Page Health Insurance

Facts and Figures

  • Insurance
    Carriers
    11
  • Number of
    General Doctors
    32
  • Number of
    Hospitals

Breakdown of Insureds

  • Employer-sponsored health insurance 64%
  • Private plans 7%
  • Medicaid 15%
  • Medicare 13%
  • Others 1%

Insurance Carriers

State Government Insurance Programs Offered

Health Insurance Plan of Iowa (HIPIOWA)


www.hipiowa.com - HIPIOWA: Offers five comprehensive preferred provider plans each with a pharmacy benefit to choose from and a Medicare carveout plan. Will not pay for any pre-existing injury or sickness for the first six months of coverage.

HIPIOWA-FED


Federal program run by the Iowa Comprehensive Health Association hipiowafed.com www.PCIP.gov - HIPIOWA-FED : Covers broad range of benefits, including primary and specialty care, hospital care, and prescription drugs.

Medicaid


www.ime.state.ia.us/Members - : Inpatient and outpatient hospital services, physician services, medical and surgical dental services, nursing facility services for persons aged 21+, family planning services, nurse/midwife services, chiropractors, podiatrists, optometrists, psychologists, dental services, physical therapy, therapiesfor speech hearing and language disorders, occupational therapy, prescribed drugs, prosthetic devices, vision, mental health, hospice care and more

Medicaid for Employed People with Disabilities (MEPD)


www.ime.state.ia.us (Search: MEPD) - Inpatient and outpatient hospital services, physician services, medical and surgical dental services, nursing facility services for persons aged 21+, family planning services, nurse/midwife services, chiropractors, podiatrists, optometrists, psychologists, dental services, physical therapy, therapiesfor speech hearing and language disorders, occupational therapy, prescribed drugs, prosthetic devices, vision, mental health, hospice care and more

IowaCare


Inpatient and outpatient hospital, physician or advanced registered nurse practitioner, and dental services. Polk County residents may receive services at either Broadlawns Hospital or University Hospitals in Iowa City. Residents in other counties must receive services at University Hospitals in Iowa City. The state’s four mental health institutes will offer mental health services. Unlike Medicaid, IowaCare is not an entitlement, meaning that it depends on specific appropriations. Must be Iowa adults ages 19– 64 with income limit of 200% FPL, not be eligible for Medicaid, and be uninsured. Also eligible: Pregnant women with incomes at or below 300% FPL, if their medical costs can bring their monthly incomes to 200% FPL. Patients who do not meet the 200% FPL test but who receive State Papers services for chronic health problems are also eligible. One can apply for a part of a household even if some members do not have legal immigrant status. Proof of immigration status is required for non-U.S. citizens.

Healthy and Well Kids in Iowa (Hawk-i)


Qualified children receive services through a health plan participating in the program: doctor visits, outpatient hospital services, vaccines and shots (immunizations) emergency care, inpatient hospital services, prescriptions, vision, dental, hospice, speech and physical therapy, nursing care services, chiropractic care mental health/substance abuse. Beginning 3/1/2010, dental-only coverage for children who have health insurance but may not have dental coverage will be available. Each county has one or more health plans. Pre-Existing Health Conditions Covered GUARANtee D COV e RAG e Must be a U.S. citizen or a qualified alien and live in Iowa, be under 19 years old, with an income up to 300% FPL. Must have no other health insurance. Must not be a dependent of a State of Iowa employee. Children who qualify for Medicaid cannot get Hawk-i.

Medicare


www.medicare.gov - "Medicare offers Part A, inpatient care in hospitals and rehabilitative centers; Part B, doctor and some preventive services and outpatient care; Part C allows Medicare benefits through private insurance (Medicare Advantage); Part C includes Parts A, B, and C not covered by Medicare. Part D covers prescription drugs."

Heath Care Reform

Small business tax credits.  57,200 small businesses in Iowa could be helped by a new small business tax credit that makes it easier for businesses to provide coverage to their workers and makes premiums more affordable.1  Small businesses pay, on average, 18 percent more than large businesses for the same coverage, and health insurance premiums have gone up three times faster than wages in the past 10 years.  This tax credit is just the first step towards bringing those costs down and making coverage affordable for small businesses.

Closing the Medicare Part D donut hole. Last year, roughly 43,100 Medicare beneficiaries in Iowa hit the donut hole, or gap in Medicare Part D drug coverage, and received no extra help to defray the cost of their prescription drugs.2 Medicare beneficiaries in Iowa who hit the gap this year will automatically be mailed a one-time $250 rebate check. These checks will begin to be mailed to beneficiaries in mid-June and will be mailed monthly throughout the year as new beneficiaries hit the donut hole. The new law continues to provide additional discounts for seniors on Medicare in the years ahead and completely closes the donut hole by 2020. 

Support for health coverage for early retirees. An estimated 36,800 people from Iowa retired before they were eligible for Medicare and have health coverage through their former employers. Unfortunately, the number of firms that provide health coverage to their retirees has decreased over time.3  Beginning June 1, 2010, a $5 billion temporary early retiree reinsurance program will help stabilize early retiree coverage and help ensure that firms continue to provide health coverage to their early retirees. Companies, unions, and state and local governments are eligible for these benefits.

New consumer protections in the insurance market beginning on or after September 23, 2010.

Insurance companies will no longer be able to place lifetime limits on the coverage they provide, ensuring that the 1.9 million Iowa residents with private insurance coverage never have to worry about their coverage running out and facing catastrophic out-of-pocket costs.

Insurance companies will be banned from dropping people from coverage when they get sick, protecting the 171,000 individuals who purchase insurance in the individual market from dishonest insurance practices.

Insurance companies will not be able to exclude children from coverage because of a pre-existing condition, giving parents across Iowa peace of mind.

Insurance plans’ use of annual limits will be tightly regulated to ensure access to needed care.  This will protect the 1.7 million residents of Iowa with health insurance from their employer, along with anyone who signs up with a new insurance plan in Iowa.

Health insurers offering new plans will have to develop an appeals process to make it easy for enrollees to dispute the denial of a medical claim.

Patients’ choice of doctors will be protected by allowing plan members in new plans to pick any participating primary care provider, prohibiting insurers from requiring prior authorization before a woman sees an ob-gyn, and ensuring access to emergency care.

Extending coverage to young adults. Beginning on or after September 23, 2010, plans and issuers that offer coverage to children on their parents’ policy must allow children to remain on their parents’ policy until they turn 26, unless the adult child has another offer of job-based coverage in some cases. This provision will bring relief to roughly 8,330 individuals in Iowa who could now have quality affordable coverage through their parents.4  Some employers and the vast majority of insurers have agreed to cover adult children immediately.

Affordable insurance for uninsured with pre-existing conditions. $34.5 million federal dollars are available to Iowa starting July 1 to provide coverage for uninsured residents with pre-existing medical conditions through a new transitional high-risk pool program, funded entirely by the Federal government. The program is a bridge to 2014 when Americans will have access to affordable coverage options in the new health insurance exchanges and insurance companies will be prohibited from denying coverage to Americans with pre-existing conditions. If states choose not to run the program, the Federal government will administer the program for those residents.

Strengthening community health centers. Beginning October 1, 2010, increased funding for Community Health Centers will help nearly double the number of patients seen by the centers over the next five years. The funding could not only help the 83 Community Health Centers in Iowa but also support the construction of new centers.

More doctors where people need them. Beginning October 1, 2010, the Act will provide funding for the National Health Service Corps ($1.5 billion over five years) for scholarships and loan repayments for doctors, nurses and other health care providers who work in areas with a shortage of health professionals. This will help the 8% of Iowa’s population who live in an underserved area.

New Medicaid options for states. For the first time, Iowa has the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.

"Vista Health Solutions" www.nyhealthinsurer.com Tel (888)215-4045 Email info@nyhealthinsurer.com