Iowa or the Hawkeye State had a lower uninsured rate even before the passage of the Affordable Care Act and this trend continues to date. The lower uninsured rate in the state is due to the state’s acceptance of Medicaid expansion under the ACA. Though most of the uninsured residents get private health insurance through an employer but rest can obtain ACA-compliant plans through the marketplace. Iowa operates a health insurance exchange in a partnership with the federal government, thus residents can use the federal marketplace, HealthCare.gov to compare and purchase health plans, whereas the state is responsible for plan management, assisting consumers, and determining Medicaid eligibility. The uninsured residents looking for private individual plans can shop for health coverage either through this federal website or directly from the health insurance carriers available in the state. All the ACA-compliant private individual health plans provide essential health benefits and are also required to cover preexisting medical conditions. Health insurance carriers cannot deny coverage to anyone based on his/her health conditions.
Residents of the state need to know that they can enroll in a health plan or make changes in their existing plan using the federal marketplace only during the open enrollment period or special enrollment period if they experience a qualifying event. However, there is a special enrollment period currently available in the state due to the COVID pandemic and because of the availability of enhanced premium subsidies offered under the American Rescue Plan. This special enrollment period continues through August 15, 2021, in the state and residents can make use of this window to enroll in a health plan through the marketplace or to switch to a different marketplace plan. People will not need any qualifying event during this period to enroll, and their plans will take effect the first of the month following the enrollment month.
Vital Statistics of Iowa Health Insurance
- Iowa has a total of 3,106,200 residents out of which around 5% of the residents are uninsured in the state.
- Iowa operates a partnership exchange with the federal government, so residents of the state use the federal marketplace to compare and shop for the health plans whereas the state is responsible for the management of the health plans and to assist residents.
- During the open enrollment period for 2021 health coverage, a total of 59,228 people enrolled in health plans through the Iowa exchange.
- The COVID-related special enrollment period is currently open in the state that continues through August 15, 2021, thereby allowing uninsured residents to enroll in a plan.
- According to the report of the CMS, 3,854 Iowa residents had enrolled in health plans during the first few weeks of the COVID-related enrollment window.
- In Iowa, for a 40-year-old person, the average health insurance premium is $451 per month for a 2021 plan.
The cheapest silver health plan in the majority of the state is either the Wellmark Silver Modified HMO or the Oscar Silver Saver plan.
Different Types of Private Health Plans available in Iowa
To help residents find out the best health insurance options in their area, the health insurance plans in Iowa are categorized under different metal tiers. Individuals depending upon their age and healthcare needs can select a health plan of a particular category that will ensure the best protection at the time of medical needs. The different metal-tiers of plans available in Iowa are Gold, Silver, Bronze, Expanded Bronze, and Catastrophic. Individuals can choose a plan from different metal tiers that offer varying levels of coverage at different rates. Higher metal tier plans like gold plans typically have higher monthly premiums and lower out-of-pocket expenses compared to silver or bronze plans. Gold health plans are ideal for individuals having high recurring medical costs that result due to chronic conditions and require regular medical attention.
Gold plans cover 80% of an individual’s health care expenses while the rest 20% of the costs are paid by the individuals themselves. Silver plans have moderate health insurance premiums, as the monthly premiums of these plans fall between gold and bronze plans. Besides, individuals having lower income may also qualify for cost-sharing reduction subsidies that are offered with a silver plan only and considerably lower the out-of-pocket expenses. Usually, silver plans cover 70% of the individuals’ health care costs while the remaining 30% of the costs are paid by the individuals themselves, but with CSR subsidies, the silver plan covers up to 94% of the individual’s health care costs.
Average Cost of Health Insurance in Iowa by Metal Tier
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Private Health Insurance Options in Iowa
Individuals who don’t have access to employer-sponsored or government-funded health plans will need to buy an individual health plan from a private health insurance carrier. Individuals using the Health Insurance Marketplace will require to fill out an application to check the health plans available in their area. Individuals can check whether they can get lower costs on their monthly premiums for private plans or not. Individuals will also get to know from the marketplace whether they qualify for free or low-cost coverage available through Iowa’s Health and Wellness Plan or not. The marketplace eases people’s search for health coverage by showing the options available in their area in one place. Individuals can compare health plans based on price, benefits, quality, and features that are vital for making a choice.
Health Insurance Companies in Iowa
In Iowa, three health insurance carriers are offering health coverage for the year 2021 through the marketplace. Every county in the state has health plans of at least two carriers. The three carriers available in the state are:
- Medica Insurance Company
- Wellmark Health Plan of Iowa
- Oscar Health Plan of Iowa