, confidential and unbiased information to assist in decision-making. Through this service, seniors can ask questions, clarify plan details and compare Medicare Advantage plans.

Contact Info

Seniors living in one of the counties served can call 800-779-8707 or complete a request for information form on the organization’s website.

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Elderbridge

One of the largest Area Agencies on Aging in the state, Elderbridge serves 29 counties across North Central, Northwest and Central Iowa. This organization is committed to providing trusted information that empowers seniors, with resources that range from health care to fitness. Medicare assistance services through Eldercare are vast, including a Benefits Enrollment Center that allows for easy enrollment in select plans as well as a Medicare Savings Program. The Iowa Senior Medicare Patrol is also a valuable service, ensuring seniors understand their plan options and are aware of signs of Medicare abuse and fraud. In addition, Eldercare offers comprehensive, free Medicare counseling, empowering seniors to make educated decisions with the aid of a confidential counselor. Elderbridge services are available to all seniors within the agency’s service area, as well as their caregivers and families.

Contact Info

Seniors can contact Elderbridge at 800-243-0678 or 641-424-0678 for the Mason City office, 515-955-5244 for the Fort Dodge office, 712-792-3512 for the Caroll office or 712-262-1775 for the Spencer office. A contact form is also available on the agency’s website.

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