Healthy Behaviors

Members in the Iowa Health and Wellness Plan can receive free healthcare if they choose to take specific steps to protect their health and complete what are known as Healthy Behaviors. To continue receiving free coverage under the Iowa Health and Wellness Plan, you must complete your Healthy Behaviors. There are two Healthy Behaviors requirements you need to complete each year: 

 

• Call your primary care provider (PCP) to schedule your wellness exam
• Tell your PCP this is one of your healthy behaviors for your Iowa Health and Wellness Plan

• Call your dentist to schedule a dental exam
• Tell your dentist this is one of your healthy behaviors for your Iowa Health and Wellness Plan

There is a copay for using the emergency room for non-emergency services. This charge may vary slightly depending on your MCO. 

 

Your MCO will send you Healthy Behavior reminder letters before the end of your enrollment year:

There are no charges for health services during a member’s first year of enrollment. Beginning in the member’s second year of enrollment, small monthly contributions may be required, depending on family income. There are no copayments for health care services and prescriptions.

• How to Read Your Iowa Medicaid Billing Statement  
• Sample of the Iowa Medicaid Billing Statement (​Español)
• Please mail your payment to:

Iowa Medicaid Enterprise

Iowa Health and Wellness Plan Contributions

PO Box 14485

Des Moines, IA 50306-3485

 

If a member is unable to pay their contribution, they may check the hardship box on their monthly statement and return the payment coupon OR call the Iowa Medicaid Enterprise (IME) Member Services at 1-800-338-8366. 

 

Important: Claiming financial hardship will apply to that current month's amount due only. Members will still be responsible for amounts due from past months. Members will also be responsible for amounts due in future months unless they claim hardship in those months. Any payment that is more than 90 days past due will be subject to recovery and, depending on their income, may be disenrolled.

An annual wellness exam or “physical” refers to a medical exam you receive from a health care provider that is aimed at preventing health problems before they occur. An annual dental wellness exam is a checkup from your dentist which aims to prevent dental problems before they occur. In the physical exam, the health care provider will do things like check your pulse and blood pressure, listen to your lungs with a stethoscope, recommend preventive screenings or take a blood sample to check your cholesterol. This is different from the type of exam you might get when you visit a health care provider because you are sick or hurt and have specific health problems that need to be addressed.

 

A routine physical exam keeps your provider updated about your health so you can get the care you need and gives you a chance to talk to your health care provider about any health concerns. Even if you do not feel sick, you should get a physical exam from your health care provider every year.

 

In a dental exam, your dentist will go over your dental health. You may receive a cleaning or basic x-rays. It’s important to maintain a healthy mouth. It’s a key part of overall health. Remember, under the Iowa Health and Wellness Plan, you will not be charged for check-ups and preventive screenings.