October 6, 2016
Medicare is a government-sponsored insurance program that offers health insurance coverage for people 65 and over and those under 65 with certain disabilities or chronic diseases. If you’re a Medicare beneficiary in Iowa, you can choose to receive your benefits under Original Medicare, which includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). You may also have the option to enroll in a Medicare approved private health insurance plan under Medicare Advantage (Medicare Part C) or a stand-alone prescription drug plan under Medicare Part D.
As an Iowa resident, you’re eligible for Medicare if:
You can apply for Medicare through the SSA. If you’re applying for retirement benefits, you can enroll in Medicare at the same time. In Iowa, you can apply:
You may enroll in Original Medicare, Part A and/or Part B, in Iowa during the following enrollment periods:
Enrollment in Medicare Part A (hospital insurance) is premium free for most Iowa residents, although in certain cases some individuals may have to pay a monthly premium. Medicare Part A benefits in Iowa include, but are not limited to, the following:
Medicare Part B, which is medical insurance, carries a monthly premium. If your annual income is above a certain amount set by Medicare, you may have to pay an additional fee. Medicare Part B in Iowa includes, among others, the following services and supplies:
As an Iowa resident, you may choose to receive your Medicare benefits through a Medicare Advantage plan (Medicare Part C), which is provided by private insurance companies approved by Medicare. A Medicare Advantage plan in Iowa, as in the rest of the United States, is required by the government to offer at least the same coverage as Original Medicare, Part A and Part B (except hospice care, which continues to be covered under Part A). Some Medicare Advantage plans also offer extra coverage not available under Original Medicare, such as routine hearing benefits or routine vision coverage. Some plans, called Medicare Advantage Prescription Drug (MAPD) plans, provide Medicare prescription drug coverage as well as health benefits in a single plan. If you join a Medicare Advantage plan or a Medicare Advantage Prescription Drug plan, you’re still required to continue paying your Medicare Part B premium to keep your coverage. You may also have a premium for your Medicare Advantage plan.
As an alternative to a Medicare Advantage Prescription Drug plan, you can receive Part D prescription drug benefits by enrolling in a stand-alone Medicare Prescription Drug Plan in Iowa. Medicare Prescription Drug Plans are offered by Medicare-approved insurance companies. They are designed to work alongside your Medicare Part A and/or Part B coverage. To enroll in a Medicare Prescription Drug Plan you must be enrolled in Part A and/or Part B and live in the plan’s service area. Premiums for Medicare Part D prescription Drug Plans in Iowa vary, as they do in the rest of the United States, generally depending on the kind of the coverage you choose.
If you decide to stay with Medicare Part A and Medicare Part B for your coverage, you may want to consider enrolling in a Medicare Supplement (Medigap) plan available in Iowa. Medicare Supplement plans are offered by private insurance companies and can help you pay for out-of-pocket costs for services covered by Medicare Part A and Part B. Medicare Supplement plans offer different standardized benefits (usually identified by a letter—A, B, C, etc.). Medicare Supplement plan premiums vary by the coverage type and the insurance company you choose. You can also add a Medicare Prescription Drug Plan to your Medicare Part A and Part B and Medicare Supplement insurance to have Medicare prescription drug benefits. You cannot have a Medicare Supplement plan if you enroll in a Medicare Advantage plan.
Your Medicare coverage options in Iowa will generally vary depending on the county in which you live. For example, if you live in Dubuque County, you may have different Medicare plan offerings than a resident of Cedar Rapids in Linn County. With the various Medicare options available in Iowa, you may want to customize your search for plans based on your individual health needs and preferences.
To get an overview of how Medicare works in Iowa and to learn what plans might be available, see: