Health insurance in Iowa: What are the most affordable options?

By: Shawnda
Updated: September 2, 2022
Health insurance in iowa

Health insurance in Iowa is now easy to get. You can frequently get health insurance through your employer or government programs like Medicare or Medicaid. You can still buy health insurance from Iowa’s insurance exchange if your employer doesn’t provide it or you don’t qualify for the latter.

Cheaper plans may be alluring to buy to save money, but they have high deductibles that can deplete your savings in a serious medical emergency. Plans with higher premiums frequently have lower out-of-pocket maximums, which is advantageous for people with numerous medical needs.

We identified the most affordable health insurance plans in Iowa for various plan types to accommodate a range of ages, income levels, and needs.

 

The Iowa State’s Lowest-Priced Health Insurance by Metal Tier

Health insurance options are separated into tiers in every state. Each Iowa’s insurance market tier has different premiums, deductibles, and out-of-pocket maximums. The higher out-of-pocket costs and vice versa, the lower the premium.

The four metal tiers describing Iowa’s state are catastrophic, Expanded Bronze, Silver, and Gold. For an example profile of a 40-year-old, the cost of health insurance in Iowa varies depending on the metal tier and is as follows:

  • Devastating: $298 monthly
  • Expanded Bronze ($405 monthly)
  • Silver costs $528 a month.
  • For gold: $523 monthly

Gold plans typically cost more than Silver plans in most states. Each state, however, has its insurance market where each insurer is free to set its rates. You can also check Cigna health insurance reviews to get more information. Occasionally, you’ll come across an anomaly where a Gold policy can cost you less money than a Silver plan.

Because of cost-sharing reductions, health insurance in Iowa may be more affordable for those with low incomes (CSR). These are only available for Silver plans, but they can significantly improve them by lowering deductibles and the plan’s cost. Some people can even purchase Silver-tier insurance at Gold-level prices.

We gathered data on all the various types of plans provided in Iowa using a sample profile of a 40-year-old male. HMOs and EPOs are included in this, with the former being the most prevalent.

 

The most affordable health insurance in Iowa by metal tier and age

Age has a substantial effect on the cost of health insurance in Iowa. For instance, the average monthly cost of health insurance in Iowa for a Silver-tier plan for a 26-year-old is about $423, while the average monthly cost is $1,121 for a 60-year-old.

Your health insurance premiums will increase as you get older. This is because younger people are less likely than older people to experience health issues. It may be tempting to stick with more affordable plans, like Expanded Bronze plans. However, doing so will make you pay more out of pocket if you incur unanticipated high medical costs with lower income limits.

Our data is based on sample ages but ignores the interaction between income and age, which also significantly impacts premiums. For instance, because older people may be eligible for tax premiums or other discounts, health insurance in the Iowa marketplace may be less expensive.

 

Cost of Health Insurance in Iowa by County

The state you reside in and the specific rating area impact your insurance premiums. Insurers use rating areas to determine premiums for each state.

Polk County has seven rating areas with the most residents out of Iowa’s 99 counties. Motivated by Medica, the least expensive Silver-tiered plan in this rating area is Medica’s Silver Copay, which has $472 an average monthly premium for a 40 year old person.

 

Iowa’s Lowest Health Insurance Has High Out-of-Pocket Maximums

Young people in Iowa with much medical insurance but still want insurance and don’t need can choose a cheap health insurance plan with high out-of-pocket maximums. Although you may pay less each month, you may pay more if you have many doctor visits in a year or a medical emergency.

Inspire by Medica Catastrophic, which costs an average of $219 per month for a 26-year-old, is the state’s least expensive plan for a high out-of-pocket maximum and is offered by Medica to those seeking affordable health insurance in Iowa.

Remember that a high out-of-pocket maximum is one with an $8,250 or higher limit, according to NewHealthInsurance.

 

Lowest Out-of-Pocket Maximum Health Insurance in Iowa

Choosing a plan with high premiums and low out-of-pocket maximums may be beneficial if you anticipate or have higher medical expenses than the majority. By doing this, you can reach the limit faster and start having your costs covered by insurance.

For those looking for low out-of-pocket maximums, the Wellmark Gold Modified HMO offered by Wellmark Health Plan of Iowa, Inc., with an average monthly premium of $447 for a 40-year-old, is the best health insurance in Iowa.

Keep in mind that we deem a low out-of-pocket maximum to be below the $4,250 cutoff. The out-of-pocket maximum for this plan is $5,250, the lowest in the state with the most affordable premiums.

 

Most affordable EPO/HMO health insurance in Iowa

Your particular requirements and preferences will determine the kind of health insurance plan you choose. Residents of Iowa have a choice of HMO or EPO plans, with the former being more prevalent.

The less expensive option is a health maintenance organization (HMO) plan, but these have limitations. For example, you must stay within your provider network and request a referral to see a specialist. While you may not always need a referral to see a specialist with an Exclusive Provider Organization (EPO) plan, you will still need to stay within the provider network, except for an emergency.

For all types of plans, the Silver tier of health insurance in Iowa offers the following rates:

  • HMO: Wellmark Health Plan of Iowa, Inc.’s Wellmark Silver Modified HMO, with an average monthly cost of $493 for a 40-year-old.
  • Oscar Insurance Company’s The Oscar Silver Saver costs an average of $485 per month for a 40-year-old.

 

Cheapest HSA-Eligible Health insurance in Iowa

Health savings account (HSA) plans are available to Iowa residents with good health and few medical expenses. They are more affordable plans with tax-free contributions that enable you to accumulate savings for medical and non-medical expenses. Now, one can easily save money on health insurance.

The following offers the best and most affordable health insurance in Iowa for all metal tiers with an HSA option:

  • Expanded Bronze: Wellmark Health Plan of Iowa, Inc.’s Wellmark Bronze HDHP HMO plan costs $313 on average per month for a 40-year-old.

Be aware that HSA-compatible plans typically have high deductibles, which could deplete your savings in the event of significant medical expenses.

Health insurance in iowa

What People Should Know About Health Insurance in Iowa?

The premiums collected by us are based on information from Iowa’s private health insurance marketplace; however, once you apply, you might discover even lower premiums. This is because you might be eligible for certain discounts or even find that Medicaid or Medicare are more affordable options than anything on the private market.

 

Using the Iowa Marketplace for private health insurance

Any state’s private health insurance market is divided into metal tiers. This does not decide the level of medical care. Instead, the cost distribution between an insurer and a policyholder is determined by each tier.

Iowa has 4 metal tiers: Catastrophic, Expanded Bronze, Silver, & Gold. The monthly premiums, out-of-pocket maximums, and deductibles vary significantly with every tier.

  • Catastrophic: This plan’s premiums are the lowest, its out-of-pocket costs are the highest, and not everyone is eligible for it. Only people under 30 or those who qualify for a “hardship” exemption are eligible for this plan. Even though it is the least expensive, those who are eligible for premium tax credits or cost-sharing reductions may not feel that it offers the best value.
  • Expanded Bronze: The Expanded Bronze tier is the market’s most affordable and widely accessible choice. It also has high deductibles and low premiums, though not as low premiums as catastrophic plans. Before the deductible is met under this plan, it is frequently necessary to cover at least one “major medical service,” such as laboratory tests or emergency care.
  • Silver Plan: The best balance between monthly premiums and out-of-pocket costs is provided by silver plans. Additionally, it provides the greatest potential for financial savings because those who are eligible for premium tax credits or cost-sharing reductions can benefit the most from this plan. This plan typically splits costs 70/30 between an insurer and a policyholder.
  • Gold Plan: Gold plans have the highest premiums and the lowest out-of-pocket maximums, making them the most expensive option available in the state. The people who use multiple prescription medications or frequently visit the doctor will benefit the most from this because they can quickly reach their maximums and begin receiving coverage from the insurer.

Points to ponder!

Getting cheap health insurance in Iowa is possible based on your income. You may qualify for premium tax credits if your income falls between 100 percent and 400 percent of the federal poverty level. Iowa’s two-person households make between $17,420 and $69,680 a year. To determine if you are eligible for premium tax credits and how much you can save, look at Healthcare.gov’s calculator.

Iowa’s private health insurance marketplace typically has an enrollment period when residents can apply for or even disenroll from health insurance. This usually falls between November and December, but COVID-19 has expanded the enrollment dates to provide residents with more flexibility.

 

Medicaid in Iowa

For individuals who have low income, health insurance in Iowa can be attained through Medicaid. Medicaid is a government assistance program that can help make cheap or even free health insurance in Iowa. As Iowa is a Medicaid expansion state, residents can qualify based on income alone — this is if your income falls under 138% of the federal poverty level. The Medicaid income limits are almost the same in all states.

 

Medicare in Iowa

Medicare may be available to Iowans 65 years or older with a qualifying illness or disability. Like Medicaid, this government assistance program still requires some payment coverage. However, this is more cost-effective than private market health insurance plans that can help pay for some expensive medical expenses.

The parts of Medicare’s coverage that each cover particular medical services are as follows:

  • Part A covers care you receive from a skilled nursing facility, hospice care, or during hospital stays.
  • Part B: Outpatient services like doctor visits, diagnostic tests, medical supplies, and preventative services are covered in Part B.
  • Part D: This section addresses any prescription medications, shots, or vaccines you might require.

 

Frequently asked questions

How much does a single person’s health insurance cost per month?

The average monthly cost of health insurance in the country in 2021 was $456 for an individual and $1,152 for a family. However, prices vary among the numerous health plans available.

 

Is healthcare or health insurance free in Iowa?

Medicaid offers eligible low-income individuals free or affordable health insurance.

 

Is There a Health Care Marketplace in Iowa?

Iowans compare and buy insurance through the federal marketplace, HealthCare.gov. Plan administration, consumer assistance, and Medicaid eligibility determination fall under state jurisdiction. During the open enrollment period for coverage in 2021, 59,228 people enrolled in health plans through the Iowa exchange.

 

Is there state health insurance in Iowa?

By using the HealthCare.gov website to compare and buy individual medical insurance coverage, residents of Iowa can do so in a partnership with the federal government. The state is in charge of managing plans, providing consumer assistance, and determining Medicaid eligibility.

 

What does the Farm Bureau of Iowa do?

Iowa Farm Bureau supports the continued growth of the agricultural industry by working for family farmers in areas crucial to their farm businesses.

 

Methodology

The most cost-effective plan for you will depend on your unique needs and characteristics; NewHealthInsurance research is based on estimates. Considering this analysis, no one plan has a guarantee as the most affordable for you in Iowa. The estimated cost of health insurance premiums on this page does not include any potential premium tax credits or cost-sharing subsidies for which users may qualify.

 

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