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Medicare in Iowa

GoHealth shares a cornucopia of information related to Medicare in Iowa

Reviewed by: Malinda Cannon, Licensed Insurance Agent. Written by: Bryan Strickland.

Key Takeaways

  • Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). in Iowa features hospital and medical coverage with the option of adding drug and supplemental coverage.

  • Medicare costs can vary and can be impacted by whether you enroll when first eligible at age 65.

  • Costs also vary with Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plans, which bundles coverages from Original Medicare while offering additional options like dental and vision care.

 

“If you build it, they will come.”

The movie “Field of Dreams” shone a spotlight on the state of Iowa and created a new tourist attraction — a baseball field carved into a cornfield.

Corn is king in Iowa, grown annually by farmers who know all the tricks of the trade.

And when it comes to Medicare in Iowa, you can count on GoHealth to deliver invaluable kernels of knowledge.

How do I apply for Medicare in Iowa?

Your options for applying for Medicare in IA include:

  • Enrolling online with the Social Security Administration. [1]
  • Visiting a local Social Security office. [2]
  • Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).

Medicare is a federal program that provides affordable healthcare for older Americans nearing retirement. At age 65, you can enroll in Part A (known as “hospital insurance”), Part B (“medical insurance”) or both — collectively known as Original Medicare. If you enroll in both, you have the option to add Part D to help with drug costs and Medigap (supplemental insurance) to help cover out-of-pocket expenses like copays and coinsurance.

Private insurance companies manage part D and Medigap plans with guidance from the federal government. That’s also the case with Medicare Advantage plans in Iowa.

Suppose you are enrolled in both Parts A and B. In that case, you have the option of switching to a Medicare Advantage plan that includes the benefits of Parts A and B, bundles drug and supplemental coverage, and offers additional coverages like dental and vision.

Is Medicare Free at 65?

Suppose you’re looking for affordable healthcare insurance. In that case, Part A provides hospital coverage without a monthly premium, though because of the plan’s deductibles, copays and coinsurance, it can’t be considered as “free.”

If you need low-cost insurance because of your financial situation, some people on Medicare in Iowa will qualify for a Medicare Savings Program. Some facing more severe needs may be eligible for Medicaid (more to come on that).

What Is the Cost of Medicare When You Turn 65?

When you first become eligible for Medicare in IA at age 65, you have the opportunity — if the circumstances are right for you — to save money beyond age 65 by signing up for Part B, Part D and Medigap. That’s because you can be assessed late-enrollment penalties for Part B and Part D that last a lifetime and can run into costly roadblocks if you wait to enroll in Medigap.

  • Part B: If you don’t have qualifying medical insurance when you turn 65 and don’t add Part B, you may face a 10% penalty on your eventual Part B monthly premium every 12 months after age 65 that you wait to enroll. Passing on Part B at 65 because you’re still using an insurance option at work usually creates a Special Enrollment Period that allows you to add Part B later without a penalty.
  • Part D: If you don’t have “creditable” drug coverage at age 65 and don’t enroll in a Part D prescription plan, you will face a 1% penalty for every month you wait to enroll. [3]
  • Medigap: Adding Medigap also can be expensive — not to mention potentially trickier. Generally speaking, it’s best to get your Medigap plan within the first six months after you enroll in Original Medicare. During this period, you won’t be asked medical questions that could impact your ability to secure a specific plan at a reasonable price.

Suppose you don’t enroll in any or all of the above offerings at age 65 and are concerned about facing higher costs. In that case, a GoHealth licensed agent may be able to find a Medicare Advantage plan that bundles those coverages and saves on your bottom line.

Who Qualifies for Medicaid in Iowa?

Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need and/or disability regardless of age.

The state of Iowa’s approach to Medicaid starts with qualifying financial situations and disabilities but goes much deeper. Overseen by the Iowa Department of Human Services, the Medicaid umbrella offers help to Medicare beneficiaries in need with the administration of Medicare Savings Programs. That only scratches the surface on Iowa’s offerings. [4]

Who Offers the Best Medicare Plan?

Comparing Medicare plans in Iowa can be complex, but GoHealth licensed insurance agents are trained to review your situation and figure out what plan is the right fit for your specific situation.

In the case of Original Medicare in IA, there’s only one plan — Parts A and B, which does open the option to add Part D and Medigap coverage from private insurance companies.

In the case of Medicare Advantage in Iowa, there are many plans.

  • Some Medicare Advantage plans include options for dental, vision, and hearing coverage.
  • Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs.
  • Some offer all of the above.
  • Some Medicare Advantage plans mirror Original Medicare but are more affordable.

What are the Pros and Cons of Medicare Advantage?

According to the Centers for Medicare & Medicaid Services, the average monthly premium for a Medicare Advantage plan in 2020 was $23.63. [5]

Every Medicare Advantage plan must offer, at the least, the same level of coverage as Original Medicare Parts A and B. In 2020, most people didn’t pay a monthly premium for Part A, but most people paid the standard monthly premium of $144.60 for Part B.

Medicare Advantage plans and Original Medicare have different coverage areas. While you can use Original Medicare nationwide, Medicare Advantage plans are usually limited to a network of providers in your area. The limited network allows Medicare Advantage plans in Iowa to often offer more affordable options.

Some people place more value on seeing virtually any doctor over the financial benefits of using a regional network of Medicare Advantage providers. However, many people find that they can still see their preferred doctors with Medicare Advantage. A GoHealth licensed agent can check for you while making sure you’re checking out other aspects of coverage that could impact your decision.

Medicare in Iowa by the Numbers

Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 588,923 people are enrolled in Medicare in Iowa. The total number of beneficiaries enrolled in Medicare Advantage in Iowa is 129,434. The previous year, 113,835 enrolled in Medicare Advantage. Medicare Advantage participation in Iowa went from 19.71% to 21.98% year over year. If you’d like to dive deeper into how Medicare in Iowa breaks down across the state, we provide a glance at who is using Medicare, and how.

Outline of Iowa
588,923
Beneficiaries with Part A & Part B
129,434
Medicare Advantage Beneficiaries
21.98%
Medicare Advantage Participation Rate
55.23%
% Female
44.77%
% Male
0.93
Average HCC Score
$8,900.29
Actual Per Capita Costs
15.54%
% Eligible for Medicaid
30.71%
% of Beneficiaries with an Emergency Department Visit
15.18%
Hospital Readmission Rate
94.58%
% Non-Hispanic White
1.47%
% African American
1.20%
% Hispanic
2.76%
% Other/Unknown

Table reflects the latest Beneficiary Demographics data: 2018, All Beneficiaries by State, Centers of Medicare & Medicaid Services (CMS)

Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.

Iowa Medicare Resources & Contacts

Beneficiaries spend an average of $8,900.29 each year on Medicare in Iowa. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Iowa-based resources, like these, may be able to help:

Iowa SHIIP AND SMP - Medicare counseling

1-800-351-4664

https://shiip.iowa.gov/

What should I know about Iowa SHIIP and SMP?

The State Health Insurance Information Program and the Senior Medicare Patrol offer free Medicare guidance and monitoring.

Iowa Department on Aging

1-866-468-7887

https://iowaaging.gov/

What should I know about the Iowa Department on Aging?

Connects Iowa residents with the state’s six Area Agencies on Agents for help with long-term care, nutrition and plenty in between.

Iowa Department of Human Services

1-855-899-7985

https://dhs.iowa.gov/ime/about

What should I know about the Iowa Department of Human Services?

Administers all of aspects of Iowa’s Medicaid program; phone number is for those new to Medicaid.

Iowa Insurance Division

1-515-654-6600

https://iid.iowa.gov/health-insurance

What should I know about the Iowa Insurance Division?

Provides helpful resources and tools for every form of health insurance offered in the state.

Nationwide Resources

Speak with an insurance agent that is licensed in Iowa about your Medicare questions.

1-855-792-0088 TTY: 711

Monday - Friday, 8 AM - 9 PM CT

Medicare & Medicaid

If you have general questions about Medicare in IA, or need help with current Medicare benefits.

1-800-MEDICARE (1-800-633-4227)

Social Security Administration

You can reach the SSA by phone for general questions. Not all questions can be answered over the phone.

Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online

Speak to SSA Representative, Monday - Friday, 8 AM - 7 PM ET

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

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New to Medicare Guide

Helpful information to get you started with enrolling in Medicare.

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Costs, coverage and enrollment details for each Medicare plan.

Low Income & Medicare Guide

For individuals with a qualifying income status.

A Caregiver’s Guide

For those helping a loved one with Medicare.