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 29, 2022
Reviewed by Dr. Brindusa Vanta, MD

Medicare is a form of health insurance for seniors over the age of 65 and people with disabilities that is backed by the federal government. As of 2020, more than 634,000 Iowa residents were enrolled in Medicare coverage, up from over 480,000 enrolled in 2010. This represents a growth of 24% over the last decade. Original Medicare remains the most popular option, with only 153,000 of 2020’s enrollees choosing an Advantage plan, but the Medicare Advantage program is slowly gaining popularity. 

Original Medicare has two main parts: Part A covers inpatient care at hospitals, skilled nursing centers, hospice care and some home health care services, and Part B covers regular doctor visits, medical transportation, diagnostic tests, medical equipment and outpatient procedures. Part A is offered for free as long as enrollees have made sufficient contributions to Medicare when they worked, and the standard Part B premium amount costs $170.10 each month in 2022. 

Part D is optional and covers prescription drugs, and enrollees can choose the level of coverage that suits their needs. Part D premiums are tied to how comprehensive the drug coverage is and costs more if enrollees need certain medications. 

The Medicare Advantage program is often referred to as Medicare Part C and allows enrollees to choose a private insurance plan instead of government-managed coverage. Original Medicare enrollees may also choose to add a Medicare Supplement (Medigap) plan to help with out-of-pocket costs.

This guide reviews all the available choices retirees have when it comes to medical coverage in the state of Iowa. It offers resources for helping seniors understand their benefits and creating personalized coverage that meets their needs. 

Options for Medicare Coverage in Iowa

Original Medicare is still the most popular choice for Iowa residents because it offers basic coverage that meets many peoples’ needs. Some residents may require more comprehensive coverage, however, and have the choice to review alternatives. Medicare Advantage plans and Medigap policies sold by private insurance companies offer ways to bring down out-of-pocket costs and add services not covered by Original Medicare.

Original Medicare (Parts A & B)

Original Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is open to seniors aged 65 and over, along with those under 65 years old, but with certain disabilities or end-stage kidney disease. It includes two parts. Part A covers inpatient hospital care, nursing home and skilled nursing care, hospice and home health care. Part B, or medical coverage, pays for medically necessary goods and services such as durable medical equipment, mental health services and emergency medical transportation. 

Unlike most private Medicare plans, Original Medicare’s provider network isn’t limited to the beneficiary’s geographic region, making it easier to obtain services while traveling within the country. In most cases, Medicare doesn’t pay for health services the individual receives outside the United States. 

Under this program, seniors pay for services as they receive them. They must pay an annual deductible, which is $1,556 for Part A and $233 for Part B in 2022. After they’ve paid this amount, Medicare covers all eligible services at 80%. Beneficiaries pay the remaining 20% out of pocket.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage is an alternative to traditional Medicare coverage that allows retirees to obtain coverage from a private insurance company at a considerable discount. Advantage plans are required to offer the same benefits as Part A and Part B, except for hospice care (which remains covered by Medicare Part A). The Advantage Plans often provide additional benefits and advantages such as vision and dental coverage, access to health clubs and discounts on wellness services, prescription drug benefits and medical transportation services.

There are four types of Medicare Advantage plans to choose from. The categories are Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee For Service (PFFS) and Special Needs Plans (SNPs). As these plans are all administered by private insurers, rules regarding eligibility, coinsurance, deductibles, premiums and out-of-pocket maximums all vary by the policies enrollees select. 

Who Should Consider Medicare Advantage

Medicare Advantage plans are ideal for seniors who:

  • Would like more control over out-of-pocket expenses through out-of-pocket maximums
  • Need coverage for vision and dental care
  • Are generally healthy, so may benefit from lower premiums
  • Don’t mind receiving managed care 

The Top 10 Medicare Advantage Plans in Iowa

Iowa residents considering Medicare Advantage have a lot of options to choose from, which could complicate the process of building custom coverage. The following table highlights the top plans in the state based on how many people have enrolled, monthly premiums and estimated out-of-pocket expenses as of April 2022. More information is available on the Medicare Advantage Plans in Iowa page

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

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Currently take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2022 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in Iowa

Understanding Medicare benefits and enrolling for coverage is often a complex, confusing process that frustrates seniors who are looking to build the right coverage for their needs. Iowa residents have access to resources to help them review plans, apply for coverage and determine if they qualify for financial assistance programs such as Medicaid. The following organizations offer free assistance and may be able to help in person, over the phone or virtually.

Social Security Administration

The Social Security Administration publishes guides on its website that help explain Medicare benefits, how to avoid costly penalties and information covering enrollment periods, how to enroll and where to get help. The website also reviews the key differences between Original Medicare and Medicare Advantage plans so that retirees can make informed choices.

The Social Security Administration has a portal where people can apply for Medicare and financial assistance. They can also arrange a meeting with someone in person to review their options.

Contact Info

Residents may contact the Social Security Administration by calling 1-800-772-1213 or using the Office Locator to find their closest office.

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Senior Medicare Patrol

Senior Medicare Patrol is a non-profit organization that educates seniors on issues regarding health care, Medicare fraud and how to protect themselves against threats such as identity theft. Iowa residents can contact Senior Medicare Patrol if they’re having trouble selecting coverage or need someone to help them apply for benefits. All services are offered free of charge.

Contact Info

Those in need of assistance can call the Senior Medicare Patrol hotline at 1-800-351-4664 or fill out the contact form on the Senior Medicare Patrol website.

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Iowa State Insurance Assistance Program (SHIIP)

The Iowa SHIIP program answers seniors’ questions regarding when and where to enroll in Medicare coverage, whether they’re qualified to receive financial aid and how to find the best Medicare plan for their needs and budget. They work closely with Iowa’s Senior Medicare Patrol to provide virtual and in-person services across the state.

Contact Info

Iowa residents may download the SHIIP fact sheet from the SHIIP website to find their local office or call 1-800-351-4664 to be connected with someone over the phone.

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Iowa Insurance Division

The Iowa Insurance Division provides resources to state residents in many health care matters. Retirees can contact a representative to learn more about their Medicare benefits, to report fraud or file a complaint against an insurance company. The website also offers resources for individuals looking for information about skilled nursing facilities, prescription drug savings plans and life insurance for seniors. 

Contact Info

Iowa residents may contact the Iowa Insurance Division by calling 1-515-654-6600 or filling out the contact form on its website.

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Iowa Department on Aging

The Iowa Department on Aging connects seniors in Iowa with local organizations that offer educational resources, support services and wellness services. Local offices can assist residents with legal services, health and nutrition programs, medical transportation, senior employment and Medicare assistance. The Department on Aging also offers valuable resources for family caregivers taking care of someone who requires a nursing level of care. 

Contact Info

Iowa residents may call 1-866-468-7887 for assistance over the phone or to obtain the location of their local area agency.

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