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Health Insurance

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.

Quick Links

Health Insurance Resources

One Plan, Two Options Health Insurance Options Side-by-Side Comparison
New Health Benefit - Telemed 2018 Iowa Choice benefit booklet
Important Information about Iowa Choice Summary of Benefits and Coverage (SBC) Iowa Choice
Guest Membership for Iowa Choice 2018 National Choice benefit booklet
Travel Out of the Country Summary of Benefits and Coverage (SBC) National Choice
Double Spouse  Wellmark: Find a Doctor or Hospital
More Information Wellmark: Drug List (Formulary: Blue Rx Complete sm)
  Wellmark's ACA Preventive Services List
    Registering for MyWellmark
   

Health Insurance Premium 

Health Insurance Premium All Employees (except SPOC-covered employees) 

Health Insurance Notices Required by Law  

Health Insurance Information

Health Insurance Marketplace Notice  Comparing the Cost of Care
HIPAA Privacy Practice Notice Explanation of Benefits: If it’s not a bill, then what is it?
“Michelle's Law” Notice  Understand Your Out-Of-Pocket Costs
Women's Health and Cancer Rights Act Understanding Jargon: Copay (Wellmark YouTube video)
  Understanding Jargon: Coinsurance (Wellmark YouTube video)
  Understanding Jargon: Deductible (Wellmark YouTube video)
  Understanding Jargon: OPM (Wellmark YouTube video)
  Understand Your Out-of- Pocket Costs (Wellmark flyer)

One Plan, Two Options

All State employees will be 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

A new benefit in 2018 is 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.  

Get treatment for:
  • Cold and flu
  • Bronchitis and sinus infections
  • Urinary tract infections
  • Sore throats
  • Allergies
  • Fever
  • Headache
  • Pink eye
  • Skin condition
  • Mental health2
Getting started is easy.
  1. Download the Doctor on Demand app or visit DoctorOnDemand.com.
  2. Have your Wellmark member ID card ready. You’ll be asked to enter your full Wellmark ID number, including the three character prefix.
  3. Create an account or sign in.
So, the next time you have a sore throat or the little one’s running a fever, pick up your smartphone and connect virtually with Doctor on Demand, any time, day or night.
 
1Doctor On Demand physicians do not prescribe Drug Enforcement Administration-controlled substances, and may elect not to treat or prescribe other medications based on what is clinically appropriate.
2 Includes treatment for certain psychological conditions, emotional issues and chemical dependency. Services performed by psychologists are covered. Psychiatry, which may include the use of prescription drugs, is not covered. For more information, call Wellmark at the number on your ID card. 

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.


The Benefits Management Team of the Iowa Department of Administrative Services developed this website to provide you with information about your benefit options and serve as a valuable resource for information about your benefits. The benefits described at this webpage are subject to change. Nothing herein shall be construed as a guarantee of benefits. This webpage is not a complete description of the State of Iowa’s benefit plans. Nothing on this website supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements. If the wording in this webpage contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern. If you have any questions, please contact your human resources associate. 


updated 07/24/2018