Medicare in Iowa: 2026 Plans, Costs, and Enrollment Guide

Iowa Medicare Snapshot

Iowa has 63 Medicare Advantage plans for 2026 with availability across all 99 Iowa counties (CMS 2026 Medicare MA & Part D Landscape State-by-State Fact Sheet). Iowa is one of a small group of states with an active Medicare Cost plan market (§1876 contracts, structurally distinct from Medicare Advantage / Part C); Cost plans operate in Iowa counties that CMS has not determined to have significant Medicare Advantage competition. Iowa uses the standard federal Medigap plan letters with attained-age pricing and does not have a state Medigap Birthday Rule or Anniversary Rule.

The average monthly MA premium in Iowa is $15.11 in 2026, up from $9.99 in 2025 (CMS 2026 Fact Sheet). The standard Medicare Part B premium is $202.90/month in 2026.

Plan Types Available in Iowa

Medicare Advantage and Medicare Cost Plans

Iowa offers 63 Medicare Advantage plans for 2026 (CMS 2026 Fact Sheet). Iowa is one of the few states with an active Medicare Cost plan market — Cost plans are §1876 contracts structurally distinct from MA (Part C). They operate in Iowa counties that CMS has not designated as having significant Medicare Advantage competition (under 42 CFR Part 417 and related CMS guidance). Cost plans pay Original Medicare for out-of-network services (you can use any Medicare provider) and the plan for in-network services.

Top MA carriers in Iowa include UnitedHealthcare, Humana, and Aetna Medicare. Average MA star rating is 3.85 (CMS Star Ratings apply to MA + PDP contracts; Cost plans are generally not part of the MA Star Ratings program).

Medigap (Medicare Supplement)

Iowa uses the standard federal Medigap plan letters (A, B, C, D, F, G, K, L, M, N, plus HDG and HDF). 38 carriers offer Plan G in Iowa in the TPP rate database (CY2026, non-tobacco, ages 65–85). Plans C, F, and High-Deductible Plan F (HDF) are closed to anyone who first became Medicare-eligible on or after January 1, 2020 (under MACRA 2015); beneficiaries who were Medicare-eligible before that date may still buy Plans C, F, or HDF from carriers that continue to offer them. High-Deductible Plan G (HDG) is the post-2020 high-deductible Medigap option and is offered by 29 Iowa carriers.

Iowa Medigap rates use attained-age pricing — premiums increase as you age. Iowa does not have a state Medigap Birthday Rule or Anniversary Rule. See our MA vs Medigap comparison →

Standalone Part D (Prescription Drug Plans)

Iowa is in CMS PDP Region 25 (combined with Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wyoming). For 2026, there are 11 standalone PDP plans available to Iowa beneficiaries (CMS 2026 Fact Sheet).

Costs in Iowa

Medicare Advantage Premiums

The average monthly MA premium in Iowa is $15.11 in 2026, up from $9.99 in 2025 (CMS 2026 Fact Sheet). The standard Medicare Part B premium is $202.90/month in 2026.

Medigap Premiums — Plan G and HDG

Iowa Medigap rates use attained-age pricing. Across the 38 Iowa Plan G carriers (non-tobacco, ages 65–85), Plan G monthly premiums in 2026 range from approximately $116 to $624/month (TPP rate database, CY2026).

High-Deductible Plan G (HDG) is offered by 29 Iowa carriers; premiums range from approximately $99 to $575/month (TPP rate database, CY2026, non-tobacco, ages 65–85). HDG works well for beneficiaries who want catastrophic protection at a lower monthly cost and can absorb the $2,950 annual deductible (2026 CMS high-deductible Medigap deductible).

Part D Costs and the LIS Benchmark

For 2026, Iowa (PDP Region 25 — IA/MN/MT/ND/NE/SD/WY) has 11 standalone PDP plans (CMS 2026 Fact Sheet). The CMS Low Income Subsidy (LIS / Extra Help) benchmark premium for Region 25 is $41.47/month (CMS CY2026 Regional Rates and Benchmarks).

Iowa-Specific Medicare Rules

No State Medigap Birthday Rule

Iowa does not have a state Medigap Birthday Rule or Anniversary Rule. Outside of the federal 6-month Medigap Open Enrollment Period and qualifying federal guaranteed-issue events, most Medigap purchases in Iowa are subject to medical underwriting at the carrier's discretion.

Medicare Savings Programs (MSPs)

Iowa offers Medicare Savings Programs (MSPs) through Iowa Medicaid (Iowa Department of Health and Human Services):

• QMB (Qualified Medicare Beneficiary): Covers Part A and Part B premiums, deductibles, and cost-sharing.
• SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premiums only.
• QI (Qualifying Individual): Also covers Part B premiums; subject to annual appropriations.

Apply through Iowa Medicaid or contact Iowa SHIIP (1-800-351-4664) for free enrollment assistance. MSP enrollment also automatically qualifies you for Extra Help / LIS on Part D. Learn more about MSPs →

Iowa SHIIP

Iowa SHIIP (Senior Health Insurance Information Program) is Iowa's federally designated State Health Insurance Assistance Program (SHIP), operated by the Iowa Insurance Division. SHIIP provides free, unbiased Medicare counseling statewide.

Phone: 1-800-351-4664
Website: iid.iowa.gov/consumers/shiip

Enrolling in Medicare in Iowa

Standard Enrollment Periods

• Initial Enrollment Period (IEP): 7-month window centered on your 65th birthday month. Enroll at ssa.gov or call 1-800-772-1213.
• Annual Election Period (AEP): October 15 – December 7 each year.
• Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31.
• Federal 6-month Medigap OEP: Starts when you are 65+ and enrolled in Part B; first-time Medigap guaranteed-issue.
• Special Enrollment Periods (SEPs): Learn more →

Iowa SHIIP Counseling

Contact Iowa SHIIP at 1-800-351-4664 for free one-on-one Medicare guidance statewide.

Frequently Asked Questions