The State of Iowa offers all employees (except SPOC employees) the same health coverage (one plan) with a choice between two network options.
All of the State-sponsored health insurance plans are provided by Wellmark Blue Cross and Blue Shield.
Health Insurance Premium |
| 2019 Health Insurance Premiums (All employees except SPOC-covered employees) |
Health Insurance Notices
|
Health Insurance Information |
| Health Insurance Marketplace Notice | Helpful Links |
| HIPAA Privacy Practice Notice | ACA Preventive Services List (updated January 2019) |
| “Michelle's Law” Notice | Wellmark: Drug List (Formulary: Blue Rx Completesm) |
| Women's Health and Cancer Rights Act | Wellmark: Find a Doctor or Hospital |
| Understanding your health insurance benefits | |
| Comparing the Cost of Care | |
| Explanation of Benefits: If it’s not a bill, then what is it? | |
| Understand Your Out-Of-Pocket Costs | |
| Video Recording | |
| Wellmark's Find a Provider | |
| Understanding Jargon: Copay (Wellmark YouTube video) | |
| Understanding Jargon: Coinsurance (Wellmark YouTube video) | |
| Understanding Jargon: Deductible (Wellmark YouTube video) | |
| Understanding Jargon: OPM (Wellmark YouTube video) |
One Plan, Two Options
All State employees (except employees covered by the SPOC contract) are offered the same health coverage (one plan) with a choice between two network options:
- Iowa Choice: Offers access to a large selection of doctors and hospitals in Iowa and in counties sharing a border with Iowa. Iowa Choice includes coverage should you have an emergency while out of the state. The provider network includes 100 percent of Iowa hospitals and 96 percent of Iowa doctors. Not all providers in the counties sharing a border with Iowa participate in the Iowa Choice network.
- National Choice: Offers access to a large selection of doctors and hospitals in Iowa and nationwide. With National Choice, you may seek health care from any provider located in the United States. In Iowa, in-network care can be received at 100 percent of hospitals and 99 percent of doctors. Outside of the state, you'll have access to 96 percent of hospitals and 93 percent of doctors. Keep in mind with this option you can see any provider you choose, but you will have lower out-of-pocket expenses if you choose a network provider.
Refer to the Health Insurance Options Side-by-Side Comparison.
Doctor On Demand
With Doctor on Demand, you and your family members can speak with a board-certified doctor who can treat the most common medical conditions and prescribe medication if needed1. Using Doctor on Demand is easy and available 24 hours a day, 7 days a week, 365 days a year. You’ll love the convenience, and your Wellmark benefits apply automatically for you and your covered family members.
- Cold and flu
- Bronchitis and sinus infections
- Urinary tract infections
- Sore throats
- Allergies
- Fever
- Headache
- Pink eye
- Skin condition
- Mental health2
- Download the Doctor on Demand app or visit DoctorOnDemand.com.
- Have your Wellmark member ID card ready. You’ll be asked to enter your full Wellmark ID number, including the three character prefix.
- Create an account or sign in.
Important Information about Iowa Choice
Iowa Choice is a managed care plan. As such, health care services are provided by a statewide network of participating health care providers. Providers who participate in these plans are called Wellmark Health Plan Network providers.
Benefits for covered services are available only when received from Wellmark Health Plan Network providers.
It is your responsibility to ensure that providers you seek services from are part of the Wellmark Health Plan managed care network. Services received from non-participating providers will not be paid by Wellmark. Visit the Wellmark website to check participating providers in your area.
Services received from out-of-network providers may be covered in the case of accidental injuries or emergencies.
Guest Membership for Iowa Choice
Guest Membership. Members traveling long-term, any covered dependents attending college out of state, or covered family members living apart are eligible to become a guest member any time they are outside the Wellmark Health Plan Network area for at least 90 days. Not all services covered under your medical benefits are covered under Guest Membership. To determine which services are covered under the Guest Membership program, call us.
To receive covered services under the Guest Membership program, you must receive the service(s) from a Participating Provider.
Before you leave the Wellmark Health Plan Network area, call Customer Service at 800-622-0043 to set up a guest membership.
Travel Out of the Country
National Choice: Under the National Choice plan, you have access to doctors and hospitals in more than 200 countries around the world through the Blue Cross Blue Shield Global™ (BCBS Global™) Core Program. With the BlueCard Program, you can locate international doctors and hospitals by visiting bcbs.com and searching the National Doctor and Hospital Finder or by calling 800-810-BLUE (2583). When you receive non-emergency care from providers outside the BlueCard service area, these services would be covered at the out of network level and you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services.
Iowa Choice: Under the Iowa Choice program, you are only covered for emergency care or care for an accidental injury when you receive care in a foreign country.
Double Spouse
If you and your spouse are both employees of the State of Iowa, you are eligible to have your health and dental family premiums divided between the two of you. For more information refer to the DAS Double Spouse webpage.
More Information
For more information about health insurance, please contact Wellmark customer service at 800-622-0043.
updated 01/16/2019