Iowa residents can access plans from metal tiers with varying deductibles, premiums and maximum out-of-pocket (MOOP) limits. For instance, Oscar offers the most affordable Bronze and Catastrophic plans, while Blue Cross Blue Shield is best for Silver and Gold plans.
MoneyGeek also found the best health insurance in Iowa by analyzing providers and plans balance cost and service.
Most Affordable Health Insurance in Iowa
Cheapest Health Insurance in Iowa by Metal Tier
The cheapest Silver plan for an Iowa resident is the Wellmark Silver Primary Care | UnityPoint Health from Blue Cross Blue Shield at $452 per month. Insurance costs differ by metal tier, and higher prices usually correlate to more comprehensive coverage.
The cheapest health insurance plans in each metal tier are as follows:
- Bronze: Bronze Simple - Standard from Oscar at $317 per month
- Catastrophic: Secure from Oscar at $273 per month
- Expanded Bronze: Wellmark Bronze Primary Care | UnityPoint Health from Blue Cross Blue Shield at $347 per month
- Gold: Wellmark Gold Primary Care | UnityPoint Health from Blue Cross Blue Shield at $428 per month
- Silver: Wellmark Silver Primary Care | UnityPoint Health from Blue Cross Blue Shield at $452 per month
Although plans with lower premiums may cover basic health care costs, opting for a more valuable metal tier, such as Gold or Silver, may require higher monthly payments; however, these plans often offer more benefits and lower MOOPs.
Policyholders can choose between different metal tiers offered on the health insurance exchange. In Iowa, they are tiered from least to most valuable (Bronze, Expanded Bronze, Silver and Gold), with premiums and out-of-pocket costs increasing by tier.
Young and healthy consumers with lower incomes may want to opt for a Silver plan, while those with higher incomes and expecting higher medical expenses, which often come with age, may opt for a Gold plan.
Resource: Learn more about metal tiers
Cheapest Silver Plans in Iowa
Wellmark Silver Primary Care | UnityPoint Health from Blue Cross Blue Shield is the most affordable Silver plan at $452 for the average Iowa resident. The top three cheapest Silver plans in Iowa and their providers are:
- Wellmark Silver Primary Care | UnityPoint Health from Blue Cross Blue Shield: $452 per month
- CareSource Marketplace Low Premium Silver from CareSource Iowa Co.: $465 per month
- CareSource Marketplace Standard Silver from CareSource Iowa Co.: $472 per month
Silver plans are mid-tier. They offer a balance between cost and coverage. Silver plans offer more coverage than Bronze but less than Gold.
In Iowa, an HMO is the most accessible plan type for residents. Because of this, MoneyGeek's recommendations in this section are HMO plans, even if they're not necessarily the cheapest options.
Cheapest Gold Plans in Iowa
The most affordable Gold plan in Iowa is Wellmark Gold Primary Care | UnityPoint Health from Blue Cross Blue Shield at $428 per month. The top three cheapest Gold plans in Iowa are:
- Wellmark Gold Primary Care | UnityPoint Health from Blue Cross Blue Shield: $428 per month
- Gold Classic - Standard from Oscar: $449 per month
- Wellmark Standard Gold HMO from Blue Cross Blue Shield: $472 per month
Gold tier plans are more expensive but offer more comprehensive coverage and lower out-of-pocket costs than cheaper plans.
Cheapest Bronze Plans in Iowa
The least expensive Bronze plan in Iowa is the Bronze Simple - Standard from Oscar, priced at approximately $317 per month.
The top three cheapest Bronze plans in Iowa are:
- Bronze Simple - Standard from Oscar: $317 per month
- Bronze Classic from Oscar: $335 per month
- CareSource Marketplace Bronze from CareSource Iowa Co.: $357 per month
Bronze plans offer customers a low-cost option with basic coverage. The trade-offs associated with this Bronze metal tier include a lower premium, higher copays and more limited coverage than the higher tiers. Also, Bronze plans have a higher deductible than Silver or Gold plans, so you will have to pay more out of pocket for medical services before your insurance kicks in.
Cheapest Expanded Bronze Plans in Iowa
Blue Cross Blue Shield has the lowest-priced Expanded Bronze plan (Wellmark Bronze Primary Care | UnityPoint Health plan) in Iowa, with an average monthly cost of $347. The three most affordable Expanded Bronze plans in the state are:
- Wellmark Bronze Primary Care | UnityPoint Health from Blue Cross Blue Shield: $347 per month
- Bronze Classic - Standard from Oscar: $354 per month
- CareSource Marketplace Bronze First from CareSource Iowa Co.: $357 per month
The Expanded Bronze metal tier is between Bronze and Silver, providing more coverage than Bronze but at a higher premium. This benefits those who want more coverage than Bronze but want to avoid paying the higher premium associated with Silver. However, it is important to note that the coverage provided by Expanded Bronze is not as comprehensive as Silver.
Cheapest Catastrophic Plans in Iowa
In Iowa, the most affordable Catastrophic plan is Oscar's Secure plan, which has a monthly cost of roughly $219 for a 26-year-old. Other inexpensive plans are:
- Secure from Oscar: $219 per month
- Inspire by Medica Catastrophic from Medica: $244 per month
- Medica with CHI Health Catastrophic from Medica: $257 per month
Catastrophic health plans typically have lower premiums and high out-of-pocket costs; they are available to young adults under 30 or those experiencing a qualifying hardship.
Cheapest Health Insurance in Iowa for Those With Low Income
If your income is less than 250% of the Federal Poverty Level (FPL), you are eligible for a cost-sharing reduction (CSR) — a subsidy provided by the federal government to help low-income individuals and families who purchase health insurance through the marketplace. You'll pay less out of pocket for a health plan if you qualify.
Iowa's cheapest plan for individuals with low income is Wellmark Silver Primary Care | UnityPoint Health from Blue Cross Blue Shield. Here's a breakdown of this plan's associated MOOPs:
- Income lower than $20,385 per year (less than 150% of FPL): Wellmark Silver Primary Care | UnityPoint Health ($1,700 MOOP)
- Income from $28,386 to $27,180 per year (151% to 200% of FPL): Wellmark Silver Primary Care | UnityPoint Health ($3,000 MOOP)
- Income from $27,181 to $47,565 per year (201% to 250% of FPL): Wellmark Silver Primary Care | UnityPoint Health ($7,200 MOOP)
These income numbers are for an individual and vary depending on one's income level. If you live in a household with more than one person, the income figures determining your CSR will differ.
Cost-sharing plans are designed to reduce out-of-pocket costs, such as deductibles, copayments and co-insurance, that individuals must pay for covered health care services.
They don't impact premium costs, but they shift more of the financial burden to insurance companies when you need medical services.
For instance, consumers may pay $452 per month for the standard and low-income Wellmark Silver Primary Care | UnityPoint Health plans. However, the MOOP for a plan with 150% FPL or below is $1,700, whereas the MOOP for a standard plan is $8,900.
The Cheapest Health Insurance in Iowa by Plan Type
In Iowa, an HMO is the most common plan type for health insurance. However, there is another option available through the health insurance exchange. The cheapest Silver plan for the alternate plan type is as follows:
- EPO: Silver Simple - PCP Saver from Oscar ($458 per month)
Although EPOs are similar to HMOs in that they require you to use in-network providers and have low premiums, they do not require a referral to see a specialist.
Iowa offers two main types of health plans: HMO and EPO.
- HMO (Health Maintenance Organization) plans provide members access to a network of doctors, hospitals and other providers. Members must select a primary care physician and get a referral to see a specialist.
- EPO (Exclusive Provider Organization) plans provide members access to a network of doctors, hospitals and other providers. Additionally, they do not require a primary care physician referral to see a specialist.
Cheapest Health Insurance in Iowa by County
Health insurance plans vary from state to state and even from county to county. Because of this variance, not all health insurance plans are available in all parts of Iowa. The availability of health insurance plans depends on the laws and regulations of the state or county in which they are offered. Additionally, some insurance companies may only offer plans in some regions due to financial viability or other factors.
MoneyGeek compared the average monthly premiums for the most affordable Silver plans in Polk County, the largest county in Iowa, and Adams County, the smallest county in Iowa.
- Polk County: Wellmark Silver Primary Care | UnityPoint Health ($453 per month)
- Adams County: Wellmark Standard Silver HMO ($535 per month)
To find the available plans in your county, filter the table below.
Health Insurance Costs in Iowa by Age and Metal Tier
Monthly costs for health insurance in Iowa can vary significantly by age and metal tier. MoneyGeek compared the average cost of health insurance for a 40-year-old Iowa resident by tier:
- Bronze: $789
- Catastrophic: $340
- Expanded Bronze: $840
- Silver: $1,069
- Gold: $1,112
As policyholders age, the cost of health insurance plans increases. For instance, the average premium for a Silver plan in Iowa is $763 for a young adult and $2,270 for a senior.
What to Know About Iowa Health Insurance
MoneyGeek analyzed private health insurance plans to find the most cost-effective options. It is important to note that those with lower incomes may be eligible for Medicaid or Medicare, which can be more beneficial and less expensive.
These government-supported programs are available during the open enrollment period and are designed to provide more specialized coverage for seniors, people with disabilities and those with lower incomes.
Private Health Insurance in the Iowa Marketplace
The open enrollment period for private insurance plans typically runs from November 1 to January 15, allowing shoppers to purchase health insurance through the marketplace.
Be aware that December 15, 2023, would be the final date to enroll for coverage beginning on January 1, 2024. Taking advantage of early enrollment allows you to make any necessary changes to your plan without experiencing coverage gaps.
If you miss the open enrollment period, you may still be able to get a marketplace plan through a Special Enrollment Period (SEP).
Qualifying life events such as losing health coverage, relocating, getting married, having a baby or adopting a child or having a household income that is below a certain amount are scenarios that make you eligible for a SEP.
The time you have to enroll in a plan depends on the type of SEP, ranging from 60 days before or after the event to a minimum of 30 days for job-based plans. There is no deadline for Medicaid or CHIP enrollment.
What Are Health Insurance Metal Tiers?
Iowa offers several health insurance metal tiers for residents to choose from. These plans are divided into five categories: Bronze, Silver, Gold, Expanded Bronze and Catastrophic. Each tier offers varying levels of coverage and cost-sharing arrangements, allowing individuals to choose a plan that meets their needs and budget.
- Bronze: Bronze plans have the lowest premiums but have higher deductibles and out-of-pocket costs than other plans. They offer basic coverage, covering only essential health benefits. They cover 60% of health care costs, leaving the customer to cover the remaining 40%.
- Silver: Silver plans offer more coverage than Bronze plans, covering 70% of health care costs. However, they also have higher premiums than Bronze plans. Additionally, customers with low incomes may be eligible for cost-sharing reductions, which can reduce their out-of-pocket costs.
- Gold: Gold plans are the most comprehensive in Iowa, covering 80% of health care costs and offering the lowest out-of-pocket costs. However, they also come with the highest premiums.
- Expanded Bronze: Expanded Bronze plans fall between Bronze and Silver plans in terms of coverage and cost. They cover essential health benefits and up to 65% of health care costs. They have higher premiums than Bronze plans but lower than Silver plans.
- Catastrophic: Catastrophic plans have the lowest premiums but high deductibles and provide limited coverage. They are only available to individuals under 30 or those who qualify for a hardship exemption.
By understanding the different metal tiers available in Iowa, individuals can find a suitable plan.
Medicaid in Iowa
If you're short on funds, you may qualify for Medicaid in Iowa. This government health care program provides free medical coverage for those who meet the state's eligibility guidelines. Generally, this includes pregnant women, children of parents with low incomes, those with disabilities and people with limited income.
Medicare in Iowa
If you are 65 or older or have a qualifying disability or illness, you may be eligible for Medicare, a government health care program. Unlike Medicaid, you will have to pay for some coverage, but it may still be cheaper than purchasing a private plan from the insurance marketplace.
With Medicare, you will have three parts to consider: Parts A, B and D.
- Part A: Hospital coverage in Iowa for inpatient stays, skilled-nursing care, hospice and home health care.
- Part B: Medical insurance for Iowa residents, covering doctor visits, preventive services, outpatient care and medical supplies.
- Part D: Coverage for prescriptions, vaccines and other recommended shots.
Iowa Health Insurance Frequently Asked Questions
Expert Advice on Affordable Health Insurance In Iowa
- What factors should individuals and families in Iowa consider when selecting a plan with the lowest out-of-pocket maxes?
- Are there any special considerations that should be taken into account when selecting a plan in Iowa for people with pre-existing conditions?
- Are there any special considerations that should be taken into account when selecting a plan in Iowa for people with pre-existing conditions?
Assistant Professor of Finance at the University of Iowa
The most frequently asked questions about health insurance in Iowa generally involve cost and availability. MoneyGeek answered some of these questions below.
About Mark Fitzpatrick