Any Iowa resident age 65 or older should enroll in the federal Medicare program. Once you enroll, you’ll receive medical coverage benefits from Parts A and B of the Medicare program. Parts A (for hospital stays) and B (for regular doctor visits) are designed to help you manage most of your health care costs. The goal of Medicare is to be comprehensive so that retirement-age citizens don’t have to worry about expensive health care costs or medical treatment. Unfortunately, there are “gaps” in Original Medicare coverage. If you aren’t careful, they could end up breaking your bank.

Medicare Plans in Iowa

Everyone with Original Medicare will pay a monthly premium and an annual deductible for Part B. Part A might be free – if you have a long enough employment history. The minimum requirement is 10 years, or 40 quarters. Anything less than that, and you could be paying some fairly expensive premiums in order to get access to your Part A benefits.

There are few things in life that are guaranteed; but for qualifying Medicare recipients, Part A benefits are one of them. As a matter of fact, if you refuse to pay for or accept Part A benefits, you can’t get Medicare, period. Part B, on the other hand, maybe optional. It largely depends on what other types of coverage you would like. Most agree to accept Part A benefits because the hospital and hospice treatments are so expensive. Part B benefits typically relate to doctor visits, inpatient treatment, and even some medical supplies.

There are certain situations in which seniors cannot opt out of Part B benefits, though. With Medicare Part C, Part B benefits are a part of that package. They cannot be rejected. Part B is also mandatory if you plan on purchasing Part D prescription coverage. Medicare Part C is a private insurance plan which replaces Original Medicare, and Part D prescription drug coverage is just one of many ways you can get help paying for your prescriptions.

For more information on Original Medicare, see the table below:

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services
Medicare Part C (Medicare Advantage)

  • Includes all benefits and services covered under Part A and Part B
  • Usually includes Medicare prescription drug coverage (Part D) as part of the plan
  • Offered by Medicare-approved private insurance companies
  • May include extra benefits and services for an extra cost
Medicare Part D (Drug Coverage)

  • Helps cover the cost of prescription drugs
  • Run by Medicare-approved private insurance companies
  • May help lower your prescription drug costs and help protect against higher costs in the future

Medicare Insurance Programs in Iowa

At this moment, there are more than half a million people (531,209 to be specific) receiving some form of Medicare benefits within the state of Iowa. Of those, 14% (or 74,369 people) have a Medicare Advantage plan, which we will explain in greater detail later. A significant 48% of Iowa residents (252,843 people) have Original Medicare, and are also supplementing it with a Medigap policy. We will discuss Medigap policies in greater detail also. The remaining 38% of Iowa Medicare beneficiaries either have employment benefit policies which are supplementing their Medicare policies, or they are relying upon Traditional Medicare alone to help cover their health care needs.

Why do so Many Iowa Residents Buy a Supplement?

Health care expenses have risen sharply over the past several years. Despite government attempts to make Traditional Medicare as comprehensive as possible, there are still gaps in coverage which require you alone to pay the difference. And if your health care needs fall through one of these coverage gaps, you could end up paying:

Medicare Part A Costs in 2022 Medicare Part B Costs in 2022
  • Part A is premium-free for most
  • Part A deductible is $1,556 per benefit period
  • Inpatient hospital stay days 61-90 is $389
  • The standard Part B premium is $170.10
  • The annual deductible for Part B is $233
  • Medicare pays 80%, you pay 20% out-of-pocket

Iowa is a great place to live – but like many other states in the Union, it is also an epicenter of rising healthcare costs. unless something changes, these Rising prices will only continue to go up. So what happens for people over the age of 65 who are no longer working, but are suddenly saying more and more expensive Medical costs? Most of them either end up purchasing a Medicare insurance Supplement Plan, or they pay out the nose for their medical care.

As comprehensive as Medicare is, there are certain things it does not pay for. Most senior citizens aren’t aware of these uncovered incidents – also referred to as “gaps” – in their Medicare coverage. if you need an extended Hospital stay, if you need end-of-life care, or even numerous blood transfusions, Medicare won’t cover you. And it will negatively affect whatever retirement finances you have left.

There are ways to protect your savings while also getting the medical care you need to enjoy your golden years. They’re called Medicare supplement plans. Some offer more than others, but it can come at a cost. It’s important to educate yourself about the policies available so that you can get the plan that best meets your needs.

If you want to protect yourself from Medicare coverage gaps, you can choose between a Medicare Advantage plan (AKA Medicare Part C) and a Medigap Insurance supplement. both of these plans come from private insurance companies who want to help you take care of your medical needs. But they are certainly not created equal.

Medigap Supplement Insurance in Iowa

For simplicity’s sake, each one of the ten available Medigap policies are assigned a letter of the alphabet in order to identify them: Plans A, B, C, D, F, G, K, L, M, and N are currently available for purchase in all 50 states. Plans E, H, N, and I are no longer available due to the Medicare Modernization Act of 2010. Plan A in Iowa offers the exact same coverage and benefits as Plan A in California; however, it will likely be cheaper in your state. You will may also have several different underwriters to choose from.

Here are the coverage and benefits options for each plan:

Iowa Medicare Advantage

If you would like to switch from receiving government Medicare to receiving identical Medicare coverage and benefits from a private health insurance company, then you might want to consider a Medicare Advantage policy. Federal law requires these policies to provide “equal or greater” benefits when compared with Traditional Medicare so that you don’t put yourself at too much of a disadvantage by relying on a private company to help manage your health care needs. Sometimes, Medicare Advantage policies offer extra benefits, like vision or dental, for a minimally higher cost.

One of the ways in which Medicare Advantage policy costs are kept low is via restricted networks. The companies are picky about which doctors and physicians they choose to allow into their HMO and PPO networks, so the doctor you may be seeing now might not be available to you if you switch to a Medicare Advantage plan. This is an important factor to keep in mind if you are thinking about purchasing such a policy.

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are special groups of doctors, hospitals, and facilities through which Medicare Advantage plans provide you with care.

by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
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