HF 500 requires health insurance companies in Iowa to cover maintenance and repairs for complex rehabilitation technology wheelchairs (CRT wheelchairs) starting January 1, 2026. It directly affects patients using CRT wheelchairs (individually configured for medical needs), qualified wheelchair suppliers, and health insurance carriers. The bill mandates that qualified suppliers provide service/repairs and annual preventative maintenance without requiring prior authorization or documentation of ongoing medical necessity from insurers. Suppliers must be accredited, employ certified professionals, and maintain service records that insurers cannot audit. This applies to all health insurance plans covering these devices, ensuring ongoing access to critical mobility support.
HF 658 requires most health insurance plans in Iowa to cap out-of-pocket costs for prescription insulin at $25 per prescription for up to a 31-day supply. It applies to all covered insulin types (rapid-acting, short-acting, intermediate-acting, and long-acting) and affects people with diabetes who have insulin-covered plans. The cap takes effect for new or renewed policies starting January 1, 2026, but excludes specialized coverage like Medicare supplements, dental, or workers’ compensation plans. Plans may offer lower costs than $25 but cannot exceed this limit. This directly reduces financial burdens for Iowans managing diabetes through their insurance.
HF 735 requires health insurers and pharmacy benefits managers in Iowa to include all payments made by a plan participant (or others on their behalf) when calculating their total out-of-pocket cost-sharing under health plans. It specifically protects Health Savings Account (HSA) eligibility by delaying HSA contribution calculations until after a participant meets the federal minimum deductible, except for preventive care services. The bill applies to most health benefit plans issued or renewed in Iowa on or after January 1, 2026, but excludes accident-only, Medicare supplement, dental, vision, and other specialized coverage. It directs Iowa’s insurance commissioner to create implementing rules under Chapter 17A.
HF 636 requires dental insurance carriers in Iowa to cover dental services approved through prior authorization, mandating they reimburse providers at the contracted rate for these services. It directly affects dental care providers, insurance carriers, and patients enrolled in dental plans. The bill prohibits carriers from denying claims for pre-approved services except under specific exceptions, such as when benefit limits were exceeded after authorization or documentation fails to support the service. Contracts attempting to waive these requirements are declared void, and the insurance commissioner may create implementing rules.
SF 552 requires Iowa's Department of Health and Human Services (HHS) and Department of Administrative Services (DAS) to review anti-obesity medications - including GLP-1 agonists - for use in two specific programs: the state's medical assistance program (Medicaid) and health insurance plans for state employees. The review must assess medication effectiveness for weight loss, impact on related health conditions (comorbidities), potential cost savings, recommended eligibility, and short- and long-term coverage costs. HHS and DAS must submit a report to the legislature by January 5, 2026, detailing their findings, proposed eligibility rules, and cost analysis. This bill does not change current coverage but mandates a formal review to inform future policy decisions.
HF 330 requires health insurance plans to cover evidence-based treatment for autism spectrum disorder (ASD) for individuals diagnosed with ASD. It directly affects people with ASD who have health insurance, mandating that insurers provide this coverage without excessive cost-sharing. The bill establishes specific requirements for insurance companies to include ASD treatment services in their coverage, applying to most health insurance plans. This law, signed by the Governor on June 11, 2025, ensures that individuals with ASD can access necessary treatment through their insurance.
