What You Need to Know
Iowa insurance companies must accept your Medicare Supplement plan application if you’re in your Medigap Open Enrollment Period or if you have guaranteed issue rights.
The three most popular Medigap policies are Plans F, G, and N.
Iowa residents have access to several Medicare resources, including the Senior Health Insurance Information Program (SHIIP), which offers free counseling to Medicare members.
What Are Medicare Supplement Plans in Iowa?
Medicare is a health insurance program for Iowans age 65 and older as well as younger people who have a disability or who have specific health conditions like end-stage renal disease. While Medicare offers a lot of benefits, it also has significant out-of-pocket costs such as deductibles, coinsurance and copayments.
Medicare Supplement plans help cover those out-of-pocket costs. These plans are standardized by letter (A-N). This means Plan A with one company offers the same benefits as Plan A from another company. However, prices vary from insurance company to insurance company.1
Learn more about these plans (also known as Medigap policies) and how they work for Iowa residents.
When Can You Enroll in a Medigap Policy?
You can apply for a Medicare Supplement plan at any time. However, if you apply outside of your Medigap Open Enrollment Period or if you don’t have guaranteed issue rights, insurance companies can use your medical history to decide whether to accept your application or charge you a higher monthly premium.
Your Medigap Open Enrollment Period is six months long. It starts the month you are both 65 (or older) and enrolled in Medicare Part B. During this period, insurance companies must sell you a Medigap policy and they can’t charge you more due to your health.2
Guaranteed issue rights are when insurance companies are required to sell you a plan due to specific circumstances. When you have these rights, insurers also can’t charge you more based on your health.
The circumstances typically involve losing or changing your health coverage. For example, you have guaranteed issue rights if you move out of a Medicare Advantage plan’s service area or if you have employer coverage along with Original Medicare and the employer coverage is ending.3
When to Sign Up
The best time to sign up for a Medicare Supplement plan is during your Medigap Open Enrollment Period, which starts when you are 65 or older and also enrolled in Medicare Part B and lasts for six months.
What Are the Most Popular Medicare Supplement Plans?
The three most popular Medigap policies in Iowa in are Plans F, G and N.
Most Popular Medigap Polices in Iowa (2019)4
|Plan||% Enrolled||# Enrolled|
Plan F’s popularity makes sense, given that it has more benefits than any other Medicare Supplement plan. It covers:
- Medicare Part A coinsurance and hospital costs.
- Medicare Part B coinsurance or copayment.
- The first three pints of blood.
- Medicare Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Medicare Part A deductible.
- Medicare Part B deductible.
- Medicare Part B excess charges.*
- 80% of foreign travel emergency costs, up to plan limits.
*Doctors who don’t accept Medicare assignment are the source of Medicare Part B excess charges. These doctors can charge up to 15% more than the Medicare-approved amount. Plan F covers these charges.
Unfortunately, Plan F is no longer available to people who started Medicare on or after January 1, 2020. If you had Medicare before that date, you may be able to purchase Plan F if you meet the underwriting requirements or if you have guaranteed issue rights.
Plan G covers everything Plan F does except for the Part B deductible.
Plan N covers everything Plan F does except for the Part B deductible and Part B excess charges. Plan N also has a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.5
How Do You Choose a Medicare Supplement Plan?
The first step to choosing an Iowa Medicare Supplement plan is to decide which lettered plan(s) you prefer. Next, visit the Medicare Plan Finder to find insurance companies licensed to sell those plans in Iowa.
Contact at least two or three plans so you can compare prices. Be sure to compare like plans. For example, compare Plan G with one company to Plan G with another company. That way, you’re making apples-to-apples comparisons.
Why do you need to compare plans if they all have the same benefits? Even though the benefits are the same, prices vary from company to company. Prices vary because insurance companies can choose one of three options to price their plans:
- Attained age ratings: This pricing is based on your current age, and premiums will get more expensive as you age. Companies that use this pricing method often offer the cheapest premiums when you’re younger, but the plans become the most expensive over time.
- Issue age ratings: With this option, insurance companies base your premiums on your age when you purchase a policy. A company may increase rates due to inflation, but not due to your age.
- Community age ratings: With this pricing method, insurance companies charge everyone the same premium. They won’t increase premiums due to age, but they may raise rates due to inflation and other factors.6
Do Medicare Supplement Plans Include Prescription Coverage?
Medigap policies do not include prescription coverage. For these benefits, consider buying a Medicare Part D prescription drug plan. Part D plans are offered by Medicare-approved private insurance companies.7
How Much Do Medigap Policies Cost?
Iowa Medigap policy prices vary depending on your age, gender and whether you use tobacco.
Look at the below examples taken from the federal Medicare website.8
Premiums for a 65-year-old man, no tobacco use
|Plan Type||Premium Range|
Premiums for a 65-year-old woman, no tobacco use
|Plan Type||Premium Range|
What If You Want to Change Your Medigap Policy?
You can apply for a different Medigap plan at any time. Keep in mind that unless you have guaranteed issue rights, insurance companies can decline your application or charge you more based on your health.
What Are Alternatives to Medicare Supplement Plans?
Medicare Advantage plans are an alternative to Medicare Supplements. Medicare Advantage plans are a bundled alternative to Original Medicare that replaces Medicare Part A and B benefits. Most also offer Part D benefits, and many offer other types of coverage, including dental, vision, and hearing care.9
An Alternative to a Medigap Policy
You can choose a Medicare Advantage (MA) plan, which replaces Medicare Parts A and B, instead of a Medigap policy. An MA plan often includes prescription drug coverage, as well as other benefits.
What Are Medicare Resources in Iowa?
Iowa residents have access to several Medicare resources.
- Senior Health Insurance Information Program (SHIIP): This program offers counseling to Medicare beneficiaries to help them make informed decisions about health insurance. Visit the SHIIP website to find a counselor in your county, then contact a counselor to set up an appointment.
- Iowa Insurance Division: If you have an issue with your Medicare Supplement plan, file a complaint with the Iowa Insurance Division online.
- Iowa Medicaid: Medicaid provides free or low-cost healthcare to those with limited incomes and assets. Apply for Medicaid online.
Ready to enroll in a Medicare Supplement plan? Review your plan options and contact several insurance companies to find the best price. Choose a plan from a reputable insurance provider that fits your budget. Consider buying a Medicare Part D plan for prescription benefits. If you have concerns, SHIIP can provide you with one-on-one advice.