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Iowa Health Advantage Choice (HMO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Iowa Health Advantage Choice (HMO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Iowa Health Advantage Choice (HMO I-SNP) in 2026, please refer to our full plan details page.
Iowa Health Advantage Choice (HMO I-SNP) is a HMO I-SNP plan offered by Mitchell Family Office available for enrollment in 2025 to people living in Iowa. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Iowa Health Advantage Choice (HMO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Iowa Health Advantage Choice (HMO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Iowa Health Advantage Choice (HMO I-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Iowa Health Advantage Choice (HMO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Iowa Health Advantage Choice (HMO I-SNP) prescription drug coverage features an annual drug deductible of $615. This deductible is the amount you must pay out of pocket for your medications before your plan coverage kicks in. Specific drug coverage tier details, including copayments and coinsurance rates, are not available for this plan. To understand how your specific prescriptions are covered, you should contact the plan directly to verify their current formulary and pricing.
Additional Benefits
The Iowa Health Advantage Choice (HMO I-SNP) plan offers robust healthcare coverage with no copays for many primary services, though a 20% coinsurance typically applies to outpatient care, emergency services, and medical equipment. Members benefit from fully covered primary care visits, preventive services, home health, and up to 100 days of skilled nursing facility care with no copays or coinsurance. Inpatient hospital stays are also covered with no coinsurance, though Medicare-defined copays and prior authorizations apply. To help with daily healthcare costs, this plan includes a $105 monthly over-the-counter allowance and a $225 annual eyewear benefit with no copays. Routine hearing exams and hearing aids are also covered with no copay up to a $500 annual limit per ear. Additionally, Medicare Part B insulin is available for a $35 copay, while other Part B drugs carry a 0% to 20% coinsurance.
Inpatient Hospital See details
Iowa Health Advantage Choice (HMO I-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, though prior authorization and Medicare-defined copayments apply. Additional days, upgrades, and non-Medicare-covered stays are not covered under this benefit.
Outpatient Services See details
Iowa Health Advantage Choice (HMO I-SNP) covers outpatient services with no copays, but a 20% coinsurance applies to outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services. Prior authorization is required for outpatient hospital, observation, and ambulatory surgical center services.
Partial Hospitalization See details
Iowa Health Advantage Choice (HMO I-SNP) covers partial hospitalization services with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Iowa Health Advantage Choice (HMO I-SNP) covers Medicare-approved ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Non-emergency transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Iowa Health Advantage Choice (HMO I-SNP) covers emergency and urgently needed services with a 20% coinsurance and no copay, both of which count toward the plan deductible. Coinsurance is waived if you are admitted to the hospital within one day, though worldwide emergency, urgent, and transportation services are not covered.
Primary Care See details
Iowa Health Advantage Choice (HMO I-SNP) covers primary care physician services, telehealth, and opioid treatment with no copay and no coinsurance, though chiropractic services are not covered in practice. Most other covered services, including specialist visits, physical therapy, occupational therapy, and mental health services, require no copay and a 0% to 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Iowa Health Advantage Choice (HMO I-SNP) with no copay and no coinsurance, though a referral is required for some services. Covered benefits include Medicare-covered preventive care, kidney disease education, and in-home support, while annual physical exams, fitness benefits, health education, and personal emergency response systems are not covered.
Hearing Services See details
Iowa Health Advantage Choice (HMO I-SNP) partially covers hearing services, offering routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Covered prescription hearing aids have no copay or coinsurance up to a $500 annual limit per ear for up to two aids, though inner ear, outer ear, over-the-ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Iowa Health Advantage Choice (HMO I-SNP) offers partially covered vision services with no deductibles, though other eye exam services are not covered. One routine eye exam is covered annually with no copay and 20% coinsurance, while eyewear is covered up to $225 per year with no copay, featuring 20% coinsurance for contact lenses and no coinsurance for eyeglasses.
Dental Services See details
Iowa Health Advantage Choice (HMO I-SNP) provides partially covered dental services, featuring Medicare-covered dental services with no copay and a 20% coinsurance. Other dental services, including oral exams, cleanings, x-rays, fluoride treatments, and orthodontic services, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Iowa Health Advantage Choice (HMO I-SNP) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Iowa Health Advantage Choice (HMO I-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Iowa Health Advantage Choice (HMO I-SNP), with durable medical equipment, prosthetics, and medical supplies requiring no copay and a 20% coinsurance. Diabetic equipment, supplies, and therapeutic shoes or inserts are covered with no copay and no coinsurance, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Iowa Health Advantage Choice (HMO I-SNP) with prior authorization required. Diagnostic procedures and tests require a copay and 20% coinsurance, lab services have no copay, and radiological services—including X-rays, diagnostic, and therapeutic services—require a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered under the Iowa Health Advantage Choice (HMO I-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Iowa Health Advantage Choice (HMO I-SNP) provides coverage for Cardiac Rehabilitation Services with no copay, although prior authorization is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and are subject to a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Iowa Health Advantage Choice (HMO I-SNP) with no copay and no coinsurance for up to 100 days, and a prior three-day hospital stay is not required. Prior authorization is required for these services, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Iowa Health Advantage Choice (HMO I-SNP) partially covers Other Services, offering Over-the-Counter (OTC) items with no copay and no coinsurance up to a $105 monthly limit. Acupuncture and meal benefits are not covered under this plan.
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