Open Enrollment Period in Iowa

• Open Enrollment for 2025: November 1, 2024 – January 15, 2025
  During this window, Iowans can:

• Enroll in a new plan

• Renew current coverage

• Switch to a new insurer or tier

Special Enrollment Period (SEP)

You may qualify for SEP outside open enrollment if you:

• Lose other coverage (employer, COBRA, Medicaid)

• Get married or divorced

• Have or adopt a child

• Move to a new area

• Experience income or household changes

Types of Health Insurance Plans Available in Iowa

Marketplace plans in Iowa are grouped by four tiers:

• Bronze – Lowest monthly premiums, highest out-of-pocket costs

• Silver – Moderate premium and cost-sharing (CSR eligible)

• Gold – Higher monthly premiums, lower out-of-pocket costs

• Platinum – Highest premiums, lowest expenses at the point of care

Plan Types:

• HMO: Limited network, referrals required, lowest premiums

• PPO: Greater flexibility and provider access, higher cost

• EPO: In-network only, no referrals required

Catastrophic Plans are available for adults under 30 or those who qualify for a hardship exemption.

Eligibility for Subsidies and Cost Assistance in Iowa

• Premium Tax Credits: For individuals/families earning 100%–400% of the federal poverty level (FPL)

• Cost-Sharing Reductions (CSR): Available with Silver plans for incomes under 250% FPL

• Medicaid Expansion: Iowa expanded Medicaid under the ACA—covers adults up to 138% FPL

• Hawki (CHIP): Iowa’s Children’s Health Insurance Program for children in working families

How to Compare and Choose a Plan in Iowa

When shopping on HealthCare.gov:

• Review premiums vs. deductible and copay limits

• Confirm if your doctors or hospitals are in-network

• Check prescription coverage and formularies

• Assess your expected health usage (preventive care, prescriptions, emergencies)

Tips:

• Freelancers: Calculate estimated annual income for subsidy accuracy

• Families: Children may qualify for Hawki even if adults don’t

• Near Medicare age? Compare ACA vs. COBRA vs. spousal coverage

Top Insurance Providers on the Iowa Marketplace

Participating insurers include:

• Medica Insurance Company

• Wellmark Blue Cross and Blue Shield of Iowa

• Oscar Health Plan

• HealthPartners UnityPoint Health

• UnitedHealthcare (in select counties)

Availability depends on your ZIP code and county.

Navigating Iowa’s Online Enrollment Portal

Use HealthCare.gov to:

Create an account or log in

Enter household and income info

Compare available plans

Apply for subsidies

Enroll online

Need help? Use the Find Local Help tool to locate agents or navigators in Iowa.

Alternatives to the Marketplace in Iowa

• Short-Term Health Insurance: Up to 364 days of temporary, limited coverage

• Off-Exchange Private Plans: Bought directly from insurers (not eligible for subsidies)

• Faith-Based Sharing Ministries: Legal in Iowa, but not regulated as traditional insurance

Common Mistakes to Avoid During Enrollment

• Not updating income after job changes

• Choosing based on price only without considering out-of-pocket costs

• Missing open enrollment or special enrollment deadlines

• Ignoring provider networks and drug formularies

• Overlooking Hawki eligibility for children

Iowa-Specific Health Programs or Innovations

• Hawki (Healthy and Well Kids in Iowa): CHIP program for low-cost child coverage

• IA Health Link (Iowa Medicaid): Managed care for Medicaid beneficiaries

• Medicaid Expansion: Covers low-income adults up to 138% FPL

• Telehealth Integration: Most Marketplace plans now include virtual care options

• Bilingual Enrollment Support: Local outreach partners provide multilingual assistance