Who Qualifies

Most members who get coverage by Iowa Medicaid will be enrolled in the Managed Care program and will select an MCO. The benefits you receive from your selected MCO will depend on the type of Medicaid coverage you qualify for.
 
 
There are some members who are excluded from Managed Health Care. They are listed below:
  • Members who qualify for the Health Insurance Premium Payment program (HIPP).
  • Members who qualify for the Medicare Savings Program (MSP) only.
    • Qualified Medicare Beneficiary plan (QMB)
    • Specified Low-Income Medicare Beneficiary (SLMB)
  • Members who are on the three day emergency plan.
  • Members who are on the Medically Needy program also known as the spenddown program.
  • Presumptively eligible members (Subject to change once ongoing eligibility is determined.
  • Members who receive eligibility retroactively for previous months.
 
Some members may choose to enroll in the Managed Health Care progrm:
  • Members who are enrolled with the 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.
  • 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.
 
If you are unsure of the type of Medicaid program you are eligible for, please contact Iowa Medicaid Member Services for assistance at 1-800-338-8366 or locally in the Des Moines area at 515-256-4606, Monday through Friday, from 8 a.m. until 5 p.m. You may also email questions to Iowa Medicaid Member Services at IMEMemberServices@dhs.state.ia.us
 
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.