Most Medicaid members are enrolled in the IA Health Link managed care program. This program gives you health coverage through a Managed Care Organization (MCO) that you get to choose. Some Medicaid members, however, receive Medicaid coverage through a Fee-for-Service model. The Children's Health Insurance Program (CHIP) services continue to be offered through the Healthy and Well Kids in Iowa program, also known as Hawki .
WHAT IS IA HEALTH LINK?
IA Health Link brings together physical, behavioral, and long term care under one program. Most Medicaid members are enrolled in the IA Health Link managed care program. Some Medicaid members, however, receive Medicaid coverage through a Fee-for-Service model.
What is a Managed Care Organization (MCO)?
A Managed Care Organization, or MCO, is a health plan that coordinates your care. These are the MCOs you can choose:
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Amerigroup Iowa, Inc.
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Iowa Total Care
WILL I STILL RECEIVE IOWA MEDICAID COVERAGE BEFORE I TRANSITION TO AN MCO?
Effective July 1, 2019, once a member has been deemed eligible for Medicaid, they will be automatically assigned to a MCO.
Members will be able to receive services from this MCO immediately.
Members will have 90 days from their initial enrollment ot change MCOs for any reason. If they don't make a choice, they will remain with the MCO assigned to them.
WHO IS INCLUDED IN THE IA HEALTH LINK PROGRAM?
Most members who get coverage by Iowa Medicaid will be enrolled in the managed care program, and receive coverage through an MCO. The benefits you receive from your selected MCO will depend on the type of Medicaid coverage you qualify for.
Some members may choose to enroll in the managed care program:
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Members who are enrolled with the Program of All-Inclusive Care for the Elderly (PACE) program. If you are a member enrolled with PACE, please contact your PACE provider before making any changes to your plan. Your PACE provider will assist you with disenrolling with PACE and enrolling with the IA Health Link managed care program.
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American Indian or Alaskan Native members may also choose to enroll in the Managed Care program. If you are a member who identifies as American Indian or Alaskan Native, contact Iowa Medicaid Member Services at 1-800-338-8366 to learn about enrolling in the IA Health Link Managed Care program.
WHO IS EXCLUDED FROM THE IA HEALTH LINK PROGRAM?
Members who are not transitioning to the IA Health Link managed care program will remain in Medicaid Fee-for-Service. This includes members who qualify for or receive services from the following Fee-for-Service programs:
- Medicare Savings Program (MSP)
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medicare Beneficiary (SLMB)
- Three Day Emergency
Up to 3 days of Medicaid is available to pay for the cost of emergency services for aliens who do not meet citizenship, alien status, or social security number requirements. The emergency services must be provided in a facility such as a hospital, clinic, or office that can provide the required care after the emergency medical condition has occurred. - Medically Needy (also known as the spenddown program)
- Presumptive Eligibility (subject to change once ongoing eligibility is determined)
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Retroactive Eligibility
- American Indian or Alaskan Native program (American Indians and Alaskan Natives may choose to enroll in the managed care program. If you are a member who identifies as American Indian or Alaskan Native, contact Iowa Medicaid Member Services at 1-800-338-8366 to learn about enrolling in the IA Health Link Managed Care program).
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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.
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