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Iowa Health Advantage (HMO I-SNP) H6765-001 • 2027 • Dickinson County, IA

CMS Rating: Not yet rated by CMS.
Monthly Premium
$24.60Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Basic, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Dickinson County, IA
Local Enrollment
22 beneficiaries in Dickinson County
Last update:

Introduction

CMS Plan ID H6765-001 identifies Iowa Health Advantage, a Medicare Advantage Institutional Special Needs Plan (I-SNP) offered by Iowa Health Advantage. Its provider network is a Health Maintenance Organization (HMO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $24.60 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.

Enrollment in this plan requires you to live in Dickinson County, Iowa. CMS reports 22 beneficiaries enrolled in this plan in Dickinson County. New members can call the plan directly at (866)327-0523 (TTY (833)312-0046) for assistance.

Eligibility

Iowa Health Advantage is a Hybrid Institutional (HI-SNP) plan for individuals that require nursing care.

Special Needs Plan Type
Institutional Special Needs Plan (I-SNP)
Medicare Requirement
Must have Medicare Part A and Part B
Special Needs Requirement
This plan accommodates individuals in a long-term care facility. It is also available to people who need the level of care given in a long-term care facility who can remain at home or live in an assisted living facility.
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Dickinson County

Compare this plan with the most-enrolled other HMO I-SNP plan available in Dickinson County, Iowa. Enrollment is based on CMS local enrollment data.

HMO I-SNP plan comparison for Dickinson County, Iowa
Plan Detail Iowa Health Advantage Iowa Health Advantage Choice
CMS Plan ID H6765-001-0 H6765-002-0
Local Enrollment 22 0
Monthly Premium $24.60 $24.60
Medical Deductible Coming soon Coming soon
Maximum Out-of-Pocket $9,850.00 $9,850.00
Part B Giveback Coming soon Coming soon
Primary Care Coming soon Coming soon
Specialist Coming soon Coming soon
Part D Deductible $700.00 $700.00
CMS Star Rating Not yet rated Not yet rated
Dental Coming soon Coming soon
Vision Coming soon Coming soon
Hearing Coming soon Coming soon

Plan Benefits

Iowa Health Advantage has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H6765-001.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H6765-001-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: 20% coinsurance

Preventive and Wellness Services

Annual wellness exam
Not covered
Telehealth benefit
In-network: $0 copay
Routine chiropractic
Not covered
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
Not covered
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: 20% coinsurance
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: 20% coinsurance
Diagnostic tests and procedures
In-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency room care
20% coinsurance
Worldwide emergency care
Coming soon
Urgent care
20% coinsurance
Inpatient hospital care
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150
Skilled Nursing Facility
Tier 1
$0 per day for days 1-20
$0 per day for days 21-100
Ground ambulance
In-network: 20% coinsurance

Mental Health Services

Outpatient individual therapy
In-network: 20% coinsurance
Outpatient group therapy
In-network: 20% coinsurance
Inpatient psychiatric hospital care
Tier 1
$0 per day for days 1-60
$434 per day for days 61-90
$868 per day for days 91-150

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: 0%-20% coinsurance
Occupational therapy
In-network: 0%-20% coinsurance

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Durable medical equipment
In-network: 20% coinsurance
Prosthetics
In-network: 20% coinsurance

Medicare Part B Drugs

Chemotherapy
In-network: 0%-20% coinsurance
Other Part B drugs (Medicare-covered)
In-network: 0%-20% coinsurance

Dental Services

Oral exam
Not covered
Dental x-rays
Not covered
Cleaning
Not covered
Periodontics
Not covered
Endodontics
Not covered
Restorative services
Not covered
Implant services
Not covered
Orthodontics
Not covered
Oral/Maxillofacial surgery
Not covered

Vision Services

Routine eye exam
In-network: $0 copay
Contact lenses
In-network: $0 copay
Eyeglass frames only
In-network: $0 copay
Eyeglass lenses only
In-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Upgrades
In-network: $0 copay

Hearing Services

Hearing exam
In-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Prescription hearing aids
In-network: $0 copay
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
Not covered
Massage therapy
Not covered
Home/bathroom safety devices
Not covered

Certain preventive services are covered 100% by Iowa Health Advantage as a Part B benefit.

Prescription Drug Coverage

Iowa Health Advantage includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Iowa Health Advantage (H6765-001-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$24.60
Supplemental Part D Premium:$0.00
Total Part D Premium:$24.60
Low-Income Premium Subsidy:$24.60
Low-Income Premium Subsidy Paid by CMS:$24.60
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Iowa Health Advantage starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Iowa Health Advantage may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Iowa Health Advantage (H6765-001-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Brand-name drugs25% coinsurance25% coinsurance
Generic drugs25% coinsurance25% coinsurance
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H6765)

Medicare evaluates plan quality using a star rating system developed by the Centers for Medicare & Medicaid Services (CMS). Ratings are based on measures such as health outcomes, member experience, and customer service, and are reported on a 1 to 5 star scale, with higher ratings indicating stronger overall performance.

2027 Medicare Star Ratings for Contract H6765
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines Not enough data available
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan Not enough data available
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service Not enough data available
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan Not enough data available
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆

Contact Information for Iowa Health Advantage

Website
Iowa Health Advantage Plan Page
Providers
Iowa Health Advantage Providers Page
Formulary
Iowa Health Advantage Formulary Page
Pharmacy
Iowa Health Advantage Pharmacy Page
New Member Health Plan Help
(866)327-0523
New Member Health Plan TTY
(833)312-0046
New Member Part D Help
(866)327-0523
New Member Part D TTY Users
(833)312-0046

Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Iowa Health Advantage (official source) http://iowahealthadvantage.com October 4, 2026
CMS.gov Institutional Special Needs Plans (I-SNPs) April 28, 2026
Medicare.gov Compare types of Medicare Advantage Plans April 28, 2026
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You April 28, 2026

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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.