Medicaid Programs

Click on program title for more information.

American Indian or Alaska 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.

Breast and Cervical Cancer:

"Care for Kids" Early Periodic Screening, Diagnosis, and Treatment for Children (EPSDT):

EPSDT is also known as "Care for Kids" Program and focuses on providing Medicaid eligible children age birth through 20 years with preventive health care services including physicals, immunizations, vision, hearing and dental exams.

Community-Based Neurobehavioral Rehabilitation Services (CNRS): 

CNRS is a specialized category of neuro-rehabilitation provided by a multidisciplinary team of allied health and support staff that have been trained in, and deliver, services individually designed to address cognitive, medical, behavioral, and psychosocial challenges, as well as the physical manifestations of an acquired brain injury. The service is provided to adults with brain injury and co-occurring mental health diagnosis.

Consumer Choices Option (CCO):

Consumer Choices Option is an option available under the Home- and Community-Based Services (HCBS) Waivers that gives you control over a targeted amount of Medicaid dollars so that you can develop a plan to meet your needs by directly hiring employees and/or purchasing other goods and services.

Consumer Directed Attendant Care (CDAC):

Consumer-directed attendant care services are services designed to help people do things that they normally would for themselves if they were able. CDAC is a direct, hands-on service which takes place in the home or community.

Dental Wellness Plan:

The Dental Wellness Plan provides dental coverage for adult Iowa Medicaid members, age 19 and older. Dental Wellness Plan Kids provides dental coverage for Iowa Medicaid kids, age 18 and under.

Early ACCESS:

Early ACCESS is Iowa’s system for providing early intervention services. It is available to infants and toddlers from birth to age three years who have a:

• Health or physical condition affecting their growth and development, or
• Delays in their ability to play, think, hear, see, eat, talk, or move.

Family Planning Program (FPP): 

The FPP is for men and women who are 12-54 years of age. The FPP helps with the cost of family planning related services. The FPP is a state-funded DHS program which replaces the Iowa Family Planning Network (IFPN) program. Eligibility and covered benefits do not change.

Hawki:

Healthy and Well Kids in Iowa (Hawki) provides health care coverage for children of working families. No family pays more than $40 per month and some families pay no premiums. Dental-only coverage is also available under Hawki for children whose families have health insurance but not dental insurance.

Health Homes:

A Health Home provides whole person, patient-centered, coordinated care for all stages of life and transitions of care. Iowa Medicaid is implementing a Health Home program for Medicaid members with specific chronic conditions. Members must have one chronic condition and be at-risk for a second condition such as hypertension, overweight, heart disease, diabetes, asthma, substances abuse and mental health. Health Homes will not cost extra for the Medicaid member. 

Health Insurance Premium Payment (HIPP):

HIPP is for people who are working in lower paying jobs and can't afford to pay the premium for their company's insurance plan. HIPP helps to pay the premium on your employer's insurance plan and keep you covered.

Home- and Community-Based Services:

Home- and Community-Based Services (HCBS) are Medicaid programs that give you more choices about how and where you receive services. HCBS are for people with disabilities and older Iowans who need services to allow them to stay in their home and community instead of going to an institution. There are several programs that provide HCBS. The program names are HCBS Waivers (there are seven), Habilitation, PACE, Home Health, Hospice, and Targeted Case management.

IA Health Link: 

IA Health Link brings together physical, behavioral and long-term care into one program across Iowa. Most Iowa Medicaid members are enrolled in the IA Health Link managed care program, with coverage provided by a Managed Care Organization (MCO) that you get to choose.

Iowa Health and Wellness Plan: 

The Iowa Health and Wellness Plan provides comprehensive health coverage at low or no cost to Iowans between the ages of 19 and 64. Eligibility is based on household income. Find more eligibility information on the Who Qualifies webpage.

Long Term Care:

Long term care services are available for Medicaid members to help them maintain a good quality of life in settings such as nursing homes, hospice, intermediate care facilities, and in their communities with help through HCBS Waiver services. Services are intended to help people reach the highest degree of independence possible.

Medicaid for Employed People with Disabilities (MEPD):

MEPD is a Medicaid coverage group that allows people to work (and earn income) and still remain eligible for Medicaid because the earnings do not count against income eligibility rules. MEPD individuals must be disabled, under age 65, earning income with a net family income of less than 250% of the federal poverty level. If family income reaches a certain level, MEPD members will pay a sliding scale premium for Medicaid coverage.

Medicaid for Kids with Special Needs (MKSN)

Most Iowa Medicaid members are enrolled in the IA Health Link managed care program. MKSN members receive coverage from the IA Health Link program. This program gives you health coverage through a Managed Care Organization (MCO) that you get to choose. 

Medically Needy:

The Medically Needy Medicaid program is for members whose income is too high for Medicaid. However, if your medical costs are so high that they use up most of you income, you may qualify for some payment help through the Medically Needy program. If you qualify, you will be responsible for paying some of the costs of your medical expenses; this is called a "spend down".

Medicare Savings Program (MSP)

Qualified Medicare Beneficiary (QMB)

Specified Low-Income Medicare Beneficiary (SLMB)

Money Follows the Person:

Money Follows the Person Partnership for Community Integration Project to provide opportunities for individuals in Iowa to move out of Intermediate Care Facility for Intellectually Disabled and into their own homes in the community of their choice. Grant funds provide funding for the transition services and enhanced supports needed for the first year after they transition into the community. 

Non-Emergency Medical Transportation (NEMT): 

The NEMT services are for members with full Medicaid benefits, who need travel reimbursement or a ride to get to their medical appointments. Eligible members will receive NEMT services from different NEMT brokers depending on their eligibility status and whether they receive coverage directly from Iowa Medicaid Fee-for-Service or are enrolled in the IA Health Link managed care program. An NEMT broker is a contracted provider with the Iowa Department of Human Services (DHS), the Iowa Medicaid Enterprise (IME), and the IA Health Link Managed Care Organizations (MCOs) The broker checks member and trip eligibility, handles claims, and follows up on trips and claims. 

Pre-Admission Screening and Resident Review (PASRR):

The goal of the PASRR process is to reduce inappropriate institutionalization for individuals with serious mental illness, intellectual disability and related conditions and improve the quality of life for those individuals who are placed in Medicaid certified facilities. PASRR process identifies people with mental illness and/or intellectual disability and ensures they are served appropriately. 

Program of All-Inclusive Care for the Elderly (PACE):

This program helps you and health providers come together for preventive care, primary care, social services, therapeutic recreation, acute and long-term care services. This program aims to protect and improve your health; and your quality of life. The goal of PACE is to keep you in your home. PACE is only available in a limited area.

Supports Intensity Scale (SIS):

Iowa is piloting a new standardized assessment tool for individuals with intellectual disabilities and/or other developmental disabilities called the Supports Intensity Scale (SIS). Developed by the American Association on Intellectual and Developmental Disabilities (AAIDD), the SIS is designed to measure the intensity of supports that each person with an intellectual or developmental disability needs in order to fully participate successfully in community life. This pilot project will take place in Boone, Franklin, Hamilton, Humboldt, Madison and Wright counties. It will also be piloted with Money Follows the Person participants and residents of Woodward and Glenwood Resource Centers. More information on the SIS assessment tool may be found at http://www.aaidd.org/sis.

Smoking Cessation:

Iowa Medicaid Smoking Cessation program is comprised of two components; Quitline Iowa and pharmacy services. Quitline Iowa provides counseling services for tobaccos users who want to quit. Toll-free helpline is 1-800-784-8669. Pharmacy services include various nicotine replacement products such as the patch, gum or other products. Medicaid members need to work with their physicians to receive a diagnosis and prior authorization for access to the products.

State Supplementary Assistance:

State Supplementary Assistance (SSA) is a program to meet the additional special needs of aged, blind and disabled people not met by the standard benefit rate paid by Supplemental Security Income (SSI). Iowa's SSA program covers six categories of special needs; blind allowance, dependent person allowance, family life home assistance, in-home health-related care assistance, residential care facility assistance, and supplement for Medicare and Medicaid eligibles.