University of Iowa Retirees are offered two Medicare Advantage plans with Part D which is administered by Health Alliance. If choosing one of these plans, you will receive top-notch coverage, a large network of doctors, hospitals and clinics. The two plans to choose from: University of Iowa HMO Rx Plus Plan or a custom PPO Rx plan to closely match the benefits you had with UIChoice and UISelect.
Coverage under these plans qualifies as Qualifying Health Coverage (QHC) and satisfies the Patient Protection and Affordable Care Act's (ACA) individual shared responsibility requirement.
Brief Comparison of both Plans
Plan Provision | UI HMO Rx Plus | UI PPO Rx |
---|---|---|
Definition of HMO and PPO |
Health Management Organization |
Preferred Provider Organization (PPO): a plan that has the freedom to go out-of-network, but you will pay less if you go to in-network doctors and hospitals. |
Premiums | $60/month | $320/month |
Out-of-Pocket Max | $4,000 | $2,000; combined in-network/out-of-network |
Deductible | $0 | $0; both in-network/out-of-network |
Primary Care and Specialist Care Visit |
$10 copay primary; $35 copay Specialist |
$5 copay in-network, 40% coinsurance out-of-network for both primary and specialists visits |
Emergency Room | $90 copay | $50 copay + 10% coinsurance in-network/out-of-network |
Urgent Care | $55 copay | $5 copay in-network; 40% coinsurance out-of-network |
Inpatient Hospital | $280/day (days 1-7); $0/day (days 8+) | 10% coinsurance in-network; 40% coinsurance out-of-network |
Outpatient Hospital | $275 copay | 10% coinsurance in-network; 40% coinsurance out-of-network |
Ambulance | $275 copay | 10% coinsurance in-network; 40% coinsurance out-of-network |
Diagnostic Tests, X-rays, Labs & Radiology | 20% coinsurance | 10% coinsurance in-network; 40% coinsurance out-of-network |
Coverage for Dependents
Retirees may cover dependents on their UI Health Alliance plan, who may not be age 65, as long as the dependent has both Medicare parts A & B.
Examples include:
- A dependent child over age 26 who is disabled and is on both parts A & B, or
- A spouse/partner who is disabled, under 65, and already on Medicare A & B.
Please visit the UI Health Alliance website to review the full plan details for each Health Alliance plan.
2023 Documents | 2022 Documents |
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