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Good Cause

Because we want you to be happy with your MCO/dental carrier, you may request to change your MCO/dental carrier during your 12 months of closed enrollment. A request for this change, called disenrollment, will require a Good Cause reason.

What are some examples of Good Cause reasons?

  • Your provider/dentist pf record is not in your MCO's/dental carrier's network.

  • You need related services to be performed at the same time and not all related services are available within your current MCO's/dental carrier's provider network. Your Primary Care Provider/dentist or another provider determined that receiving the services separately would subject you to unnecessary risk.

  • Lack of access to providers experienced in dealing with your health care/dental needs.

  • Your provider has been terminated or no longer participates with your MCO/dental carrier. 

  • Lack of access to services covered under the contract.

  • Poor quality of care given by your MCO/dental carrier.

  • The MCO/dental carrier plan does not cover the services you need due to moral or religious objections.

How do I change my MCO/dental carrier if I have a Good Cause reason?

We want you to be happy with your MCO/dental carrier. If you are requesting to change your MCO/dental carrier due to Good Cause, please follow the two steps below.

  1. First, you must contact your current MCO/dental carrier to go through the MCO's/dental carrier's grievance process for resolution.

  • The MCO grievance process may take up to 30-45 days to process.

  • The dental carrier grievance process may take up to 30-90 days to process.

Please contact your MCO/dental carrier's Member Services department:

IA Health Link Members

Managed Care Organization Member Services Contact Information
Amerigroup Iowa, Inc.
Phone:     1-800-600-4441
Email:      MPSWeb@amerigroup.com
Iowa Total Care Phone:     1-833-404-1061

Dental Wellness Plan Members

Dental Carrier Member Services Contact Information
Delta Dental
Phone:     1-888-472-2793
MCNA Dental
Phone:     1-855-247-6262
Email:      info@mcna.net

If your issue has not been resolved following the decision of your grievance, you may call Iowa Medicaid Member Services at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606, Monday through Friday, from 8 a.m. to 5 p.m. for additional assistance. The final decision for disenrollment will be determined by the Department of Human Services (DHS).

Iowa Medicaid Member Services (Monday to Friday from 8 a.m. to 5 p.m.)
1-800-338-8366 (Toll Free) 
515-256-4606 (Des Moines Area)
515-725-1351 (Fax)
 
For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking, call Relay Iowa TTY at 1-800-735-2942.
 
Llame al 1-800-735-2942, a Relay Iowa TTY (teléfono de texto para personas con problemas de audición, del habla y ceguera) si necesita asistencia telefónicamente.