Frequently Asked Questions

The Frequently Asked Questions (FAQs) are updated regularly to reflect the latest questions from members and providers. Check this webpage regularly for the most up-to-date information on the Iowa Health Link managed care program.

What is the Iowa Health Link program? 

• What is Iowa Health Link?
• What is a Managed Care Organization (MCO)?
• Will I still receive Iowa Medicaid coverage before I transition to an MCO?
• Who is included in the Iowa Health Link program?
• Who is exlcuded from the Iowa Health Link program?

Choose a Managed Care Organization (MCO)

• I have received my enrollment packet, what do I need to do now? Or how long do I have to change my MCO?
• What is my "Choice Period End Date"?
• How do I know which MCO is right for me?
• How do I make my MCO choice?
• What if I didn't make a change but now I want to?
• What are some examples of "Good Cause" reasons?
• When will my choice take effect?
• What is a Confirmation of Coverage letter?
• I selected a different MCO than what the letter states?
• Will I get a new ID card?
• When will my MCO ID card arrive?
• Who am I getting my ID card from?
• What do I do if my ID card is not from the MCO that I selected?

MCO Annual Choice Period (Current Iowa Health Link Members)

• Do I have to change my MCO?
• Do I need to let Iowa Medicaid know if I am staying with my current MCO?
• How do I know which MCO is right for me?
• How long do I have to change my MCO?
• What if I don't make a change in my MCO but I want to later?
• How do I change my MCO?
• When will my choice take effect?
• Why doesn't my choice take effect immediately?
• Will I still receive Medicaid benefits before I start coverage with my new MCO?
• Will my benefits change?
• Will I get a new ID card?
• I have an upcoming appointment, which ID card do I use?

Benefits and Services

• How do I know if a service is covered with Iowa Health Link or not?
• Are my pharmacy services covered under managed care?
• Are my dental services covered under managed care?
• Do I have a copay?
• What if I have an emergency and the hospital is not in my MCO’s network?
• What about Urgent Care?
• I have an upcoming appointment and need to schedule Non-Emergency Medical Transportation (NEMT), who do I contact?
• Which NEMT company does my MCO use?
• Even though my MCO is not covering my dental services, will transportation to my dental appointments still be provided by my MCO?
• How do I arrange a ride for a dental appointment, or other Non-Emergency Medical Transportation (NEMT)?
• I recently gave birth, will my newborn receive MCO coverage? If so, how do I enroll my newborn?
• Are smoking cessation services still available with my MCO?
• What is the Long Term Services and Supports (LTSS) Ombudsman program?
• Who is the LTSS Ombudsman program for?
• I am not in one of populations listed, can I receive help from the LTSS Ombudsman program?
• Why would I contact the LTSS Ombudsman?
• How do I contact the LTSS Ombudsman?

Prior Authorizations

• How are prior authorizations handled?
• What is the turnaround time for authorizations?   
• What is the direct number for prior authorizations?

Providers 

• My current provider is not in my MCO's network, can I continue to see my provider?
• What if I choose an MCO and my provider chooses a different MCO? Will my visit still be covered or will I have to pay out-of-pocket?
• A lot of patients are sent to Mayo Clinic in Rochester for services that are not offered in our state. Is my MCO contracted with these facilities?
• If a member goes to Urgent Care or an emergency room, for something that is not determined to be ‘Urgent Care,’ will the member be charged?
• If a member of Iowa Health Link sees a provider who is a registered Fee-for-Service (FFS) provider with Iowa Medicaid, but not signed with any MCO and not willing to work with the MCOs, will the state pay?
• Can patients be billed from providers who are not participating with the MCOs or Medicaid? 

Medicaid Programs

• I am part of the Iowa Health and Wellness Plan, will I still need to finish my healthy behaviors?
• Are members who identify as American Indian or Alaska Native (AI/AN) required to enroll with an MCO?
• Members in Long Term Care programs, and in nursing facilities, are required to have their Level of Care evaluated. Who will determine a member's Level of Care?

Resources

• How do I contact the MCOs?
• Where can I find important documents?
• Where can I find new announcements and updates to the Iowa Health Link program?

Estate Recovery

When you received Medicaid benefits, which includes capitation fees paid to a managed care organization, even if the plan did not pay for any services, the State of Iowa has the right to ask for money back from your estate after your death. Members affected by the estate recovery policy are those who: 

• Are 55 years of age or older, regardless of where they are living; or
• Are under age 55 and: 
  • Reside in a nursing facility, an intermediate care facility for persons with intellectual disability, or a mental health institute, and
  • Cannot reasonably be expected to be discharged and return home.