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Iowa Health Insurance

Want to get the best health insurance for you and your family? We will provide you with instant and accurate health insurance quotes in Iowa to help get you started. We will also give you information on how to save on your health coverage. Enter your Iowa zip code above to start your search and read more about the health insurance plans available in your area.

Facts and Figures

  • Place in State
    Health Report Card
    17th
  • Insured 2,691,270
  • Uninsured 312,600
  • Insurance
    Carriers
    10
  • Number of
    Primary Care Physicians
    4600
  • Number of
    Hospitals
    118

Breakdown of Insureds

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

Insurance Carriers

State Health Report Card

1. Smoking among adults went down from 23.2 percent to 16.1 percent in the past ten years, There are 373,000 Iowa adults who still smoke. 2. In the past ten years, 204,000 individuals added to the number of obese adults in Iowa, increasing the total to 675,000 adults. 3. In the past year, the percentage of children living in poverty went down from 14.7 percent to 12.5 percent of those under 18 years old. 4. During the last ten years, diabetes went up from 6.1 percent to 7.5 percent of the adult population. There 174,000 adults living with diabetes in the state. 5. Overall healthiness may decline over time in Iowa, as indicated by a lower ranking for determinants than for outcomes.

Iowa Health Insurance Laws and Regulations

Iowa health insurance plans are required to be sold with a guaranteed renewability clause. With this clause, you can renew your coverage every time you see it necessary provided you’ve fully paid your premiums. Furthermore, insurers cannot cancel a subscriber’s health coverage due to health reasons. When writing new Iowa health insurance plans, insurers can exclude coverage for a pre-existing condition. Your health insurer will not pay for expenses related to your health condition during this period which can last for up to 12 months. However, when you decide to switch plans, your new plan will not be subjected to another exclusion period as long as you’ve maintained continuous coverage. Small businesses operating in Iowa with 2 to 50 employees have the option of purchasing group health plans available in other parts of the state. However, certain condition must be met in order to maintain group health coverage such as a minimum percentage of employee participation and a minimum employer contribution to each member’s premiums. Failure to comply with these requirements may result in the cancellation of group health plans. Iowa health insurance quotes for group coverage can vary according to the risk factors of its members. However, small group health plans cannot be cancelled due to a member’s health condition. Self-employed residents are not eligible to purchase group health coverage unless they have one other employee. However, premium payments for individual health insurance may be tax-deductible.     

Heath Care Reform

With the new health care law, children under the age of 26 can choose to stay under their parent’s Iowa health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In Iowa, more than 18,000 young adults have insurance coverage through this provision as of June 2011.

The new health care law allowed nearly 46,000 Medicare policyholders in Iowa to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, more than 42,000 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $616 per person or a total of $25,876,475 was saved in Iowa.

Previously uninsured individuals without health coverage because of a pre-existing condition can now apply for a Pre-Existing Condition Insurance Plan. This plan is available to U.S. citizens or legal residents with a pre-existing condition and have been uninsured for at least 6 months. In 2011, 238 individuals in Iowa have benefited from this new law.

When looking at Iowa health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. All private policyholders in Iowa will get greater value for their premium payments because of this 80/20 rule.

Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all Iowa health insurance with no deductibles or co-pays. In 2011, more than 388,000 Medicare subscribers and 611,000 individuals with private policies received such services in Iowa.

Under the new law, insurance companies are no longer allowed to impose an annual dollar limit-a cap on the yearly spending for your benefits, or a lifetime dollar limit-a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 1,187,000 Iowa residents have benefited from this law.

All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In Iowa, 84 community health centers received a total of $25.4 million to fund these improvements.

In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. Iowa has already received a total of $10.9 million to support its policies, programs, and communities to help its residents lead healthier lives.

State Government Insurance Programs Offered

Health Insurance Plan of Iowa (HIPIOWA)

877-793-6880

Health Insurance Plan of Iowa (HIPIOWA) offers health insurance for individuals with serious health conditions who may have been denied coverage. Applicants can choose among the five different comprehensive preferred provider plans available under the program each with a pharmacy benefit and a Medicare carve out plan. Eligibility: 1. Must be a resident of Iowa for at least 60 days; denied health coverage within the last 9 months because of a pre-existing condition, or insurance offered has fewer benefits or more expensive premiums, or previous insurance was not lost due to failure to pay premiums. 2. Must be living in Iowa (regardless of length of stay) provided applicant is a beneficiary of TAA, HIPAA-eligible, Basic and Standard Policy plan holder.

HIPIOWA-FED

877-505-0513

This plan is a temporary high-risk pool created by the Health Care Reform and operated by HIPIOWA. This program provides coverage for individuals with a pre-existing condition who have a hard time finding private coverage. Coverage includes a wide range of benefits which includes hospital care, primary care, specialty care, and prescription drugs. Eligibility: 1. Must be a U.S. resident living in Iowa. 2. Must be uninsured for at least six months. 3. Must have a qualified pre-existing health condition.

Medicaid

515-281-6899

Medicaid offers coverage to low-income individuals and families who cannot pay for their medical care. Applicants for this program should meet financial and other eligibility requirements. Medicaid benefits include physician services, hospital services, prescribed drugs, medical and surgical dental services, dental services, vision, optometrists, chiropractors, podiatrists, psychologists, nurse and midwife services, therapy (physical, occupational, speech), mental health and more. Eligibility: 1. Must be U.S. citizens or legal residents living in Iowa. 2. Must not exceed income limits: Pregnant women: 300% FPL. Children aged 0-5: 133% FPL. Children aged 6-19: 100% FPL. Aged, blind, and disabled: Singles earning 75% FPL with asset limit of $2,000. Couples earning 83% FPL with asset limit of $3,000.

Medicaid for Employed People with Disabilities (MEPD)

800-338-8366, 800-972-2017

Medicaid for Employed People with Disabilities (MEPD) aims to assist individuals with disabilities to work and have access to medical assistance. MEPD offers physician services, hospital services, prescribed drugs, medical and surgical dental services, dental services, vision, optometrists, chiropractors, podiatrists, psychologists, nurse and midwife services, therapy (physical, occupational, speech), mental health and more. Eligibility: 1. Must have a disability (determined by the Department of Human Services). 2. Must be under 65 years. 3. Must be employed or self-employed. 4. Must not exceed income limit of 250% FPL and asset limits of $12,000 for singles and $13,000 for couples.

IowaCare

800-338-8366 515-256-4606

Iowa Care offers limited coverage to qualified adults who are not eligible for Medicaid. This program aims to provide some health coverage to those who would otherwise not get it. Iowa Care covers inpatient and outpatient services, physician or advanced registered nurse practitioner, and dental services.

Healthy and Well Kids in Iowa (Hawk-i)

800-257-8563 TDD: 888-422-2319

Hawk-i in Iowa is created to provide quality health insurance to uninsured children under 19 years living in the state. Benefits covered include doctor visits, outpatient hospital services, hospital services, inpatient prescriptions, emergency care, nursing care services, immunizations, chiropractic care, vision, dental, hospice, speech and physical therapy, mental health and substance abuse. Eligibility: 1. Must be U.S. citizen or qualified resident living in Iowa. 2. Must be under 19 years old.  3. Must have no other health insurance and ineligible for Medicaid coverage. 4. Income must not exceed 300% of the federal poverty level.

Medicare

(Age 65 and up) 800-633-4227

Medicare is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.

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