State Guides

Iowa

Pivot Health is pleased to offer quality health insurance plans to Iowa residents. These plans, described below, offer Iowa individuals and families the ability to choose the benefit structure that best meets their insurance coverage needs and budget.

Short Term Medical Insurance – Also known as short term medical, or temporary health insurance, this plan provides comprehensive benefits coverage for physician visits, in-hospital care, urgent care facility visits and much more. Thanks to no provider network restrictions, you may seek treatment from any doctor or hospital to access benefits. Pivot Health’s fast, user-friendly online application process means that you know within minutes of applying if you’ve been approved for coverage. Qualified applicants may choose any coverage start date – even within 24 hours after you apply.

Supplemental Insurance Coverage – Major medical insurance plans can have high deductibles and costly coinsurance rates. If you find yourself struggling with these types of expenses, then supplemental insurance may provide you the financial support you need. The cash benefits provided by a supplemental coverage plan help you pay out-of-pocket medical expenses, such as insurance deductibles, copayments or coinsurance. The cash payments offer you flexibility – you may use the cash for any expenses you incur due to a serious illness or accident. Designed to work with your primary major medical coverage – whether you have an individual plan or employer-sponsored coverage – a supplemental insurance plan helps you protect your financial security from costly expenses related to medical care.

Pivot Health membership packages also include many additional non-insurance benefits, such as:
Unlimited access to discounted telehealth doctor consultations. Why spend your time sitting in a waiting room to speak to a health care provider? Instead, connect directly with a doctor at whatever time of day works for you – telehealth is available 24/7. And it saves money compared to a standard office or urgent care facility visit.

Discounts on eye care and eyewear. With savings of 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses, it’s never been so affordable to maintain good eye health.
Savings on prescription drugs. Enjoy discounts of up to 75 percent on prescription drugs at thousands of pharmacies across the nation.

Health Exchange Challenges in Iowa

A recent County Health Rankings report shows that approximately 10 percent of Iowa residents under the age of 65 have no health insurance – just higher than the national uninsured rate of 9.1 percent. Uninsured rates vary by county: Bremer, Dallas and Warren Counties have the lowest rate at 7 percent, while Buena Vista and Davis Counties have rates more than twice that, at 17 percent.

Over the past year, Iowa has experienced several insurance carrier changes for the individual plans sold on the federal exchange which operates in Iowa. At the end of 2016, UnitedHealthcare exited the individual insurance market (both on and off the exchange) leaving approximately 9,000 insureds scrambling to find new coverage. In addition, other insurers reduced their market presence, and beginning in 2017, residents in 13 rural Iowa counties have only one insurance carrier option – Medica.

Wellmark Blue Cross Blue Shield, which had previously offered only off-exchange plans in the individual market, joined the individual exchange in 2017. However, the insurer offers exchange plans in only 40 of Iowa’s 99 counties. Wellmark’s new exchange plans are narrow network HMO plans, and the company no longer promotes its PPO plan options. In addition, Wellmark has stopped offering Gold plan options in the individual market.

Spiking premium increases are adding to the frustration Iowa consumers are already feeling about the insurance carrier changes. For 2017, the Iowa Insurance Division approved premium rate increases ranging from 19 to 43 percent. Approximately 87 percent of Iowans receive federal premium subsidies to help pay for their exchange plan premiums, and won’t be significantly affected by the 2017 premium adjustments. However, the 2017 premium increases have been staggering for Iowans who purchase exchange plans but don’t receive federal premium subsidies, and for those who buy off-exchange plans.

A higher-than-national-average rate of uninsured residents, reduced insurance carrier and plan choices, and rising premium rates all underscore the importance of offering Hawkeye State residents access to a broader range of health insurance choices.

  • Pivot Health’s short term health insurance enables Iowa residents to purchase comprehensive coverage at a fraction of the cost of major medical insurance coverage – with no provider network restrictions.
  • Pivot Health’s supplemental health insurance provides Iowans the opportunity to select insurance designed to provide financial protection against the coverage gaps of high deductible major medical insurance plans. This supplemental insurance – also called “gap” coverage – helps insureds pay for high deductibles, out-of-pocket costs, coinsurance, copayments, and other costs that they typically incur before their high deductible major medical plans begin to pay benefits.

A Report on Iowa’s Well-Being

The recent Gallup-Healthways State of American Well-Being report examined how well-being varies by state. Iowa ranked 19th out of the 50 states, based on survey responses to questions covering different categories of well-being.

Iowa residents reported lower-than-average ratings (ranking 35th and 42nd, respectively) for the following categories:

  • Physical: having good health and enough energy to get things done daily
  • Social: having supportive relationships and love in your life

However, Iowa had much more positive rankings (5th, 12th and 22nd, respectively) for well-being in these categories:

  • Financial: managing your economic life to reduce stress and increase security
  • Community: liking where you live, feeling safe and having pride in your community
  • Purpose: liking what you do each day and being motivated to achieve your goals

The State of Health in Iowa

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Iowa an overall ranking of 6 out of 51 (the 50 states plus the District of Columbia). This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.

The Commonwealth Fund’s Scorecard rated Iowa in several areas, including:

  • Uninsured adults aged 19 to 64: 6th ranking (7 percent in Iowa, compared to U.S. average of 13 percent)
  • Uninsured children ages 0 to 18: 11th ranking (4 percent, compared to the U.S. average of 5 percent)
  • Adults who went without care because of cost in the previous year: 1st ranking (7 percent in Iowa, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income: 10th ranking (12 percent, compared to U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years: 19th ranking (12 percent in Iowa, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year: 8th ranking (13 percent, compared to the U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings: 14th ranking (70 percent in Iowa, compared to the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects: 5th ranking (71 percent, compared to U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 16th ranking (19.3 in Iowa, compared to U.S. average of 20.6)
    Colorectal cancer deaths per 100,000 people: 36th ranking (15.5 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000: 15th ranking (12.9 percent in Iowa, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations: 3rd ranking (21 percent, compared to the U.S. average of 26 percent)
  • Adults who smoke: 26th ranking (18 percent in Iowa, compared to the U.S. average of 17 percent)
  • Adults who are obese: 37th ranking (32 percent, compared to the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 13th ranking (28 percent in Iowa, compared to U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease: 22nd ranking (10 percent, the same as the U.S. average of 10 percent)

Iowa had positive ratings in other categories, including:

  • Adults with a usual source of care
  • Adults receiving age-appropriate vaccines
  • Children with medical and dental preventive care visits in the past year
  • Children with emotional, behavioral, or developmental problems who received needed mental health care in the past year
  • Children ages 19-35 months who received all recommended doses of seven key vaccines
  • Home health patients who improved in walking or moving around
  • A lower-than-national-average rate for hospital admissions for children with asthma
  • Hospitalized patients given information about what to do during their recovery at home

2017 Health Insurance Plans in Iowa

The Iowa Insurance Division confirmed that the following insurance companies offer individual plans on the exchange:

  • Aetna Health of Iowa (offered in 76 Iowa counties)
  • Gundersen Health Plan, Inc. (offered in 5 Iowa counties)
  • Medica Insurance Company (offered in all 99 Iowa counties)
  • Wellmark (offered in 40 counties)

Pivot Health offers in Iowa:

  • Short term health insurance
  • Supplemental health insurance

Medicaid in Iowa

Iowa has gradually expanded its Medicaid program over the past several years. Initially, the state used a waiver to implement its own version of the Medicaid expansion which the federal government has helped fund under the terms of the Affordable Care Act. However, in 2015, the state decided to move forward with a full Medicaid expansion.

Effective April 1, 2016, Iowa converted Medicaid to a managed care, privatized program. This format is similar to what 39 other states and the District of Columbia have adopted for their Medicaid programs. Critics of the switch to managed care have pushed for a return to traditional Medicaid, citing concerns that the privatization system is preventing enrollees from accessing health care, as well as failing to pay providers.

As of July, 2016, more than 613,000 Iowans were enrolled in the state’s Medicaid program.

Your Health Care Coverage Choices

If you are an Iowa resident and do not have health insurance: Pivot Health’s short term health insurance offers you the choice of comprehensive medical coverage to meet your benefit and budget needs.

If you are an Iowan and have a high deductible health insurance plan: Pivot Health’s supplemental insurance can help relieve the burden of costly out-of-pocket expenses, such as deductibles, coinsurance, copayments and more.

Pivot Health: offering you choices and flexibility to help meet your coverage and budget needs over time.