Medicare Supplement Plans in Iowa

Medicare Supplement Plans in Iowa help Medicare recipients who are enrolled in Original Medicare (Medicare Part A and Part B). The Federal Medicare Program (Original Medicare) typically pays 80% of Medicare-approved costs for hospital (in-patient) and medical (out-patient) health care and durable medical equipment (DME).

The beneficiary is responsible for the remaining 20% consisting of copays, deductibles, and coinsurance of Part A and Part B. No ceiling is placed on the amount of out of pocket costs the individual must pay, so Medicare Supplement insurance plans in Iowa (Medigap) can be purchased from Medicare-approved private insurance companies to help cover these expenses.

Medigap plans are named by letters (A, B, C, D, F, G, K, L, M, and N). These health insurance plans are standardized. The same letter plan will offer the same benefits regardless of insurance company or location. The insurance company sets the price for its health plans, so doing some research and talking to an insurance agent about Medicare plans would be wise. Your agent can assist you with finding a suitable life insurance policy if needed.

What is the best Medicare Supplement plan in Iowa?

The five best Medicare Supplement plans in Iowa are Plan F and High Deductible Plan F, Plan G and High Deductible Plan G, and Plan N.

Best for full coverage: Medicare Plan F

For Medicare enrollees in Iowa who became eligible for Medicare before January 1, 2020, Medigap Part F offers the best, most comprehensive coverage. Both Part A and Part B benefit deductibles are covered under this plan.

Standard Medigap benefits under Part F include:

• Medicare Part A deductible, coinsurance, and hospital costs
• Medicare Part B deductible, coinsurance, or copayment
• Part A coinsurance or copayment for Hospice care
• Skilled Nursing Facility coinsurance
• First 3 pints of blood
• Medicare Part B Excess Charges
• Foreign travel emergency benefits up to 80%

Best comprehensive coverage: Medicare Plan G

For Medicare beneficiaries new to Medicare after January 1, 2020, Medigap Plan G is the most popular of all Medigap plans. This Medigap plan offers more cost savings than Part F and is good for enrollees with pre-existing conditions.

Its coverage matches that of Part F except Medigap Part G does not cover the annual Part B deductible, which is $233 in 2022. It does offer lower monthly premiums that can offset paying the deductible.

High deductible Part G (and Part F) each offer the same benefits as the regular plans. The difference is that the high deductible plans set a higher out-of-pocket limit to be covered before 100% coverage kicks in. The out-of-pocket limit for 2022 is $2,490, up from $2,370 in 2021.

Best value: Medicare Plan N

Some enrollees want Medicare health plans with lower monthly premiums and greater predictability of pocket costs.

One popular feature of Plan N is that it covers 100% of Part B coinsurance. Cost-sharing includes a $20 copayment for doctor visits and some other out-patient services and a $50 copayment for Emergency Room visits that do not lead to hospital admission.

Some features of Medicare Plan N include:

• 80% coverage of Emergency heath care when in a foreign country following a $250 deductible
• Enrollees need to be flexible about choice of doctors (higher cost for providers who do not accept Medicare)
• No coverage for Excess Charges (up to 15% above Medicare-approved charges)
• Part B yearly deductible is not covered
• First 80 days of care in a Skilled Nursing Facility
• First three pints of blood

How Much Does a Medicare Supplement Plan in Iowa Cost?

Factors that determine the cost of a Medigap Policy include:

• Age
• Choice of insurance company
• Smoker or non-smoker
• Eligibility
• Gender

A 65-year-old nonsmoking female in Polk County (Zip Code 50047 would pay an average of $100 a month for a Medicare Supplement plan. This enrollee’s monthly premium rate for Medigap G would range from $108.21 to $221.02. The price range for Plan N would be between $79.30 and $160.02.

Insurers determine their Medigap rates in three ways:

• Issue Age: Rates are based on the enrollee’s age at the time the policy was purchased
• Attained Age: Rates will increase as the beneficiary’s age increases
• Community Rating: Rates will be the same for all beneficiaries regardless of ageWhen Can I Apply for a Medicare Supplement Plan?

Although you can apply for a Medicare Supplement Plan at any time during the year, there are not any yearly enrollment periods like there are for Medicare prescription drug plans and Medicare Advantage plans.

Each year from January 1 to March 31, a General Enrollment Period allows Medicare recipients to enroll in Part C or Part D Medicare or to drop or exchange their current policies for a different choice.

The Annual Enrollment Period from October 15 to December 7 gives Medicare beneficiaries an opportunity to review their current Medicare benefits and choose a different Medicare Advantage or prescription drug plan.

Medicare Supplement Open Enrollment Period

The best time to enroll in a Medicare Supplement plan is during the Medigap Open Enrollment Period (OEP) which is different for each person. It is a six month period that begins the first day you are both 65 years old and enrolled in Part B Medicare. It cannot be rescheduled or repeated unless the beneficiary has guaranteed issue rights.

During the Medigap OEP, you can enroll in the Medigap plan of your choice without any Medical Underwriting, waiting period for pre-existing conditions, or risk of being refused for coverage or charged extra due to poor health status. Once enrolled, you will not be dropped from coverage as long as you pay your Part B monthly premiums.

Annual and Open Enrollment Periods only apply to:

• Medicare Advantage and Part D drug coverage plans
• Aging into Medicare at age 65
• Losing a Medicare Advantage Plan
• Retiring from group coverage

If you or your spouse are still working and have creditable employer-based medical insurance, you may not want to sign up for Medicare Part B until employment or insurance coverage ends. You will have a Guaranteed Issue Right to enroll in a Medigap plan at that time. There are time limits, so you will need to consult with a Medicare agent to find out the details.

Medicare Advantage Plans

Medicare Advantage is a good way for many recipients to receive Medicare benefits because it often offers extra benefits such as dental, hearing, vision, fitness, and wellness benefits for no extra charge. Many Medicare Advantage Plans offer prescription drug coverage. You cannot enroll in a stand-alone prescription drug plan (Part D) with Medicare Advantage plans.

Advantage plans focus on Medicare preventive care to avoid more serious health problems that would be more costly.

These health plans do not typically cover Skilled Nursing Facility care, but they do cover some home health benefits that are deemed medically necessary by the health care provider.

Advantage plans are either a PPO (Preferred Provider Organization) or an HMO (Health Maintenance Organization). With a Medicare Advantage PPO, you will have your choice of any doctor in the U.S. that accepts Medicare. With the HMO, you will choose your doctor from a network list of providers.

Prescription Drug Plan

Prescription drug plan premiums in Iowa range from about $13 to $190 a month. New Medicare enrollees need to enroll in the plan of their choosing at the time of their Initial Enrollment Period when they turn 65 unless they have proof of creditable drug coverage though another source. This could be an employer-based plan or a private insurance plan.

Iowa residents with limited resources and incomes can qualify for Extra Help with prescription drug benefits. Eleven organizations that offer drug plans in Iowa have premium-free drug plans that are available to Medicare recipients who qualify for Extra Help.

Iowa Medicare Resources

https://shiip.iowa.gov/new-medicare