Bordered by a river on either side of the state, Iowa is home to many bridges, due to the many lakes and rivers throughout. Iowa is also the manufacturing site and corporate headquarters of Quaker Oats and Winnebago. Larger cities like the capital, Des Moines, and Cedar Rapids provide the state with art, historical and military museums and other cultural attractions, as well as an interesting selection of restaurants and festivals. Iowa has many parks to offer outdoor recreation and exercise to its residents, including Gray’s Lake Park in Des Moines with over 300 miles of trails, Iowa West Foundation Trailhead Park in Council Bluffs, and more throughout the state.
Residents of Iowa have access to several great health insurance companies, including Blue Cross Blue Shield of Iowa, Coventry and UnitedHealthOne. To compare plan types and pricing specific to you and your family, enter your zip code below. You can get a more accurate idea of the options you have an how much it will cost to get the coverage you need. If you have any questions, you can call one of our agents at 888 803 5917, and they will be happy to help you.
Overall health in the state of Iowa has declined over the past two years, though it still falls in the top 50%. Ranked by UnitedHealth Foundation at number 17 in 2011, it was 15 in 2010, and appears to be declining over the years. Things could always change if Iowans take the proper measures to improve their health, like participating in wellness programs through their insurance plan and seeking necessary health care services. There are certain issues that caused a drop in their ranking, including a fluctuation in the overweight/obese adult population, which is now at 675,000. More adults in Iowa are also diabetic, the disease affecting 174,000 individuals over the age of 19 in 2011. Bing drinking is also a problem among Iowans, with 17% of the state’s adults qualifying for this statistic.
There are a few redeeming qualities of Iowa’s health, including a low amount of uninsured individuals (11% of the population), low rate of infant mortality and small percentage of children living at poverty level. Smoking is decreasing in popularity among Iowa adults, now at 16%, which has come down from 23% since ten years ago. If Iowa residents utilized their health insurance or public health programs to a greater extent and made lifestyle changes to improve their everyday health, these statistics could take a turn for the better. There are plenty of outlets for outdoor recreation and physical activity in Iowa, even if you choose walking over driving, these alterations can lead to a big overall impact.
Health Insurance Plans
- HealthGear plans are available in four different types with varying levels of coinsurance. HG A2500 and HG A5000 plans cover 80% of covered services after you have met the deductible, while HG B3500 plans cover 70% and HG C5000 cover 60%. With every type of HealthGear plan, there is a $40 copay for primary care office visits and $60 for specialists, and preventive care covered in full with network doctors. Generic prescription drugs are covered for a $15 copay, all other tiers are not covered but there is no separate deductible. Covered care includes inpatient and outpatient hospital services, home health care, transplants and hospice care.
- Spectrum plans come in two deductible options, $1,500 and $3,500 for individuals, and double for families. Both plans cover preventive care with network providers at 100%, and physician office services, prescriptions of all tiers, and emergency care for a copay as soon as your plan begins. After a $100 prescription drug deductible, you receive all tiers of prescriptions for a reasonable copay. Covered services for major medical care are available for 10% coinsurance after deductible with Spectrum plans.
- Torch plans from CoventryOne come in a variety of deductibles, ranging from $1,000 to $5,000, with 80/20 coinsurance after deductible. Immediate benefits include physician office services with a specialist or non-specialist for a copay and preventive care covered in full with network providers. After you meet the deductible, there is 80% coverage on major medical care with in-network providers. There is also a separate prescription deductible of $100 and drugs available for a copay.
- TorchLight plans have a higher deductible, ranging from $2,000 to $10,000 for individuals. These plans cover 60% of your health care costs for inpatient and outpatient services once your deductible has been met. When your plan begins, doctor’s office visits are available for a copay, as well as urgent care services. There is a $500 prescription deductible, after which all levels of prescriptions can be purchased for a low copay. Preventive care is no cost when using in-network providers.
- Prism plans have the most comprehensive set of benefits, offering 100% coverage after deductible. Once you have met the deductible amount, which can be $2,500, $3,500 or $5,000, you can see a physician, receive inpatient care, surgery, skilled nursing, home health care, prescription drugs and more for no cost. As soon as your plan starts, you may receive preventive services covered in full within the PPO network. These plans are convenient and easy to use and provide a great number of benefits.
- Copay plans in Iowa are available in a range of deductibles, from $1,000 to $10,000 for individuals, and offer several benefits as soon as your plan starts. By choosing the Copay Select plan, you receive more covered services than the Value plan, including all tiers of prescription drugs, and the option of either 70%, 80% or 100% coverage based on the deductible you choose. Value plans are more limited in benefits but more cost effective, covering 70% of care after deductible. When your plan starts, you can visit a primary care doctor or specialist for a $35 copay (for the first four visits), and use in-network doctors for preventive care at no cost.
- High Deductible plans come in three types in Iowa, Plan 100, Plan 80 and Saver 80. Plan 100 offers coverage in full after deductible when using in network doctors for all types of medical care. Plan 80 also gives members access to a large amount of benefits, including inpatient and outpatient hospital care, prescription drugs, emergency room visits and more for 20% coinsurance. Saver 80 plans have a lighter level of coverage, but provide necessities for a very low monthly premium and a wide range of deductibles. Each of these plans covers preventive services at 100% from the start date of your plan.
- Health Savings Account plans have high deductibles and the allow the opportunity to use a health savings account (HSA) to pay for medical care or build savings. These plans are available with either 70/30 or 100%coverage after deductible on a wide array of medical services, including doctor’s office visits, prescriptions, hospital care, surgery and more. Deductibles range from $2,500 to $5,000 for individuals for HSA 100 plans, and $1,250 to $5,000 for HSA 70 plans. With the ability to allocate funds specifically for health care costs, HSAs offer peace of mind, flexibility and control – with a comprehensive set of benefits in your health plan.
Public Health Options
A variety of public health programs are available in the state of Iowa, mostly available through Medicaid, for residents who may not be able to afford health insurance. Medical Assistance offers various plans to families, children, pregnant women, disabled and aged persons and other groups of individuals so that those without insurance can still receive health care. To see who else is eligible for Iowa Medical Assistance, visit our Medicaid Eligibility by State page. Other state-funded programs are available for temporary assistance or occasional services, but not full health care. The Pre-Existing Condition Insurance Program is also available to individuals in Iowa who have pre-existing conditions, and there is a high-risk pool as well. For a full list of services, visit the Iowa Department of Human Services.
- Medicaid: medical insurance for low income residents of Iowa who have children, are elderly or disabled, or have medical needs of another sort.
- IowaCare: health care coverage for uninsured adults who do not qualify for Medicaid and meet certain income and other criteria.
- Healthy & Well Kids in Iowa (Hawk-I): affordable health insurance for children with working families living in Iowa.
- Health Insurance Premium Payment (HIPP) Program: assistance for individuals on Medicaid or another type of health plan to pay their premiums and keep their insurance.
Health Insurance Laws
Health insurance is regulated by state and federal government to protect the business of the insurer and the well-being of the insured. In Iowa, laws permit insurance companies to take several actions when it comes to individuals with pre-existing conditions. A pre-existing condition is defined in Iowa by the prudent person standard, opening the possibility of a person’s medical history to anything for which they could have used medical attention – even if they did not. As long as there was some kind of illness or condition, whether it be a skin rash or diabetes, before applying for health insurance, it can be counted as a pre-existing condition. Once an insurer reaches this conclusion, they can decide not to sell the person a plan, or they can raise the premiums they pay monthly.
Iowa health insurers also have the right to accept someone with a pre-existing condition for a plan but refuse to pay for care related to the condition. By issuing an exclusion period, which can last up to 24 months in Iowa, the insurer opts out for a certain time limit. They can also use an elimination rider to permanently excuse themselves from covering treatment for the pre-existing condition. If you change from one company to another, you can credit your previous plan towards the exclusion period to pay for care that is not covered, however.
There is an insurance alternative for Iowans who have pre-existing conditions through the Pre-Existing Condition Insurance Plan. Iowa PCIPs are run by the state, and offer a basic set of health care benefits for low rates to individuals who qualify. These plans will expire at the end of the year 2013, when the Affordable Care Act makes it possible for all adults with such conditions to receive a fair plan from private insurers. Under the ACA, insurance companies are not allowed to reject anyone, nor can they issue exclusion periods or elimination riders.
When anyone has health insurance in Iowa, they are protected by the guaranteed renewability provision. Because of this law, insurance companies have to offer to renew their clients’ plans when their term has ended, so to avoid any gaps in coverage. This law also prevents insurers from canceling coverage as a result of a policy-holder becoming ill after they have enrolled in their plan. Guaranteed renewal is part of HIPAA, therefore making sure anyone who uses the health care system is protected and can use services freely as long as they meet their payments.