If you live in Iowa, you may be eligible for Medicare. This federal program provides health insurance for Iowans who are age 65 or older, as well as some younger people with disabilities.
If you’re new to Medicare, it’s not always easy to figure out your coverage options. This article offers an introduction to Medicare Iowa, including Medicare Advantage options and how to choose a plan that’s right for you.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Iowa for the 2021 plan year:
- A total of 637,393 residents of Iowa are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly increased in Iowa compared to last year — from $9.46 in 2020 to $9.86 in 2021.
- There are 55 Medicare Advantage plans available in Iowa for 2021, compared to 39 plans in 2020.
- About 97 percent of Iowa residents with Medicare have access to buy a Medicare Advantage plan, and 96 percent have access to plans with $0 premiums.
- There are 12 different Medigap plans offered in Iowa for 2021.
There are a few Medicare coverage options in Iowa. You can choose either original Medicare, Medicare Advantage, or other supplemental plans.
Original Medicare is also called traditional Medicare. It’s offered through the federal government and includes:
- Part A (hospital insurance). Part A covers various hospital-related services, including inpatient hospital stays and limited skilled nursing facility care.
- Part B (medical insurance). Part B includes coverage for many medically necessary and preventive services, such as doctor’s visits, physical exams, and flu shots.
Medicare Advantage in Iowa
In Iowa, your other option is a Medicare Advantage (Part C) plan. These plans are offered by private companies and are regulated by the government. They cover all the same hospital and medical services as original Medicare, but they often include extra benefits, such as:
As of 2021, the following carriers sell Medicare Advantage plans in Iowa:
- Aetna Medicare
- Medical Associates Health Plan, Inc.
These companies offer plans in many counties in Iowa. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Medicare supplement plans in Iowa
Original Medicare doesn’t cover everything, but insurance companies offer plans that can help fill the gaps. If you need help paying for Medicare copayments, coinsurance, and deductibles, you can sign up for Medicare supplement insurance (Medigap).
Many companies offer Medigap plans in Iowa. In 2021, some of the companies offering Medigap plans throughout the state include:
If you’re younger than age 65, you’re eligible for Medicare Iowa if:
- you’ve been diagnosed with end stage renal disease (ESRD)
- you’ve been diagnosed with amyotrophic lateral sclerosis (ALS)
- you’ve been getting Social Security Disability Insurance for at least 2 years
For Iowans who are turning age 65, meeting one of the following criteria makes you eligible for Medicare:
- you’re either a U.S. citizen or a permanent resident who’s been in the country for at least 5 years
- you currently receive Social Security retirement benefits or qualify for these benefits
There are additional eligibility rules for Medicare Advantage plans in Iowa. To be eligible, you must live in the plan’s service area and have Medicare parts A and B.
When can I enroll in Medicare Iowa plans?
If you’re eligible for Medicare, you can sign up at certain times during the year. These times include:
- Initial enrollment period. If you’re first eligible when you turn age 65, you can sign up during this 7-month period. It starts 3 months before the month you turn age 65 and ends 3 months after the month of your 65th birthday.
- Medicare open enrollment period. The annual open enrollment period happens between October 15 and December 7. At this time, you can join a Medicare Advantage plan or switch to a new plan.
- Medicare Advantage open enrollment period. If you’re already in a Medicare Advantage plan, you can switch to another one between January 1 and March 31 every year.
Certain life events, such as losing a job that provides you with health coverage, will trigger a special enrollment period. This gives you an opportunity to sign up for Medicare outside of the standard enrollment periods.
In some cases, you may be signed up for Medicare automatically. If you’re eligible because of a disability, you’ll get Medicare after you’ve received 24 months of Social Security Disability Insurance. You’ll also be signed up automatically when you turn age 65 if you’re already getting Social Security retirement benefits.
Tips for enrolling in Medicare in Iowa
When you’re shopping for Medicare Advantage plans, narrowing down your options can be overwhelming. To make the process easier, keep these things in mind as you shop around.
- Your budget. Before choosing a plan, decide how much you can afford to spend. Consider not only monthly premiums, but other coverage costs, such as coinsurance, copayments, and deductibles.
- Your doctors. When you join a Medicare Advantage plan, you typically get care from doctors in the plan’s network. If you want to keep seeing your current doctors, make sure they’re in the network.
- Your coverage needs. Medicare Advantage plans may cover services that original Medicare doesn’t, and these extra benefits vary from plan to plan. If you need specific benefits, such as dental care or vision care, make sure your plan offers them.
- Your health needs. If you have a chronic health condition, such as cancer or an autoimmune disease, you may want to join a Special Needs Plan. These plans tailor their services and provider networks to better suit the needs of people with specific conditions.
There are many helpful resources that can help you understand Medicare Iowa, including:
- Senior Health Insurance Information Program (SHIIP) 800-351-4664
- The Social Security Administration 800-772-1213
- More than 600,000 Iowa residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have slightly increased for 2021 Medicare Advantage plans in Iowa.
- There are also several Medigap plan options if you live in Iowa and are looking for additional coverage.