Cost Estimator Tool

Through your myWellmark account, you can access Care Finder and the Cost Estimator Tool. This tool can provide you insight into how much a procedure, service, or doctor's visit will cost depending on where you seek service. This will not only show your out-of-pocket cost, but also what the service will cost the health plan.

The Iowa Hospital Association also provides an Iowa Hospital Charges Compare tool that allows you to compare the cost of service offered by Iowa Hospitals.

The costs of services cost more when a member seeks services out-of-state. This is to portray the differences in costs for the UNI PPO (Alliance Select), as the UNI Blue Advantage (HMO) only has coverage out-of-state for accidental injuries or emergencies.

Wellmark also has a helpful guide on questions you should ask before a procedure, during a hospital stay, and after receiving care.

Steps to Access the Cost Estimator Tool

1. Log into your myWellmark Account.
2. Choose 'Find Costs' under Latest Claims
3. Click on either Medical or Drug Costs
4. Select 'Estimate your costs'
5. Enter the name of a procedure ("MRI") or a billing code ("73221") to compare costs

In 2020, the Federal Government finalized the Transparency in Coverage Rule (TCR), which requires health insurers of self-funded plans to provide cost-sharing data to consumers via machine-readable files as of July 1, 2022 for plan years beginning on or after Jan. 1, 2022. These files provide pricing data for covered items and services based on in-network negotiated payment rates and historical out-of-network allowed amounts. Information in these files must be updated and published monthly.

Machine-Readable Files

• University of Northern Iowa

Note: Machine-readable files are not meant for users. Those enrolled on the UNI self-insured health plans should use the Cost Estimator Tool provided on the myWellmark Account.