Medicare in Iowa

In this article...
  • Are you eligible for Medicare benefits? Find out more in this guide to Medicare in Iowa, which includes summaries of all the various plans.

What Iowa Medicare Plans Are Available? 

If you live in Iowa, you have access to Medicare Part A, Medicare Part B, Medicare Advantage and Medicare Part D via enrollment with Medicare. In addition to this, you have the option to work with private insurers to join a Medicare Supplement plan. A good portion of your premiums comes from the government and Social Security, but you will be financially responsible for a portion of your premiums and any copays you are required to meet. The plans available in Iowa follow below. 

  • Medicare Part A: This is referred to as Original Medicare and covers the cost of your inpatient services, such as hospital stays, nursing care, hospice services and home health care.  
  • Medicare Part B: The second part of Original Medicare is Part B, which covers the cost of your routine doctor’s visits, physical examinations and covered tests your doctor may order. Your medical supplies and medical devices are covered under this plan as well. 
  • Medicare Advantage: If you wanted to allow a private insurer to administer your coverage, you can select a Medicare Advantage plan. These plans are required by law to provide all of the benefits offered through Medicare Part A and B, but you may be able to receive additional coverage, such as prescription drug coverage, dental and vision. Your premium will depend on the coverage you select. 
  • Medicare Part D: Whether you elect to enroll in traditional Medicare or an Advantage plan, you are able to opt into a Medicare Part D plan to cover the cost of your medications. Those enrolled in Medicare Advantage plans will do this if the plan that they selected does not offer coverage for prescription drugs. 
  • Medicare Supplement Plans: Traditional Medicare only covers 80% of your medical expenses after you meet your deductible and the copayment you are responsible for may vary if you select a Medicare Advantage plan. A Medicare Supplement plan is meant to help you with your out-of-pocket expenses, such as your deductible and copay.  

Traditional Medicare plans are much more popular in Iowa than Medicare Advantage. In 2020, roughly 480,000 Iowans enrolled in Medicare Part A and B, compared with only 153,000 who selected a Medicare Advantage plan. It is advised that you consider your medical history, health risks and any diseases you are being treated for currently while deciding on a plan to meet your specific needs. A Medicare Supplement plan is an excellent way to reduce your financial responsibility if you fear you will not be able to afford your copays. 

Who Is Eligible for Iowa Medicare? 

There is a strong chance that you will be enrolled in a traditional Medicare plan the day you turn 65 years old. It is still advised to check your status and decide if you would like to amend your plan. Reasons you might not be enrolled automatically can include not collecting your Social Security benefits for four months before your birthday or not having contributed enough to Social Security during your lifetime. You can still enroll if this is the case, but you may face penalties later if you don’t sign up quickly. 

Part A and B

Medicare Part A is free as long as you meet the requirements for automatic enrollment. Medicare Part B does have a monthly premium, but you are not required to send in a monthly payment. It will be drawn out of your pension or Social Security payment each month instead. Part B costs around $150 a month, but premiums may rise over time. 

Medicare Advantage

If you select a Medicare Advantage plan, your coverage will be administered via the private insurer you select. Some of your premiums will be offset by your Social Security benefits, and what you will pay can depend on the level of coverage you are seeking. Some people pay next to nothing for their Advantage plans. Medicare Part D premiums fluctuate depending on the level of prescription drug coverage you seek. 

Enrollment

The initial enrollment period for Medicare begins three months before the month of your 65th birthday and concludes three months after that month. Enrolling during this period will ensure you do not receive a penalty. If you miss your initial enrollment period, you can sign up during the general enrollment period that begins at the beginning of each year and lasts until March 31. The cost of your coverage will be greater, however, which can result in more expensive health care for the rest of your life. 

If you missed your initial enrollment period because you were volunteering or serving abroad, still receiving coverage from your employer or taking care of someone with a disability, you can qualify for a special enrollment period. You will avoid any penalties you would have received if you meet the conditions for special enrollment. 

Medicare Supplement

Medicare Supplement plans are provided through private insurers, and you can shop for one that is right for you. As long as you enroll within six months of your birthday, you may not be denied coverage and your premiums and coverage may not be altered based on your age or health conditions. You lose this protection if you wait longer than six months after turning 65 to enroll in one of these plans. 

How Do I Enroll in Medicare in Iowa? 

To find out if you have been enrolled, alter your coverage or enroll in a Medicare plan when you are not covered, you can visit Medicare.gov. The process is very simple and all you need to do is follow the instructions on the webpage to sign up online. To enroll in a Medicare Supplement plan, you will need to go through a private insurer because Medicare does not administrate these policies. 

Contact Information for Iowa Medicare, Medicaid and Insurance Help 

For more information about Medicare in Iowa and how to get insurance assistance, you can visit the following sites. 

Senior Health Insurance Information Program 

Iowa Medicaid Eligibility and Enrollment 

Medicare Savings Program 

Iowa + Medicare 

Iowa Department of Administrative Services 

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