Medicare in Iowa: Eligibility, How to Apply, & More

There’s a lot more to Iowa than farms and livestock. In fact, Iowa residents are so well-known for being polite and kind that “Iowa nice” is a familiar phrase.

If you’re approaching the age of 65, you’ll soon be joining 17% of the state — and you’ll be eligible for Medicare. You probably have a lot of questions about Medicare and Medicare Advantage in Iowa.

This guide will answer many of the questions we commonly hear about Medicare in Iowa. If you have more specific concerns, don’t be afraid to contact us. We’re here to help.

Does Iowa Have Medicare?

Medicare is a federal program that provides health coverage for those who are less likely to get health insurance from a job, such as those 65 and older and people with specific health conditions.

As a result, Medicare exists in every state, including Iowa. There are two primary types of Medicare: Original Medicare and Medicare Advantage.

Original Medicare is the default program, although it may not be the right coverage for your needs. Original Medicare consists of Part A (hospital insurance) and Part B (medical insurance), along with optional add-ons like Part D (prescription drug insurance).

Medicare Advantage, also known as Medicare Part C, is a full replacement for Original Medicare and may offer additional benefits. Advantage plans are sold by private health insurance companies within the state, so Advantage plans in Iowa will be different than the plans available in another state.

Who is Eligible for Medicare in Iowa?

What age does Medicare start in Iowa? What makes you eligible if you’re younger than that?

As we mentioned, Medicare is intended to help those who are less likely to have access to health insurance through an employer.

To qualify for Medicare coverage in Iowa, you need to be a U.S. citizen or permanent resident who has lived in the US for at least five years, and one of the following conditions must also apply:

• You’re age 65 or older
• You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
• You have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease
• You have end-stage renal disease (ESRD)

If you qualify for coverage, you have the opportunity to enroll or change your coverage during an initial enrollment period, and after that, you can make changes each year during the annual enrollment period (AEP).

Keep in mind that the default Medicare enrollment is Original Medicare Parts A and B, which may not be the right selection for you. For example, that doesn’t give you access to insurance coverage for prescription medication.

Make sure that you take advantage of your initial enrollment period to compare available plans and make the right choice for your specific needs.

How Do I Apply for Medicare in Iowa?

Once you’re eligible, you’ll want to select the Medicare plan that makes the most sense for you. If you like Original Medicare, you can let yourself be automatically enrolled in Medicare Part A and B, and then compare Part D plans and choose the one that fits your needs. You might also want to review Medigap (Medicare Supplement) plans to help with out-of-pocket costs.

Or, you can compare Medicare Advantage plans, either online or over the phone, and choose the one where the costs and benefits fit what you’re looking for. For example, you might want an Advantage plan that includes vision and dental benefits. Or, there might be specific doctors that you need to have within the provider network.

Sometimes, you aren’t enrolled in Original Medicare automatically. If you need to enroll, you can:

• Contact your local Social Security office
• Call 1-800-772-1213 to enroll over the phone
• If you retired from a railroad, call the Railroad Retirement Board at 1-877-772-5772

- Sign up for Part A online at www.socialsecurity.gov and Part B using Form CMS-40B

Once you’re sure you have the options you need for Medicare, you can rest easy knowing that your coverage is in place. If you want to make changes, you can enroll during AEP, which runs from October 15th - December 7th.

What Age Does Medicare Start in Iowa?

If you qualify for Medicare due to age, it will be when you turn 65. However, there are ways to qualify for Medicare before you’re 65.

If you’re disabled and getting Social Security disability benefits or railroad disability benefits, you can qualify for Medicare early, after you’ve been getting payments for 24 months. If you have a specific health condition, the waiting period will depend on your illness and current condition.

Is Medicare Advantage Available in Iowa?

Medicare Advantage plans are available in all states, including Iowa, but the specific insurance company, medical network, and coverage may vary depending on where you live. More than 1.6 million people in Iowa are enrolled in a Medicare Advantage plan.

Advantage plans are offered by private insurance companies. The medical network is generally focused on your local area, which means that when you’re traveling you may not have access to non-emergency medical care through your insurance. However, Medicare Advantage plans often have benefits that Original Medicare does not offer.

For example, an Advantage plan might offer vision or dental coverage, which are not covered by Original Medicare. Or, you might be able to get free access to local gyms, get cash back, or access other benefits.

Some Medicare Advantage plans cost the same as your monthly Part B premium, while others have an additional monthly premium. Because Advantage plans vary so much, it’s important to compare plans before you make a final selection.

Talking to a licensed agent may be a great way to discuss your needs and find the right plan!

Learn More About Medicare in Iowa

We’ve talked about the most common questions about Medicare in Iowa, but frequently our visitors have additional questions based on the specific situation. We welcome these and invite you to contact us any time.

Our licensed agents are happy to answer your questions and help you compare Medicare plans. Let’s get you the coverage you need!