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Senior Health Insurance Information Program

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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 four (4) types of Medicare Advantage plans in Iowa: HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), PPFS (Private Fee-For-Service and SNP (Special Needs Plan). 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 also listed in the resources section on this page.

You can also call SHIIP at 1-800-351-4664.

Last Updated: 12/07/2018 (JLR)

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