Rights and Responsibilities



IMPORTANT UPDATE

AmeriHealth Caritas Iowa, Inc. is withdrawing from the IA Health Link managed care program effective November 30, 2017. AmeriHealth Caritas members have been tentatively assigned to UnitedHealthcare but may choose to receive coverage through Amerigroup Iowa. Members may change their MCO for any reason until March 1, 2018. Members must  change their MCO by November 16, 2017, for their coverage to begin with Amerigroup Iowa on December 1, 2017. Learn more by reading the sample member letter and the Press Release 
 

FAQ for Members

FAQ for Providers

Updated information will be posted as it is available. Please check back regularly.

 
Member Rights
  • To receive timely, appropriate, and accessible medical care
  • To obtain a second opinion regarding a medical diagnosis
  • To choose the provider of your choice from the providers available with your MCO
  • To change your MCO as allowed by program policy
  • To appeal a decision that you do not agree with
  • To be treated with respect and dignity
  • To be treated without discrimination with regard to race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, political belief or veteran status
  • To participate in decisions regarding your health care, including the right to refuse treatment 
Member Responsibilities
  • To be knowledgeable about your medical coverage
  • To obtain routine and ongoing care from your provider in an office setting
  • To contact your provider before emergency room visits with the exception of situations requiring emergency care. (See page 15 of the IA Health Link Member Handbook for the definition of emergency situations.)
  • To carry your current medical assistance card and MCO card at all times and present it when accessing medical care. 
  • To call the number on the reverse side of your medical cards if you move or have incorrect information printed on your medical cards
  • To be responsible for any medical bills if you do not present your Iowa Medicaid card or MCO card at the time of your visit
  • To be responsible for any medical bills for services provided by a practitioner who is not participating in the Iowa Medicaid program or is not enrolled with your MCO
You Have the Right to Appeal

IA Health Link members have the right to file an appeal with their MCO, before filing an appeal with Iowa Medicaid. For benefit or service-related issues, please contact your MCO to learn about your appeal rights with them. If an Iowa Medicaid member is dissatisfied with the MCO’s decision, the member can access the State Fair Hearing appeal process through the Department of Human Services (DHS).

For more information on appeals see page 20 of the IA Health Link Member Handbook.

Learn more about the appeal process here: Appeals

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.