Program 3 Plus is a comprehensive health care program that covers hospital, medical, surgical, outpatient, and other health care services such as physical therapy. Coverage is also provided for routine physicals, newborn care (including inoculations, scheduled visits, etc.), well-child checkups, treatment of mental health conditions, treatment of chemical dependency, and prescription drugs.
- State of Iowa Program 3 Plus Insurance Certificate (pdf)
- State of Iowa Program 3 Plus Summary of Benefits and Coverages - 2017 (pdf)
- State of Iowa Program 3 Plus Summary of Benefits and Coverages - 2016 (pdf)
- Prescription Drugs
How an Individual Uses Program 3 Plus
Health care under the Program 3 Plus may be obtained from almost any provider you wish. However, there are advantages to using participating providers who have contracts with Blue Cross and Blue Shield.
In Iowa, participating providers will accept payment arrangements and file claims for you with Wellmark Blue Cross and Blue Shield of Iowa. Payment is made directly to these providers.
Non-participating providers do not have contracts with Blue Cross and Blue Shield. They do not agree to accept payment arrangements and are not responsible for filing claims for you. Non-participating providers may charge more for health care than participating providers. Payment is made to you and you are responsible for paying the provider. Non-participating providers can bill you for the difference between what Blue Cross and Blue Shield will pay for a service and what they charge (balance billing).
In an emergency, if you cannot reasonably reach a participating provider, emergency care received during the course of the emergency will be reimbursed as though the service were received from a participating provider (excludes ambulances).