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Modified health plans

Our Affordable Care Act (ACA) modified health plans are designed with you in mind — providing a simple approach to health insurance and one less number to remember.  A modified plan might be best for you if you need predictable costs for high value, commonly used services.

You will find the following modified health plans offered through Wellmark on External Site:

Wellmark Health Plan of Iowa (state-based network)
Wellmark Value Health Plan (community-based network)
Wellmark Bronze
Wellmark Value Bronze
Wellmark Silver
Wellmark Value Silver
Wellmark Gold
Wellmark Value Gold

High-deductible health plans

High-deductible health plans (HDHP) put you in the driver's seat by giving you more control of your health care costs. Because you pay the full cost for care (excluding preventive care) and prescriptions until you reach your deductible, an HDHP helps you understand the true cost of care. An HDHP might be best if you want to pair your health plan with a health savings account.

You will find the following high-deductible health plans offered through Wellmark on External Site:

Wellmark Health Plan of Iowa
Wellmark Value Health Plan
Wellmark Bronze HDHP
Wellmark Value Bronze HDHP

What are metallic tiers?

Metallic tiers make it easy to compare plans. Each tier represents an overall percentage that your plan will cover. These percentages represent a combination of the plan's deductible, copayments and coinsurance.

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Metallic tiers to consider are Bronze, Silver and Gold.

  • Bronze: member pays 40%; insurance plan pays 60%.
  • Silver: member pays 30%; insurance plan pays 70%.
  • Gold: member pays 20%; insurance plan pays 80%.

Prescription drug coverage

Both our Wellmark Value Health Plan and Wellmark Blue HMO plans have the Blue Rx EssentialsSM drug plan. To find out if your current prescription drug is covered, visit the Blue Rx Essentials Drug List External Site.

Know your tiers of coverage

  • TIER 1: Generic drugs and select brand-name drugs
  • TIER 2: Preferred brand-name drugs
  • TIER 3: Non-preferred brand-name drugs
  • PREFERRED specialty drugs
  • NON-PREFERRED specialty drugs

CVS SpecialtyTM Pharmacy

As a Wellmark member, your specialty prescriptions will be filled through CVS. With CVS Specialty and its dedicated CareTeam, you can:

  • Pick up prescriptions locally or have them shipped to you.
  • Talk to your CareTeam, led by pharmacists and nurses, who can help to answer all your questions.
  • Refill prescriptions and check order status from your computer or phone.