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Medicare-Eligible Retirees Health Options

You can continue your health coverage with the State of Iowa when you become eligible for Medicare.

You become eligible for Medicare when you are:

  • Age 65
  • Under age 65 with certain disabilities
  • Any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant)

If you or your covered dependents on the insurance become eligible for Medicare before age 65, contact DAS-HRE at 866-895-2464.


Retiree Health and Dental Insurance Premiums

2020 Health and Dental Premiums (Non-Medicare-eligible) 
2020 Health and Dental Premiums (Medicare-eligible)

Putting All the Health Premiums Together for Medicare-eligible Retirees

Applications and Forms

Resources

State of Iowa Group Retiree Health Application  2020 Medicare & You (Official Medicare Handbook) 
Wellmark Automatic Bank Account Withdrawal  Senior Health Insurance Information Program (SHIIP) 
Group MedicareBlue Rx Application (Iowa Choice and National Choice)  Iowa Group MedicareBlue Rx
Group MedicareBlue Rx Application (Group Plan F and Group Plan N) Iowa Group Medicareblue Rx (PDP) Overview
Group MedicareBlue Rx EFT form  2020 Group MedicareBlue Rx FORMULARY
Cancellation of Retiree Health Insurance Understanding the Coverage Gap
CVS/caremark Mail Service Order Form  Frequently Asked Questions
  2020 Summary of Benefits
  2020 Medicare Prescription Drug Creditable Coverage Notice
  2020 Group MedicareBlue Rx Star Rating 2020
   
Iowa Choice and National Choice Group Program F and Group Program N
Iowa Choice/National Choice Options Comparison  Group Program F Summary
2020 Iowa Choice Summary of Benefits and Coverage (SBC) Group Program N Summary
2020 National Choice Summary of Benefits and Coverage (SBC)

Quicklinks

Medicare-Eligibility and SLIP Dollars
MedicareHealth Plans Available to Medicare-Eligible Retirees 
Health Insurance Plans and Medicare 
Group MedicareBlue Rx 
Group Program F and N
For More Information

Medicare-Eligibility and SLIP Dollars

If you were a Sick Leave Insurance Program (SLIP) retiree and you turn 65 or become Medicare-eligible, your SLIP money will no longer be available to you. 

If you receive Medicare due to Social Security disability, you need to contact DAS at 866-895-2464, as you are no longer eligible for SLIP.

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Health Plans Available to Medicare-Eligible Retirees

The State offers retirees the following health plans.

  • Iowa Choice
  • National Choice
  • Group Program F
  • Group Program N

Information about these plans is available at Retiree Health Insurance.

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Iowa Choice/National Choice and Medicare

You can continue coverage with Iowa Choice or National Choice when you become eligible for Medicare. The benefit design of Iowa Choice and National Choice is the same as the benefit design offered prior to becoming Medicare-eligible except Medicare becomes the primary payer on your claims and Iowa Choice or National Choice is the secondary payer.

If you have covered dependents who are not eligible for Medicare, Iowa Choice or National Choice will continue to be primary on their health claims.

Iowa Choice or National Choice fills in the gap, if any, between what Medicare paid and what the options would have paid if you were not on Medicare.  Wellmark computes what it would have paid for your treatment as your primary insurer (including any unpaid deductible and co-pay).  Wellmark then subtracts the amount Medicare paid.  If the results are positive (that is, Medicare paid less than Wellmark would have), then Wellmark pays the difference.  If the result is equal to or greater than the amount Wellmark would have paid, they do not pay.

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Group MedicareBlue Rx 

With Iowa Choice or National Choice, you have an option of lowering your health insurance premium by purchasing a Medicare Part D plan – Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%). 

If you enroll in Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%), this plan will be your primary coverage for prescription drugs and Iowa Choice or National Choice will provide secondary coverage.  When you enroll in Iowa Group MedicareBlue Rx ($5/$10/20%/45%/33%), you can significantly reduce your Wellmark premium for either option.

Iowa Group MedicareBlue Rx Iowa Premium

The 2020 Iowa Group MedicareBlue Rx Iowa premium is $94.30 per month* per Medicare-eligible individual.

*Since January 1, 2011, higher-income beneficiaries will pay an additional amount to Social Security/Medicare for your Medicare Part D coverage. 

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Group Program F and Group Program N

Medicare Parts A and B pays for many, but not all, health care services and supplies.  A Medicare Supplement Insurance policy helps pay some of the health care costs that Parts A and B don’t cover, like copayments, coinsurance, and deductibles.

The State offers both the Group Program F and the Group Program N to Medicare-eligible retirees and their Medicare-eligible dependents.  The designs of the Group Program F and Group Program N are identical to the Medicare Supplement Plan F and N that you can purchase individually.  Group Program F and Group Program N provide extensive coverage in supplementing your Medicare coverage.  They have national coverage with any healthcare provider that accepts Medicare.

More information about the Group Program F and Group Program N is available at the Group Program F and N webpage.

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For More Information

Contact the Department of Administrative Services, Human Resources Enterprise at 866.895.2464 or email stateretirees@iowa.gov if you have any questions or need additional information.

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The Department of Administrative Services – Human Resources Enterprise is providing this information about the State of Iowa’s benefits. The information on this web page is 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 web page supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements. If the wording in this web page contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern.

Updated 02/03/2020