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
(HMO): personal care from a set network.
You'll need a PCP to manage your care and refer you to specialists. You must go to certain doctors and hospitals, unless it's an emergency/urgent care.

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.