Iowa Medicaid Eligibility and Enrollment
- Find out if you are eligible for Medicaid in Iowa. Learn how Medicaid works and how to apply for benefits in Iowa and how it differs from other states.
Iowa Medicaid provides a variety of health care and medical support services to low-income people who are blind, aged 65 and older, pregnant or disabled. The Iowa Department of Human Services manages the Medicaid program and administers benefits to those who qualify.
A wide range of medically necessary services are available under one of the state’s managed health care plans. Medicaid members receive their health care services through a provider network of Managed Care Organizations (MCO) that they participate in. There are a few treatments for which beneficiaries must pay a small co-payment at time of services.
A Managed Care Organization is a health plan that administers your care and coordinates your coverage. Iowa Medicaid has two MCOs that you can choose: Amerigroup Iowa, Inc., and Iowa Total Care.
What Does Iowa Medicaid Cover?
Iowa Medicaid is designed with three main coverage groups: IA Health Link, Medicaid Fee-for-Service and HAWKI. Most Iowa Medicaid beneficiaries participate in the IA Health Link managed care program, where they access medical services from a large network of providers of their choice across the state.
The Iowa Health and Wellness Plan is offered under the IA Health Link program and provides comprehensive medical care at low or no cost to residents between the ages of 19 and 64. Eligibility is based on household income. All Iowa Health and Wellness Plan members receive medical care for free if they choose to participate in the Healthy Behaviors program. Some beneficiaries are served through the Medicaid Fee-for-Service system where their medical care providers are paid separately for each treatment, such as a doctor’s visit, test or procedure.
Children in Iowa receive health care from the Children’s Health Insurance Program (CHIP) — also known as the Healthy and Well Kids in Iowa Program (HAWKI). Iowa provides comprehensive health coverage for uninsured children of working families who cannot afford medically necessary care.
No family in Iowa pays more than $40 a month for the service, and many families pay zero. Most of the applicants who qualify for HAWKI program in Iowa are in one of these groups:
- Under age 19
- Have no other health insurance plans
- A citizen of the United States or qualified alien
- Be in a family that meets the income requirements for this program
- Not a dependent of a State of Iowa employee
- Not currently covered under the Medicaid program
Children from two-member households who have a yearly income level of $31,000 may receive their medical care for free. Children from four-member households who have a yearly income of $47,160 may receive their medical care for free.
Who Is Eligible for Medicaid in Iowa?
How much Medicaid you qualify for and the specific benefits you receive will depend on your family size, income, assets and medical needs. The Iowa Department of Human Services administers and determines eligibility for all applicants. Iowa Medicaid supports more than 724,000 enrollees who depend on the state’s health care program. There are several key eligibility criteria for receiving Medicaid in Iowa:
- Children under the age of 21 or an adult age 65 and older
- Parents living with a child under the age of 18
- Pregnant women
- Women diagnosed with breast or cervical cancer
- Those who are residents of Iowa and U.S. citizens
- Adults between the ages of 19 and 64 and who have incomes at or below 133% of the federal poverty level
To qualify for Medicaid in Iowa, applicants must earn less than $16,971 annually for an individual and $34,846 annually for a family of four.
How Do I Enroll in Medicaid in Iowa?
If you are qualified for Iowa Medicaid, you can enroll in several ways. Applications are available online at the Department of Human Services Benefits portal. The website allows you to read about the Medicaid program and learn about the benefits you’re eligible for. To apply for Medicaid coverage, visit the Medicaid’s How to Apply web page.
Contact Information for Iowa Medicaid
You may contact the Iowa Medicaid Member Services hotline Monday through Friday from 8 a.m. to 5 p.m. at (800) 338-8366.