Medicare Supplement (Medigap) Plans in Iowa

Medicare Supplement Plans, also known as Medigap plans, are private insurance plans that you can add on to Original Medicare. These plans are not mandatory but, for the cost of a monthly premium, they can help you lower other out-of-pocket costs you would normally pay with Original Medicare, like copayments and deductibles.

If you are eligible for Medicare in Iowa, you have the option of enrolling in a Medigap plan. While these plans aren’t mandatory, you can usually get the best price when you first become eligible for Medicare. This is also the only time that your coverage is guaranteed. If you wait to sign up for a Medigap plan, you may be denied due to things like pre-existing health conditions.

If you want to sign up for a Medicare Supplement Plan in Iowa, you should decide what kind of coverage you want, what your budget is, and then see what plans and prices are offered where you live. A GoHealth insurance agent can help you find specific Iowa Medigap plans that meet your needs.

There are 12 different types of Medigap plans, two of which are high-deductible versions of other plans. The federal government dictates what each plan has to cover, but each insurance company has some room to tailor individual plans and prices.

All Iowa Medigap plans will cover:

• Medicare Part A coinsurance for hospital and hospice care
• Medicare Part B coinsurance and copayments
• Blood needed for medical procedures (first 3 pints in a year)

Some Iowa Medigap plans will also cover:

• Part A coinsurance for skilled nursing care facility
• Part A deductible
• Part B excess charges
• Up to 80% of foreign travel emergency healthcare

You can compare each of the 12 available Medigap plans, including the high-deductible versions of Plan F and G, in this side-by-side comparison chart. Each of these plans is offered in Iowa, but availability can vary from one insurance company to another and between zip codes. Plans C and F can no longer be sold to people who became eligible for Medicare after January 1, 2020. This is the result of a change that prohibits plans from fully covering Part B deductibles.

The cost of your Medigap plan in Iowa will depend on the specific plan you choose, as well as the company offering that plan. You may also find that factors like your age, whether or not you are married, and what health problems you have can also impact the total cost of your supplement plan.

Rates vary by plan type and insurance company. Monthly premiums for Medigap policies in Iowa range from about $38 to $959 in 2022. For the two high-deductible plans, you can expect to pay a monthly premium of between $28 and $326. Most plans offer a $0 deductible for Part A services, and a $0 to $233 deductible for Part B services. For the high-deductible plans, however, you will pay around $2,400 for an overall plan deductible, and then pay no separate deductibles for Part A or B coverage. Copayment and coinsurance rates also vary by plan, but usually range from $0 to about 10% of the service cost after your deductible is met.

No matter which Medigap plan you choose, Original Medicare will pay its share of your healthcare costs first, and then your supplemental plan coverage will be applied. Although you will pay a premium for your Medigap coverage, for people who have a lot of healthcare needs — and expenses — the cost of your Medigap premium is usually less than you would pay for out-of-pocket costs without supplemental insurance.

You are eligible to purchase a Medigap plan if you are eligible for Original Medicare. However, if you don’t buy a Medicare Supplement Plan when you first enroll in Medicare, there’s no guarantee you will be able to buy a plan later on, and you could pay more if you do get one.

The best time to sign up for Medigap is during your initial enrollment period, which is a six-month window that begins the first month you have Medicare Part B. During this period, insurance companies cannot deny you coverage based on any pre-existing health conditions, or charge you more for the same plan. After the initial enrollment period, you are not guaranteed coverage, and your rates may increase based on your age and overall health.

If you do add a Medigap plan to your Original Medicare coverage, you should review which plans best fit your health needs and your budget. You can use Medicare’s online plan finder tool to help you locate plans and providers in your zip code, and compare what different plans cost and cover. GoHealth licensed insurance agents can also help you thoroughly compare plans in your area so you can find the right one that will fit your needs.

Some Medigap plans used to cover prescription medications, but this changed in 2006. Plans purchased after January 1, 2006, cannot include prescription drug coverage. If you bought your Medigap plan before that date, you can keep the coverage, but you may lose it if you make changes to your plan.

If you missed out on drug coverage in your Medigap plan, there are other options to help you pay for prescriptions. Even with Original Medicare and Medigap, you can enroll in Medicare Part D. These are private insurance plans that help you cover the cost of prescription medications. If you don’t sign up for one of these plans when you are first eligible, you will have to pay a late enrollment penalty based on how long you went without a drug plan.

Medicare Supplement Plans are only an option if you have Original Medicare. These plans cannot be combined with a Medicare Advantage plan because those plans are already designed to help you get more coverage or lower your out-of-pocket costs.

If you have Medicare Advantage and you want to enroll in a Medigap plan, you will have to drop your Medicare Advantage plan and go back to Original Medicare. Similarly, if you have Original Medicare with Medigap coverage and you want to join a Medicare Advantage plan, you will have to contact the company you purchased your Medigap policy through and cancel the plan before enrolling in Medicare Advantage.

If you switch from Original Medicare with a Medigap plan to a Medicare Advantage plan and you’re not happy with your choice, you have a one-time, 12-month grace period to switch back to Original Medicare and get your Medigap plan back or buy a different one.