Iowa Health Advantage (HMO I-SNP)

Iowa Institutional Special Needs I-SNP Plan (2024 Plan)


Monthly Premium

Your Cost
$42
by Iowa Health Advantage

Additional Coverage

HearingVision

Overall Government Star Rating

No Rating (new plan)

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Plan Name
Iowa Health Advantage (HMO I-SNP)
Insurance Carrier
Iowa Health Advantage
Plan Type
Institutional Special Needs Plan (I-SNP)
Network Type
HMO

Iowa Health Advantage (HMO I-SNP) is a Institutional Special Needs Plan (I-SNP), which is available in Iowa and offered by the health insurance company Iowa Health Advantage. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$42
Annual Deductible
$240 per year for in-network services.
Max Out-of-Pocket
$8,850
Primary doctor visit
$0 copay
Specialist visit
0-20% coinsurance per visit
ER visit
20% coinsurance per visit (always covered)
Ambulance
20% coinsurance

Iowa Health Advantage (HMO I-SNP) has a monthly premium cost of $42 per month, with an annual deductible of $240 per year for in-network services. and a maximum out of pocket cost sharing of $8,850 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Iowa Health Advantage (HMO I-SNP) are defined below.

Yes
Part D Prescription Drug Coverage
No
Dental
Yes
Vision
Yes
Hearing

Iowa Health Advantage (HMO I-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Iowa Health Advantage (HMO I-SNP) includes coverage for hearing, vision.

Medicare Advantage health plans can offer even more additional benefits. Iowa Health Advantage (HMO I-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Not covered
Over the counter drug benefits
Not covered
In-home support services
Limited coverage
Home and bathroom safety devices
Not covered
Meals for short duration
Not covered
Annual physical exams
Not covered
Telehealth
Limited coverage

Monthly Premium
$42
Health Portion of Premium
$0
Drug Portion of Premium
$42
Health Plan Deductible
$240 per year for in-network services.
Health Plan Max Out-of-Pocket
$8,850 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
No

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
0-20% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures
20% coinsurance
Lab services
$0 copay
Diagnostic radiology services (like MRI)
20% coinsurance
Outpatient x-rays
20% coinsurance
Emergency care
20% coinsurance per visit (always covered)
Urgent care
20% coinsurance per visit (always covered)

Hospital Services

Inpatient hospital coverage
In 2024 the amounts for each benefit period are:
$1,632 deductible for days 1 through 60
$408 copay per day for days 61 through 90
Outpatient hospital coverage
20% coinsurance per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$0 per day for days 21 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
20% coinsurance

Therapy services

Occupational therapy visit
0-20% coinsurance
Physical therapy & speech & language therapy visit
0-20% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist
0-20% coinsurance
Outpatient individual therapy with a psychiatrist
0-20% coinsurance
Outpatient group therapy visit
0-20% coinsurance
Outpatient individual therapy visit
0-20% coinsurance

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
20% coinsurance per item
Prosthetics (like braces, artificial limbs)
20% coinsurance per item
Diabetes supplies
$0 copay

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$0 copay

Brand-name drugs :
$0 copay

Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Hearing

Hearing exam
20% coinsurance
Fitting/evaluation
$0 copay
Hearing aids - All types
$0 copay

Preventive Dental

Oral exam
Not covered
Cleaning
Not covered
Fluoride treatment
Not covered
Dental x-rays
Not covered

Comprehensive dental

Non-routine services
Not covered
Diagnostic services
Not covered
Restorative services
Not covered
Endodontics
Not covered
Periodontics
Not covered
Extractions
Not covered
Prosthodontics, other oral/maxillofacial surgery, other services
Not covered

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$0 copay

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