Medicare Advantage Plans are an alternative to traditional Medicare coverage and
some include additional benefits. Many also provide prescription drug coverage.
SHIIP can help you make the Right Call in deciding whether it’s right for you.
What are Medicare Advantage plans and which plans are available in Iowa?
Medicare Advantage plans are offered by private companies which contract with Medicare
to provide Medicare Part A, B and sometimes D (prescription drug) benefits. When
you enroll in a Medicare Advantage plan you do not lose Medicare, you just get your
benefits in a different way. The plans are available to all Medicare beneficiaries
except those with end stage renal disease.
There are three (3) types of Medicare Advantage plans in Iowa: HMO (health maintenance
organization), PPO (preferred provider organization), PPFS (private fee-for-service). In addition, a special type of health plan called a “cost plan”
is offered in a few counties.
Before you enroll in a Medicare Advantage plan it’s important to know the following:
- Whether or not all of your providers (physicians, hospitals, etc.) accept the plan.
- You must have both Medicare Parts A and B and live in the service area for the plan.
- You must stay in the plan until the end of the calendar year. (There are a few exceptions)
- Each year plans can change benefits, premiums, service areas, provider networks
(if applicable), and can terminate their contract with Medicare
- You do not need a Medicare supplement insurance policy. In fact, Medicare supplements
cannot pay benefits when you are enrolled in a Medicare Advantage plan.
For more information on plans available in Iowa, see our consumer guide “Medicare
Advantage Plans in Iowa.” The guide is listed in the resources section on
You can also call SHIIP at 1-800-351-4664.
Last Updated: 02/19/2016 (JLR)