Knoxville Hospital & Clinics and Red Rock Healthcare-Pella are committed to serving as a resource and providing important updates regarding the Iowa Health Insurance Marketplace and changes that may impact you and your family.
The Affordable Care Act requires most Americans to have health insurance. Understanding your health insurance options, getting the right coverage and properly enrolling through the Health Insurance Marketplace is important.
- Who needs Marketplace coverage? Anyone who doesn’t have coverage through a job, Medicare, Medicaid, the Children’s Health Insurance Plan (CHIP) offered through Iowa’s Healthy and Well Kids, or other qualifying coverage. You may be able to receive help paying your health insurance premium, or qualify for plans with reduced deductibles and copays (Cost Share Reduction plans). You can get this assistance if you receive health insurance coverage through the Health Insurance Marketplace and your income is below a certain level. To see if you are eligible, please visit healthcare.gov.
- Deadlines for 2018 coverage: For coverage starting January 1, 2018, individuals and families must enroll by December 15, 2017.
- Individual health insurance is what you purchase yourself – not through an employer, or anything provided through a government health insurance program.
- Medica is the only individual health insurance provider in Iowa. Individual health insurance policies for individuals or families in Iowa are available on the Health Insurance Marketplace from one carrier: Medica.
- Three Medica insurance plan options are available for Iowans. Medica provides three plans, but only one plan option per county in Iowa. You must reside within a specific county service area to enroll in (and remain in) one of these plans. Each plan’s network includes specific details regarding county availability, as well as access to doctors and hospitals and the corresponding benefits and costs.
- Medica Insure Plans: As a broad, two-tiered network plan, you are free to see most doctors and hospitals in most of Iowa and throughout Nebraska with this plan. Most Mercy Health Network providers are Tier 2 Standard providers. It is important for you to understand you will receive the highest level of benefits and lowest out-of-pocket costs when you access Medica Insure Tier 1 Preferred providers.
To enroll and remain in Medica Insure, you must reside in Nebraska or one of the following Iowa counties: Adair, Adams, Allamakee, Appanoose, Audubon, Buena Vista, Calhoun, Carroll, Cass, Cerro Gordo, Chickasaw, Clarke, Clinton, Crawford, Davis, Decatur, Des Moines, Floyd, Franklin, Fremont, Guthrie, Hamilton, Hancock, Hardin, Henry, Howard, Humboldt, Ida, Jasper, Jefferson, Johnson, Keokuk, Kossuth, Lee, Louisa, Lucas, Madison, Mahaska, Marion, Mills, Mitchell, Monona, Monroe, Montgomery, Page, Palo Alto, Pocahontas, Poweshiek, Ringgold, Sac, Shelby, Story, Taylor, Union, Van Buren, Wapello, Washington, Wayne, Webster, Winnebago, Winneshiek, Worth or Wright.
- Inspire by Medica Plans: The Inspire options are localized and more narrowly focused. Mercy Health Network providers are considered out-of-network providers. Inspire will provide benefits with higher deductibles and co-insurance for out-of-network providers, except in the case of emergency medical events.
To enroll and remain in Inspire by Medica, you must reside in one of the following Iowa counties: Benton, Black Hawk, Boone, Bremer, Buchanan, Butler, Cedar, Clayton, Dallas, Delaware, Dubuque, Fayette, Greene, Grundy, Iowa, Jackson, Jones, Linn, Marshall, Muscatine, Polk, Scott, Tama, Warren or Woodbury.
- Medica with CHI Health: This option is only available for individuals and families living in Harrison or Pottawattamie counties in Iowa and provides access to CHI Health doctors, as well as others in southwestern Iowa and southeastern to central Nebraska.
- Be sure and understand the Medica plans and benefits available to you. It is important to fully understand the plans available in your county of residence, as well as each plan’s specific provider options and benefits. Please contact Medica directly for more information.
Contact Medica directly. To fully understand the plans available in your county of residence, as well as each play’s specific provider options and benefits, please contact Medica directly at 1-844-752-6742 or visit medica.com.