IHAWP Community Engagement Requirements

You can work at least 80 hours per month or earn at least $580 per month, based on the federal minimum wage.

What counts as work?

Work can include:

• Full-time or part-time employment
• Self-employment
• Seasonal work
• Work in exchange for money, goods, or services
• Unpaid work other than community service 

Examples of proof

You can provide:

• Pay stubs
• A W-2
• An employer earnings statement or letter showing your earnings and/or hours worked
• A self-employment ledger showing your earnings and/or hours worked
• A tax return, including all pages and schedules

What must the proof show?

If you earn less than $580 per month, your proof must show the number of hours you work.

You can participate in a qualifying job training or work program for at least 80 hours per month.

What counts as job training?

Your program must qualify under at least one of the following:

• Title I of the Workforce Innovation and Opportunity Act (WIOA) of 2014
• Section 236 of the Trade Act of 1974
• The Employment and Training Program under section 6(d)(4) of the Food and Nutrition Act of 2008. Find eligible programs in Iowa.
• An employment and training program operated by the U.S. Department of Labor or the U.S. Department of Veterans Affairs

Examples of proof

You can provide training logs or a letter from your training program.

What must the proof show?

Your proof must confirm that the program qualifies and show the dates and hours you participated.

You can be enrolled in an educational program at least half-time.

If you are enrolled less than half-time, you must complete other qualifying activities to meet the requirement of at least 80 hours per month.

What counts as education?

Qualifying educational programs include:

• A college or other institute of higher education
• High school or an equivalent program
• A career or technical school

Examples of proof

You can provide:

• An enrollment letter
• A transcript
• A registration letter
• A class schedule

What must the proof show?

If you are enrolled less than half-time, your proof must show the number of credit hours or monthly attendance hours.

You can complete at least 80 hours of unpaid community service per month as part of a structured program that benefits the community.

Community service can be voluntary or court-ordered. It cannot involve partisan activities.

Examples of community service

You may be able to complete community service at:

• Schools
• Humane societies
• Libraries
• Food banks
• Parks through volunteer programs

Examples of proof

You can provide a letter from the organization, signed by your community service supervisor.

What must the proof show?

Your proof must include:

• The organization's name and address
• The type of activity
• The dates and hours of service
• The name of a contact person

You can meet the community engagement requirement by combining qualifying activities that total at least 80 hours per month.

What activities can you combine?

You can combine:

• Work
• Education
• Job training or work programs
• Community service

Example

You could work 60 hours per month and complete 20 hours of community service per month to reach the 80-hour requirement.

Examples of proof

Provide proof for each activity you use to meet the requirement. See the sections above for examples of acceptable proof and what the proof must show.

Who qualifies

You are excluded from the community engagement requirement if you are currently pregnant or received postpartum coverage through Iowa Medicaid within the last 12 months.

Examples of proof

You can provide a written statement or a completed Community Engagement Declaration form. You can also report a current pregnancy by calling your eligibility worker.

What must you provide?

If you report a current pregnancy, provide your due date and the number of babies you are expecting.

Who qualifies

You may be excluded if you provide regular, ongoing care to a child under age 14 or a person with a disability.

• If you are related to the child or person with a disability, or live with them, you must provide care that is regular and not incidental.
• If you are not related to the child or person with a disability and do not live with them, you must provide at least 80 hours of care per month. The care must be regular and not incidental.

Examples of proof

You can provide:

• A school enrollment letter
• Custody or guardianship papers
• A doctor's statement confirming the person needs daily assistance or a care plan
• Home and Community-Based Services (HCBS) paperwork naming you as a caregiver
• A completed Community Engagement Declaration form

What must the proof show?

Your proof must show that the care is regular and not incidental.

If you are not related to the child or person with a disability and do not live with them, your proof must also show the number of hours of care you provide each month.

Who qualifies

You are excluded if:

• You are currently incarcerated or were released from incarceration within the last four months.
• You are currently participating in a work release program or left a work release program within the last four months.

Examples of proof

You can provide a letter from your probation or parole officer, a booking record, or a court record.

What must the proof show?

Your proof must show the dates of your incarceration or participation in a work release program.

Who qualifies

You are excluded if you participate in an inpatient or outpatient drug or alcohol addiction treatment program that meets the program requirements.

The program must be operated by a qualifying private nonprofit organization or institution, or a publicly operated community mental health center, and provide treatment intended to help people recover from drug or alcohol addiction.

Examples of proof

You can provide a letter from the program or your counselor, confirmation of enrollment or attendance, or a discharge summary.

What must the proof show?

Your proof must confirm that the program meets the requirements and show your dates of participation.

Who qualifies

You are excluded if you are blind or disabled, have a substance use disorder or disabling mental disorder, have a physical, intellectual, or developmental disability, or have a serious or complex medical condition that prevents you from completing 80 hours per month of approved activities.

Your medical provider must confirm that your condition prevents you from meeting the 80-hour monthly requirement for work, education, volunteering, or other approved activities.

Examples of proof

You can provide a written statement or a completed Community Engagement Declaration form.

You can also report a disability, medical frailty, or serious medical condition by calling your eligibility worker.

Who qualifies

You are excluded if:

• You live in a household receiving Supplemental Nutrition Assistance Program (SNAP) benefits and are subject to at least one of the SNAP work requirements, including the general work requirement or the time-limit work requirement.
• You are subject to the Family Investment Program (FIP) work requirement.

How is this verified?

Iowa HHS will check available electronic data sources to determine whether you qualify for this exclusion.

You do not need to provide proof unless HHS requests it.

Who qualifies

You are excluded if the U.S. Department of Veterans Affairs (VA) has given you a temporary or permanent disability rating of 100% (total).

Examples of proof

You can provide:

• A VA disability rating decision
• A VA award letter
• A VA benefits summary
• A screenshot from VA.gov showing your disability rating

Who qualifies

You are excluded if you are a member of a federally recognized tribe or have received a referral or services from the Indian Health Service, a tribal health program, or an urban Indian health program.

Examples of proof

You can provide a written statement or a completed Community Engagement Declaration form.

You can also report that you qualify for this exclusion by calling your eligibility worker.

For New Applicants: 

These requirements take effect December 1, 2026, for individuals who apply on or after that date. 

Applicants must meet the requirement for the month immediately preceding their application month.

For Current Members: 

These requirements apply to active IHAWP members with renewal dates on or after February 2027. 

Members must meet the requirement for any two months during the review period since their last eligibility determination or renewal.

If the requirement applies to you, you must spend at least 80 hours each month on one or more of these activities:

• Work: Work for 80 hours per month or earn at least $580 per month (based on the federal minimum wage).
  *Income from seasonal work may be averaged.
• Job Training: Take part in a qualifying job training or work program for 80 hours per month.
• Education: Enrolled in a high school, college, GED, or other career and technical programs at least half-time.
• Community Service: Volunteer work for 80 hours per month.

You can combine different activities to reach your 80 hours.

Note: New applicants must meet CER for the month prior to the month of their application. Current members must meet CER for at least two months since their last Medicaid application or renewal.

Some people on the IHAWP program are excluded from these new requirements.

These groups include: 

• American Indians/Alaska Natives
• Those under 19 or over 64
• Individuals who are medically frail or otherwise have special medical needs 
  • NOTE: The state may require medical documentation for the medically frail exclusion.
• Pregnant or had a baby in the last 12 months while on Iowa Medicaid
• Caregivers of children under 14 or someone with a disability
• Participating in a drug or alcohol treatment program
• Participants in SNAP or FIP work programs
• Veterans rated as totally disabled
• Individuals currently or recently in jail or prison

• Update your contact information. Make sure Iowa HHS has your current information (like address, phone number, and email address) so they can contact you about these eligibility changes. To report a change, call 1-877-347-5678 or email [email protected].
• Check your mail and email. Iowa HHS will send you a letter or email in the upcoming months if the eligibility changes apply to you.
• Track your activities. Keep track of, or gather documents for, any work, volunteer, job training, or school hours you complete each month. Iowa HHS will contact you when this information is required. 

If you want to see whether these requirements apply to you, visit our Self-Service Portal and chat with Ellie, our virtual assistant.

To report a change call 1-877-347-5678 or by emailing [email protected] 

Iowa HHS will contact you if they need information about your Community Engagement activities. If you’re contacted, you can use the Community Engagement Portal (CEP) to upload information, but you can also provide information by:

• Phone: 1-877-347-5678
• Fax: The fax number will be provided on the request for information.
• Or visit your local HHS office.

The online CEP will be active on December 1, 2026. The CEP will only be available if you are required to submit your hours, and only during your application and renewal period. To learn how to report your hours in the CEP, view the CER Reporting Process (386.34 KB) .pdf .

If the new requirement applies to you and you don’t meet it, your Medicaid coverage may be denied or discontinued.

If this happens:

• You can apply again at any time. Visit Iowa’s Self Service Portal at https://hhsservices.iowa.gov/apspssp/ssp.portal to get started if you lose coverage.
• You might be able to get health coverage through the Health Insurance Marketplace®, but you might not qualify for financial help to lower your monthly premium. Visit HealthCare.gov to find or enroll in a health plan or call 1-800-318-2596 (TTY: 1-855-889-4325).

• Call 1-877-347-5678 Monday through Friday from 8:00 a.m. to 4:30 p.m. 
• Email us at [email protected]