BlueCross BlueShield of Iowa
Wellmark Blue Cross Blue Shield
Health Insurance in Iowa
Wellmark Blue Cross and Blue Shield is Iowa’s largest health insurance company, an independent licensee of the Blue Cross Blue Shield Association with about 2 million members across both states it serves. Wellmark Health Plan of Iowa offers individual and family coverage in all 99 counties for 2026, with customizable options that range from low-premium Bronze to rich Gold benefits, including HSA-eligible plans for health care spending with pre-tax dollars. Every plan covers the essential health benefits required by the Affordable Care Act.
Blue Cross Gold Plans
Gold HMO plans carry the most comprehensive benefit levels: higher premiums, but the lowest out-of-pocket costs of any metal tier. Best for anyone expecting surgery, taking regular medications, or preferring fixed copays for every doctor visit with predictable inpatient and outpatient costs.
Blue Advantage Gold HMO Plans may be right for you if you are an individual or family who:
- Are willing to have a primary care physician (PCP) coordinate your care
- Prefers fixed doctor visit copayments
- Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
- Requires regular prescription medication
| Plan Name | Blue Advantage Gold HMO 101 | Blue Advantage Gold HMO 111* | Blue Advantage Plus Gold 101 |
|---|---|---|---|
| Deductible | $500 | $0 | $2,750 |
| Coinsurance | 30% | 0% | 20% |
| Out-of-Pocket Maximum | $5,250 | $7,150 | $3,500 |
| Primary Care Office Visit | $20 | $50 | $10 |
| Specialist Office Visit | $40 | $75 | $20 |
| Mental Illness Treatment | $20 | $50 | $10 |
| Emergency Room | $500 copay, then 30% | $750 | $400 copay, then 20% |
| Urgent Care | $20 | $50 | $10 |
| Inpatient Hospital Service | $300 copay, then 30% | $1,500 | $200 copay, then 20% |
| Outpatient Surgery | $200 copay, then 50% | $500 | $200 copay, then 40% |
| Outpatient X-Rays | 50% | $100 | 40% |
| Outpatient Imaging (CT/MRI) | 50% | $250 | 40% |
| HSA Eligible | No | No | No |
| Rx Drugs (Preferred) | $0/$10/$50/$100/30% | $0/$10/$50/$100/30% | $0/$10/$50/$100/30% |
Blue Cross Silver Plans
The middle tier balances premium against out-of-pocket exposure, and on-exchange Silver enrollment can qualify for cost-sharing reductions based on income. A strong fit for people with regular medications or frequent specialist visits.
| Plan Name | Blue Advantage Silver HMO 102 | Blue Advantage Silver HMO 103 | Advantage Silver HMO 107 | Blue Advantage Plus Silver 102 |
|---|---|---|---|---|
| Deductible | $3,000 | $3,750 | $3,500 | $3,250 |
| Coinsurance | 30% | 0% | 20% | 20% |
| Out-of-Pocket Maximum | $7,150 | $3,750 | $7,150 | $6,850 |
| Primary Care Visit | $40 | $30 | 100% after ded. | First 3 visits $0, then 20% |
| Specialist Visit | $60 | 100% after ded. | $65 | 20% |
| Mental Health | $40 | 40% | $30 | $0 |
| Emergency Room | $600 copay, then 30% | 40% | $400 copay after ded. | $600 copay, then 20% |
| Urgent Care | $40 | 100% after ded. | 100% after ded. | $20 |
| HSA Eligible | No | Yes | No | No |
Blue Cross Bronze Plans
Bronze plans are ideal for healthy Iowans who want affordable monthly costs and protection from worst-case bills, with deductibles from $5,000 to $6,850 and two HSA-eligible options. Full breakdown on our Wellmark Bronze plans page.
| Plan Name | Blue Advantage Bronze HMO 006 | Blue Advantage Bronze HMO 105 | Blue Advantage Plus Bronze 103 | Blue Advantage Plus Bronze 104 |
|---|---|---|---|---|
| Deductible | $6,500 | $6,850 | $6,600 | $5,000 |
| Coinsurance | 0% after ded. | 30% | 20% | 40% |
| Out-of-Pocket Max | $6,500 | $7,150 | $7,150 | $6,550 |
| Primary Care Visit | 0% after ded. | First 2 visits $40, then 30% | First visit $0, then 20% | 40% |
| Specialist Visit | 0% after ded. | 30% | 20% | 40% |
| Emergency Room | 0% after ded. | 30% | $950 copay, then 20% | 40% |
| HSA Eligible | Yes | No | No | Yes |
Multi-State Plans
The Multi-State Plan (MSP) Program, established under the Affordable Care Act, directs the Federal Office of Personnel Management to contract with private health insurers in each State to offer high-quality, affordable health insurance options called Multi-State Plans.
| Plan Name | BCBS Premier 101 | BCBS Solution 102 | BCBS Basic 103 |
|---|---|---|---|
| Deductible | $1,000 | $3,750 | $6,250 |
| Coinsurance | 20% | 20% | 30% |
| Out-of-Pocket Maximum | $5,800 | $6,500 | $7,150 |
| Primary Care Visit | First 3 visits $15, then 20% | First 2 visits $0, then 20% | First visit $0, then 30% |
| Specialist Visit | 20% | 20% | 30% |
| Emergency Room | $600 copay, then 20% | $750 copay, then 20% | $1,000 copay, then 30% |
| HSA Eligible | No | No | No |
HSA Plan Comparison
Three of the plans pair with a Health Savings Account, cutting your tax bill while you save for medical costs. Deductibles run $3,750 to $6,500. See our Iowa HSA plan guide for the full comparison.
| Plan Name | Blue Advantage Bronze HMO 006 | Blue Advantage Plus Bronze 104 | Blue Advantage Silver HMO 103 |
|---|---|---|---|
| Deductible | $6,500 | $5,000 | $3,750 |
| Coinsurance | 0% after ded. | 40% | 0% |
| Out-of-Pocket Maximum | $6,500 | $6,550 | $3,750 |
| Primary Care Visit | 0% after ded. | 40% | $30 |
| Specialist Visit | 0% after ded. | 40% | 100% after ded. |
| Emergency Room | 0% after ded. | 40% | 40% |
| HSA Eligible | Yes | Yes | Yes |
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Blue Advantage Gold Plans
Most comprehensive benefits with lower out-of-pocket costs. Ideal for those expecting surgery or requiring regular medications.
Find Providers and Use Your Plan
Every plan above uses the Blue Advantage HMO network, built around local health systems and clinics statewide, from every major Des Moines hospital to rural critical access facilities, and staying in-network keeps costs lowest. Already a member and needing to find, select, or change your primary care provider? The carrier’s mobile app and member portal handle it, along with your member ID card and claims. Studying abroad or traveling? The Blues network travels with you through reciprocity nationwide, and emergency benefit protection applies wherever you are. Or skip the apps and call us; that is the point of having a local agent with real customer service.
BCBSIA Dental Plans
Dental coverage here features a $50 deductible per individual ($150 family max), deductibles waived for preventive services, and a $1,000 orthodontia benefit for children under 19, with the freedom to see any dentist.
Highlights:
- $50 deductible per individual
- $1,000 orthodontia benefit for children under 19
- Use any dentist, in or out of network
Popular Hospital Network
| Medical City Hospital (Dallas) | YES |
| Memorial Hermann (Sugar Land) | YES |
| Mother Frances (Tyler) | NO |
| North Austin Medical Center | YES |
| Seton Medical Center | YES |
| UT Southwestern (Dallas) | NO |
| Baylor University Medical | YES |
| Methodist Hospital (Houston) | YES |
Frequently Asked Questions
2026 Wellmark Blue Cross Blue Shield of Iowa plans & member ratings
Wellmark Blue Cross Blue Shield of Iowa sells individual HMO plans on the statewide Blue HMO network through HealthCare.gov. Below are representative 2026 on-exchange plans with verified fixed cost-sharing and member ratings. Figures are single/individual values; several Wellmark plans track medical and drug out-of-pocket costs separately, so combined out-of-pocket can be higher. Premiums vary by age and county.
Wellmark Gold Traditional HMOPopular
Gold HMO with a low $1,750 deductible on the statewide Blue HMO network.
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Rate all four categories - Cost, Plan Value, Customer Service and Network Size - to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.6 / 5 - seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Wellmark Silver Traditional HMO
Silver HMO with a low medical out-of-pocket max.
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Baseline: 3.6 / 5 - seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Wellmark Bronze HDHP HMO HSA QualifiedHSA-eligible
HSA-qualified Bronze HMO; single deductible equals the out-of-pocket max, so it pairs with a health savings account.
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Rate all four categories - Cost, Plan Value, Customer Service and Network Size - to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.6 / 5 - seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Wellmark Standard Bronze HMO
Standardized Bronze HMO for a lower premium.
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Baseline: 3.6 / 5 - seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Wellmark Bronze Traditional HMOLowest premium
Bronze HMO for the lowest monthly premium.
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Rate all four categories - Cost, Plan Value, Customer Service and Network Size - to unlock submit. Comment optional. A first name or county are shown with your review; leave them blank to stay anonymous.
Baseline: 3.6 / 5 - seeded from CMS quality ratings and public member reviews; updates as visitor ratings come in.
Iowa individual-market rate history
| Plan year | IA individual market (avg approved) |
|---|---|
| 2019 | -7.9% |
| 2020 | -10.8% |
| 2021 | -0.2% |
| 2022 | +6.6% |
| 2023 | +2.3% |
| 2024 | -5.5% |
| 2025 | -3.1% |
| 2026 | +15.3% |
Sources: Iowa Insurance Division filings, carrier 2026 SBCs, and ACA Signups Iowa 2026 summary. The column is the Iowa individual-market average approved change.
Wellmark is Iowa's statewide Blue plan.
Wellmark covers all 99 counties with broad provider access. A licensed agent can compare it against Oscar and Ambetter and check your after-subsidy price at your ZIP, free. Call (855) 847-7020.