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Medicare Advantage Plans in Iowa

Explore popular providers, top-rated plan types, price comparisons, and enrollment periods for a Medicare Advantage Plan in Iowa.

Medicare Part C, or Medicare Advantage in Iowa, is a type of health insurance that gives Medicare beneficiaries alternative coverage options for Original Medicare.

Those eligible for Medicare benefits can buy Medicare Advantage plans in Iowa from private insurance companies selling them. These Medicare Part C plans cover the same benefits as Medicare Part A (hospital insurance) and Medicare Part B (outpatient medical insurance). Many of the Medicare Advantage plans also offer Medicare Part D (prescription drug coverage) and extra benefits bundled together in one plan.

Top rated Medicare Advantage providers in Iowa

  • Aetna: In Iowa, Aetna has tied for a share of about 26 percent of plan members.
  • Humana: Humana has attracted about 18 percent of Medicare Advantage plan members in the past.
  • Coventry: Coventry offers both PPOs and HMOs in some Iowa counties.
  • Senior Preferred: This small insurer has the only plans that earned a 5-star rating for quality from Medicare.

Popular Medicare Advantage plan types in Iowa

Best for network freedom: Medicare Advantage PPO plans

  • PPOs provide enrolled Medicare beneficiaries with a less limited network for health care services.
  • PPOs don’t require referrals from primary care physicians.
  • Monthly premiums for PPO plans typically range from $0 to $100.00.

Best plan for low out of pocket costs: Medicare Advantage HMOs

  • Most HMOs carry $0 monthly premiums.
  • HMOs require referrals to see specialists.

Best plans for people on a low income or with pre-existing health issues: Medicare Advantage D-SNP

  • D-SNPs, or Dual Eligible Special Needs Plans, cover those who qualify by income level or who have health conditions like end-stage renal disease.
  • D-SNP plans are for people with both Medicare and Medicaid coverage. These plans lower medical expenses for beneficiaries.

Iowa Enrollment Facts

  • Total number of people enrolled in Medicare Advantage plans in Iowa: 113,149
  • The number of people enrolled in Local HMO plans is 38,316
  • The number of people enrolled in Local PPOs is 64,458
  • People enrolled in Regional PPOs: are 0
  • The percentage of Medicare beneficiaries enrolled in Medicare Advantage in Iowa is still low at 27%, although it is showing steady growth.
  • The number of people enrolled in Medicare Advantage nationwide is over 26 million.
  • The percentage of Medicare beneficiaries enrolled in Medicare Advantage nationwide is 42%.

How much does Medicare Advantage in Iowa cost?

In Iowa, those who are eligible can enroll in an HMO Medicare Advantage plan with a $0.00 monthly premium. There may also be PPO plans with zero monthly premiums, although they are less common.

As of 2021, Iowa Medicare Advantage plans with bundled prescription drug coverage known as MAPDs, have an average monthly premium of $30.94 and average deductibles of $80.75.

How much do Advantage Plans cost in Iowa?
Plan Type Premium Range
PPO Plan$0.00 to $30.94
HMO Plan$0.00

When can I enroll in a Medicare Advantage plan?

1. Individual Initial Enrollment Period (IEP)

A. When you are 65 and you are:

  • Receiving retirement benefits from the Social Security Administration Railroad Retirement Board
  • IEP begins three months prior to the month of your 65th birth date.
  • It ends three months after the month of your 65th birth date.

B. If you are under age 65 and you are:

  • On Social Security or Railroad Retirement Board disability for at least 24 months.
  • In this instance, your IEP begins three months before the 25th month and ends three months after the 25th month of your receiving disability benefits.
  • If you have end-stage renal disease or ALS you can enroll in Medicare Advantage earlier.

2. Open Enrollment Period (OEP) or Annual Election Period (AEP)

During AEP people can take the following actions:

  • Enroll in a Medicare Advantage plan
  • Switch from one Part C plan to another
  • Switch from Medicare Advantage back to Original Medicare Part A and Part B
  • Make changes to existing prescription drug plans or enroll in a new Medicare Part D plan

AEP runs from October 15 to December 7, and changes take effect on January 1.

3. Medicare Advantage Open Enrollment Period

During the Medicare Advantage Open Enrollment Period, people can take the following actions:

  • Switch back to Original Medicare
  • Switch from one Part C plan to a different one

The Medicare Advantage Open Enrollment Period runs from January 1st to March 31st every year. Changes take effect the first day of the month following the switch.

4. Special Enrollment Periods (SEP)

During a special enrollment period, people who qualify can enroll in a Medicare Advantage plan with or without prescription drug coverage, or a stand-alone Medicare prescription drug plan.

Qualification for special enrollment periods include:

  • Moving away from your current service area.
  • Moving back to the U.S. after living abroad.
  • Moving into or out of a skilled nursing or long-term care facility or institution.
  • Being released from jail.
  • If Medicare ends a Medicare Advantage plan or changes its coverage. If your Medicaid coverage ends, or if you become eligible for both Medicare and Medicaid coverage.
  • Switching from Original Medicare Part A and Part B plus Medigap to Medicare Advantage.

5. Five-star Special Enrollment Period

If there is a new Medicare Advantage plan with a five-star rating in your service area and you wish to enroll, you can do so during this period.

6. Special Enrollment Period for the “Extra Help” program

If you qualify for Extra Help or Medicaid, you can make changes to your Medicare coverage during the following time periods:

  • January – March
  • April – June
  • July – September

Medicare Advantage Highlights:

Here are some features and facts about Medicare Advantage plans:

  • All Medicare Medicare Advantage plans must at least cover all benefits provided by Medicare Part A and Medicare Part B.
  • Private insurance companies selling Medicare Advantage plans must follow Centers for Medicare and Medicaid Services regulations.
  • Beneficiaries must also pay their Medicare Part B premiums for coverage eligibility.
  • Most Medicare Advantage health plans require enrollees to use healthcare providers that are within the plan’s network.
  • Medicare Advantage Prescription Drug plans (MAPDs) bundle Part D prescription drug coverage with other Medicare benefits in the same plan.
  • Many Medicare Advantage plans provide extra benefits. These can be vision, dental, and/or hearing care; wellness club memberships like SilverSneakers; over-the-counter medications allocations; transportation to and from doctors’ visits; and meal delivery programs.

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Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.