Hawkeye state residents are spoiled for choice when it comes to health care options. A study by US News found that Iowa has the third best health care in the country! That ranking considers access, quality, and good public health.
Health insurance options in Iowa
According to the Iowa Insurance Division, there are several ways to get health care coverage in your state.
Employer-provided
- From your employer
- Through your spouse's employer
Individual or family plans
- Through HealthCare.gov
- Directly from a health insurance company
Government-assisted
- Medicare
- Medicaid
Where do most Iowa residents get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 54% | ||
| Individual or family | 5% | ||
| Medicaid | 19% | ||
| Medicare | 15% | ||
| Military | 1% | ||
| Uninsured | 5% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
Five percent of Iowa residents are uninsured, less than the national average. That’s good news for policyholders. Higher rates of uninsured people lead to higher rates for insured people.
Iowa health insurance costs and rate factors
IA residents spend an average of $8,200 per year on health care. That’s a few hundred dollars more than the national average. What determines health care costs in Iowa? Rates vary person to person, based primarily on these factors:
Plan type
Marketplace plans come in metal tiers: bronze, silver, and gold. The more coverage you want, the more you’ll have to pay in monthly premiums.
So, how much should you expect to pay for health insurance in IA? These are the average monthly premiums for a middle-aged state resident in 2020:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $398 | $636 | $527 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
Purchasing a gold plan will cost about 32 percent more than a bronze plan. That’s because gold plans cover 80 percent of costs, whereas bronze plans cover 60 percent of costs.
You may also qualify for a catastrophic plan, the lowest level of marketplace coverage available. They’re designed for people under the age of 30, or with certain financial exemptions. Catastrophic plans have low monthly premiums but a yearly deductible of $8,150. You’ll likely save money with a bronze plan if you need to use your insurance.
Body mass index
A high body mass can lead to serious health conditions. So, a high BMI often means higher insurance rates. Insurers analyze your BMI to determine your risk-level.
In 2019, IA had a 34 percent obesity rate, the 21st highest rate in the country. Out of the many Iowans who used QuoteWizard to compare health insurance plans, 35 percent have a BMI in the obese range.
Tobacco use
Because of the health conditions tobacco causes, health insurance rates increase if you’re a smoker. About 16.7 percent of IA residents are smokers, the 22nd lowest rate in the country.
Age
According to HealthCare.gov, a health insurance plan for an older person costs up to three times more compared to a younger person. IA residents who used QuoteWizard to shop for health insurance are, on average, 42 years old.
Location
Your location plays a big role in how much you’ll pay for health insurance. That’s because every state has different health care rules, regulations, and providers.
Also, health insurance providers use a community-rating system to determine your costs. That means rates are based in part on the combined claims everyone files. If your state files a high number of insurance claims, your prices could rise.
That’s why the overall health of residents in your state can influence your prices. According to America’s Health Rankings, IA is the 15th healthiest state in the country.
Iowa health insurance companies
What are the top insurance companies in Iowa? Unfortunately there are only a couple providers who offer individual and family plans in your state:
- Medica
- Wellmark
Coverage tends to vary based on your county, so check with the provider to see what plans you qualify for.
Iowa medical insurance laws
The Affordable Care Act prevents insurance companies from considering certain factors while pricing your policy.
- Pre-existing conditions: The ACA limits providers from bumping up your cost because of pre-existing conditions.
- Gender: According to a study by Health Services Research, women historically pay more for health care. Luckily, the ACA limits insurance companies from charging men and women different prices for the same plan.
- Insurance and medical history: Insurance companies used to charge more if you had previous medical problems or lapses in health insurance coverage. The ACA doesn’t allow that to happen anymore.
In 2020, marketplace plans come with out-of-pocket limits of $8,150 for an individual plan and $16,300 for a family plan.
Iowa state law requires health insurance companies to offer at least some coverage for the following services:
- Mental illness and substance abuse treatment for veterans
- Autism spectrum disorders
- Coverage for prosthetic devices
- Emergency room services
- Post-delivery benefits and care
- Diabetes coverage
There are additional services that providers need to offer. Find the full list on cms.gov.
Medicare and Medicaid in Iowa
Government-funded programs Medicare and Medicaid aim to make health care more affordable. Medicare helps seniors, whereas Medicaid aids low-income families and children.
Medicare
Iowa’s Medicare program is for residents 65 years and older. There are several options within the Medicare program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for one of these Medicare Savings Programs:
- Individual monthly income limit: $1,456
- Married couple monthly income limit: $1,960
Medicaid
The rate of uninsured Americans has improved considerably since the Affordable Care Act (ACA) became law in 2010. Medicaid expansion was influential in reducing Iowa’s overall uninsured rate.
In 2013, 8.8% of Iowa’s residents had no health insurance. After Iowa expanded its Medicaid program in 2014, the state’s uninsured rate dropped by 16.3% by 2019. The primary cause of this was a 12.6% increase — or 66,500 Iowa residents — in Medicaid enrollment from 2014 to 2019.
Medicaid is designed for low-income families and children. These are Iowa’s Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $16,971 |
| 2 | $22,930 |
| 3 | $28,888 |
| 4 | $34,846 |
| 5 | $40,805 |
| 6 | $46,763 |
| 7 | $52,722 |
| 8 | $58,680 |
Iowa Insurance Division
- Website:
- Homepage
- Insurance Commissioner:
- Doug Ommen
- Insurance Hotline:
- (515) 281 - 5705
- Office Hours:
- Monday - Friday
8:00 am to 4:30 pm
- File a Consumer Insurance Complaint
- Complaint Page
Sources:
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