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The Iowa Refugee Health Program coordinates with local clinics, resettlement agencies, local public health agencies, and community organizations to protect and improve the health and well-being of refugees.
The primary goal of the program is to ensure each newly arriving refugee receives a comprehensive health assessment.
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During the initial refugee health assessment, clinicians:
- identify and address the immediate health needs of refugees
- evaluate for diseases of public health significance
- treat acute and chronic conditions
- establish primary care, and
- make referrals to specialists when needed.
Health assessment data guides the development of public health responses to emerging refugee health issues.
The Iowa Refugee Health Program communicates pertinent refugee health related updates to local partners and is responsible for compiling, analyzing, and communicating data obtained from health assessments.
Back to topRefugee Health
List items for Refugee Health
A refugee is a person who has been forced to flee his or her home country because of fear of persecution or violence. The United Nations High Commissioner of Refugees (UNHCR) defines a refugee as a “person who, owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable to, or owing to such fear, is unwilling to avail himself of the protection of that country.”
Iowa’s official involvement with refugee resettlement began in 1975, when Governor Robert Ray answered President Ford’s call to state governments to help resettle Southeast Asian refugees. Governor Ray established a task force, began to resettle Tai Dam refugees, and became an activist and leader in refugee resettlement.
For more information about refugees:
The Federal Refugee Act of 1980 directs every state to offer a health examination to newly arriving refugees; however, the assessment is not mandatory. In Iowa, newly arriving refugees typically enroll in Medicaid, which covers the cost of the initial health assessment as well as any necessary follow-up. The Iowa Refugee Health program developed the Initial Refugee Health Assessment using the Centers for Disease Control and Prevention (CDC) Guidelines for the Domestic Refugee Health Assessment. Ultimately, completion of the initial refugee health assessment will:
- Protect and improve the health of Iowa’s refugee populations
- Prevent disease
- Familiarize refugees with the U.S. health-care system
The CDC recommends that refugees receive an initial health assessment within 30 days of arrival. Resettlement agencies coordinate appointments, transportation, and accompany refugees to the initial health assessment.
An overseas medical examination is mandatory for all refugees coming to the U.S. to identify applicants with inadmissible health-related conditions. Panel physicians selected by the U.S. Department of State perform the examination, which includes a physical examination, an evaluation for tuberculosis, and a blood test for syphilis. The vaccination requirements include vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Some refugees may receive a pre-departure medical screening conducted approximately three weeks before departing for the U.S. if previously diagnosed with class B1 TB (tuberculosis fully treated using direct observed therapy, or abnormal chest x-ray with negative sputum smears and cultures, or extrapulmonary TB). This screening includes a repeat physical examination with focus on TB signs and symptoms, chest x-ray, and sputum collection.
The final overseas medical screening includes a Fit to Fly Pre-Embarkation Check, in which panel physicians perform two pre-embarkation checks within 48 hours of departure. Clinicians assess fitness for travel, screen for lice, and administer presumptive treatment for malaria and intestinal parasites depending on country of origin.
The Iowa Initial Refugee Health Assessment, also known as a post-arrival medical screening, differs from the overseas medical examination and other screenings in its purpose and scope. The refugee health assessment is a comprehensive examination designed to assess refugees’ health conditions, including testing for acute and chronic health conditions. The assessment aims to reduce health-related barriers to successful resettlement, introduce refugees to the U.S. healthcare system, and protect the health of Iowa residents and the U.S. population.
Currently, 14 clinics in Iowa provide initial refugee health assessments.
If you are a medical professional interested in providing initial health assessment services to refugees, please contact the Refugee Health Program at 515-322-0037. See locations by downloading the Refugee Health Clinic List (110.94 KB).pdf (110.94 KB) .pdf .
Medicaid for Non-Citizens
List items for Medicaid for Refugees (Non-Citizens)
Beginning October 1, 2026, Refugees and similar groups will lose Medicaid. New arrivals will instead receive up to eight months of Refugee Medical Assistance, and emergency Medicaid will remain available for life‑threatening situations. Learn more below.
Federal law recently changed under the OBBA (One Big Beautiful Bill), also known as the Working Families Tax Cut (WFTC). Starting October 1, 2026, the federal government will only help pay for Medicaid for:
- U.S. citizens;
- Lawful permanent residents (people with a green card); and
- A few other specific noncitizen groups
Under these new rules, refugees and certain other newcomers without a green card will no longer qualify for full Medicaid. Some groups—such as lawfully present children—can still qualify under other federal options. Iowa continues to use one of these options (called CHIPRA Section 214) to keep children eligible.
The following groups will no longer be eligible for Medicaid beginning October 1, 2026, unless they have obtained lawful permanent resident status (a green card):
- refugees
- asylees
- Afghan evacuees who are not LPRs
- individuals granted humanitarian parole for at least one year
- survivors of human trafficking
- survivors of domestic violence
If someone in one of these categories has received a green card, they can continue to qualify for Medicaid. These groups are also exempt from the five-year bar, meaning they do not need to wait five years after receiving their green card to be eligible.
- Q&A Reference Guide (201.82 KB) .pdf
- Refugee and Newcomer Checklist (134.29 KB) .pdf
- Understanding Medicaid Changes (228.55 KB) .pdf
- Food Pantry Directory (90.82 KB) .xlsx
- Free Medical Clinic Directory (187.31 KB) .pdf
- Federally Qualified Health Centers (FQHCs) (182.53 KB) .pdf
- Certified Community Behavioral Health Clinics (295.23 KB) .pdf
Amharic - Refugee Medicaid Changes QA Reference Guide (307.09 KB) .pdf
Amharic - Refugee-Newcomer Checklist (199.37 KB) .pdf
Amharic - Understanding Medicaid Changes (305.47 KB) .pdf
Arabic - Refugee Medicaid Changes QA Reference Guide (284.03 KB) .pdf
Arabic - Refugee-Newcomer Checklist (263.73 KB) .pdf
Arabic - Understanding Medicaid Changes (370.46 KB) .pdf
Burmese - Refugee Medicaid Changes QA Reference Guide (269.38 KB) .pdf
Burmese - Refugee-Newcomer Checklist (182.72 KB) .pdf
Burmese - Understanding Medicaid Changes (296.57 KB) .pdf
Dari - Refugee Medicaid Changes QA Reference Guide (284.59 KB) .pdf
Dari - Refugee-Newcomer Checklist (261.12 KB) .pdf
Dari - Understanding Medicaid Changes (353.77 KB) .pdf
French - Refugee Medicaid Changes QA Reference Guide (204.13 KB) .pdf
French - Refugee-Newcomer Checklist (145.58 KB) .pdf
French - Understanding Medicaid Changes (226.19 KB) .pdf
Haitian Creole - Refugee Medicaid Changes QA Reference Guide (179.37 KB) .pdf
Haitian Creole - Refugee-Newcomer Checklist (136.21 KB) .pdf
Haitian Creole - Understanding Medicaid Changes (200.55 KB) .pdf
Pashto - Refugee Medicaid Changes QA Reference Guide (246.21 KB) .pdf
Pashto - Refugee-Newcomer Checklist (280.08 KB) .pdf
Pashto - Understanding Medicaid Changes (352.22 KB) .pdf
Somali - Refugee Medicaid Changes QA Reference Guide (185.28 KB) .pdf
Somali - Refugee-Newcomer Checklist (139.14 KB) .pdf
Somali - Understanding Medicaid Changes (213.1 KB) .pdf
Spanish - Refugee Medicaid Changes QA Reference Guide
Spanish - Refugee-Newcomer Checklist (141.62 KB) .pdf
Spanish - Understanding Medicaid Changes (214.43 KB) .pdf
Swahili - Refugee Medicaid Changes QA Reference Guide (188.91 KB) .pdf
Individuals who do not qualify for ongoing Medicaid coverage, such as refugees who have not yet obtained lawful permanent resident status (a green card), may still be eligible for Limited Medicaid for Emergency Services. If approved, Limited Medicaid for Emergency Services provides coverage only for services related to a qualifying emergency medical condition. Limited Medicaid for Emergency Services is for the duration of the emergency medical diagnosis.
- Verification of Emergency Health Care Services (VEHCS) form no. 470-4299 needs to be signed by the applicant and completed by the provider. If the form is not provided with the application one will be sent to the applicant.
- The application for Limited Medicaid for Emergency Services should be submitted during the same month of the emergency.
Iowa Administrative Code 441-75.11(1) defines an emergency medical condition as a medical condition of sudden onset (including labor and delivery) that manifests with acute symptoms of such severity, including severe pain, that without immediate medical attention could reasonably result in:
- Serious jeopardy to the individual's health
- Serious impairment of bodily functions
- Serious dysfunction of any bodily part or organ
If approved, Limited Medicaid for Emergency Services may cover eligible emergency services provided during the month in which the application is received, for dates on which qualifying services were rendered.