About 64,700 people in Iowa receive health benefits through Medicare Advantage (MA) Plans. MA Plans provide all of your Part A and Part B Medicare benefits by contracting with a private company. Iowa offers six types of MA Plans: HMO (Health Maintenance Organization), HMO-POS (Health Maintenance Organization with Point-of-Service), PPO (Preferred Provider Organization), and PFFS (Private Fee for Service), SNP (Special Needs Plan), and MSA (Medical Savings Account). The Medicare Cost Plan is also offered in several counties in Iowa. Similar to Advantage HMO plans, these plans cover non-network provider services through Original Medicare and you pay coinsurance and deductibles. Which plans are available to you will vary with your specific location in the state. You can choose between plans that offer prescription drug coverage (Part D) and those that don’t, but all plans require that you have Medicare Part A and Part B. The average quality rating for Medicare Advantage Plans in Iowa is 3.44. Find details on all the available plans, including quality ratings, by visiting www.medicare.gov/find-a-plan.
Iowa plans with exceptional quality and performance are given a five-star rating. Plan ratings are determined by measurements in the following five categories: staying healthy, managing chronic conditions, responsiveness and care, member complaints and appeals, and telephone customer service. Drug plans are similarly evaluated and rated. Beginning in 2011, you can change to a five-star-rated Medicare Advantage Plan or Medicare Prescription Drug Plan available in your area at any time during the year. This special enrollment cannot be used to join a Medicare Cost Plan and you can change only once per year.
Medigap policies are another option for meeting your health insurance needs. These policies are sold by private insurance companies and provide supplemental insurance to help you pay for costs that extend beyond Original Medicare coverage. The choice between a Medicare Advantage Plan and a Medigap policy is either-or, as you cannot receive Medigap benefits if you are enrolled in an Advantage Plan. Medigap Policies can come with higher premiums than MA Plans, and costs may change annually. It is important to carefully review all of your plan and policy options every year.
Iowa offers various programs to assist seniors with what can be challenging aspects of the Medicare system. The Senior Health Insurance Information Program (SHIIP) provides personalized health benefits counseling and other Medicare-related assistance to Iowa residents.
The Extra Care program and the Program for All-Inclusive Care for the Elderly (PACE) help qualifying Medicare recipients in Iowa with medical expenses. Other programs in the state that may benefit Medicare recipients include the Diabetes Assistance Program and IowaCare.
More than 530,000 Iowa residents receive Medicare benefits, or about 17 percent of the state’s population. Of these, the majority (197,300) are aged 65-74 while nearly 125,000 are aged 75-84. These statistics generally match broader trends in the United States, though the percentage of individuals aged 19-64 receiving Medicare benefits in Iowa is slightly below the national average. About 260,000 of Iowa’s Medicare beneficiaries are women while just over 190,000 are men.
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