Iowa Health and Wellness Plan



The Iowa Health and Wellness Plan provides comprehensive health coverage at low or no cost to members. 
The Iowa Health and Wellness Plan refers to one plan that includes two separate coverage programs. All Iowa Health and Wellness Plan members are covered for the same types of health benefits but how members get medical care is different for each program. Eligibility is based on household income. Read the most up-to-date information on the Iowa Health and Wellness Plan relative to the Medicaid Modernization transition.
 

The Iowa Health and Wellness Plan was enacted through bi-partisan legislation to provide comprehensive health care coverage to low income adults. The plan offers coverage to adults age 19-64 with an income up to 133 percent of the Federal Poverty Level ($15,521 per year in 2014). The plan began on January 1, 2014, and currently serves more than 100,000 Iowans.

  • Iowa Wellness Plan: The Iowa Wellness Plan is an Iowa Medicaid program that covers adults ages 19 to 64. Eligible member income is at or below 100 percent of the Federal Poverty Level ($11,490 for individuals or $15,510 for a family of two). Members can choose a provider from the statewide provider network and are able to get care from local providers. A list of Iowa Wellness Plan providers by Iowa County is available at the Find a Provider webpage. 

  • Iowa Marketplace Choice Plan: The Iowa Marketplace Choice Plan covers adults age 19 to 64 with income from 101 percent through 133 percent of the Federal Poverty Level (between $11,491 and $15,282 for individuals or $15,511-$20,628 for a family of two). The Marketplace Choice Plan allows members to get health care coverage through select insurers with plans on the Health Insurance Marketplace. Medicaid pays the premiums of the health plan for the member. Members get care from providers approved by the health plan.

Timeline of Events for the Iowa Health and Wellness Plan

News and Announcements
  • CMS Approves Launch of IA Health Link for April 1, 2016: The Centers for Medicare and Medicaid Services (CMS) has approved Iowa’s plan to modernize Medicaid. Iowa and CMS have agreed to an April 1, 2016 implementation date. Read the Governor’s press release. Read the letter from the Iowa Medicaid Director. Read the letter from CMS.

  • Extension of Waiver for NEMT: The Centers for Medicare and Medicaid Services (CMS) has granted Iowa's request for a temporary extension of the Non-Emergency Medical Transportation (NEMT) waiver from March 31, 2016 through May 31, 2016. Read the CMS letter for more information.

  • Iowa Wellness Plan Provider List:  A list of Iowa Wellness Plan providers is now available to Iowa Wellness Plan members through the Iowa Medicaid website. Members may use this list to find an Iowa Wellness Plan provider to enroll with. This list will be updated periodically. 

  • Iowa Wellness Plan Benefits Coverage List.  The Iowa Wellness Plan is an Iowa Medicaid program that covers adults ages 19 to 64.  The Iowa Wellness Plan Benefits Coverage List of covered benefits and excluded codes and arranged by category of service is now available for providers.















On this page, you’ll find all documents related to the Section 1115 Demonstration Waivers authorizing the Iowa Health and Wellness Plan and ongoing implementation and evaluation.
 
Access the most up-to-date information on the Iowa Wellness Plan Accountable Care Organizations and the Value Index Score on this page.
 
Provider Information: Toolkit, Patient Manager Agreement, Guide and FAQ

Find the latest information for providers on the Iowa Health and Wellness Plan, including the patient manager agreement and guide.

Archive: Iowa Health and Wellness Plan Weekly Updates
Find archived issues of the Iowa Health and Wellness Plan stakeholder and partner email updates on this page.




Healthy Behaviors Program
On this page, you'll find information on the Healthy Behaviors Program, samples of member mailings, the provider toolkit and more.

Member Contributions
On this page, you'll find information on the member contribution process, samples of the statement, instructions on how to read the statement and frequently asked questions.

Managed Care and County-Based Enrollment Maps
Iowa Health and Wellness Plan Enrollment Maps by County (December 2015)
Iowa Health and Wellness Plan Enrollment Maps By County (September 2015)
Iowa Wellness Plan Managed Care Map (May 2015)

Iowa Marketplace Choice Plan Changes
Iowa Marketplace Choice Plan Changes Frequently Asked Questions (November 2014)
Iowa Marketplace Choice Plan CoOportunity Member Letter (November 2014)
Iowa Marketplace Choice Plan CoOportunity Member Pharmacy Flyer (November 2014)

Fact Sheets and Frequently Asked Questions
Medicaid Renewal Process for Members Fact Sheet (November 2014)
Medicaid Renewal Process for Enrollment Assisters Fact Sheet (November 2014)
Iowa Health and Wellness Plan Waiver Fact Sheet (January 28, 2014)
Iowa Health and Wellness Plan Outreach and Education Fact Sheet (January 28, 2014)
Iowa Medicaid Managed Care Fact Sheet (February 2015)
Iowa Health and Wellness Plan Implementation Frequently Asked Questions (January 23, 2014)
Iowa Health and Wellness Plan Waiver Approval Frequently Asked Questions (January 3, 2014)

Dental Wellness Plan
Dental Wellness Plan Information Sessions Flyer (March 20, 2014)
Dental Wellness Plan Fact Sheet (January 28, 2014)
Iowa Health and Wellness Plan Accountable Dental Care Plan- Working Draft (October 4, 2013)
Dental Wellness Plan Website

Educational Presentations
Iowa Health and Wellness Plan Overview Presentation (January 21, 2014)
Medically Exempt Training Presentation (April 2014)
Iowa Wellness Plan: Bridge to Transformation (August 14, 2013)

Medically Exempt Materials
Iowa Health and Wellness Plan Medically Exempt Toolkit (April 2016)
Medically Exempt Frequently Asked Questions (April 2014)
Medically Frail/Exempt Provider Referral Form (November 19, 2013)
Medically Frail/Exempt Definition (November 19, 2013)

Iowa Health and Wellness Plan Benefits Documents
Iowa Health and Wellness Plan vs. State Medicaid Plan Medically Exempt Benefit Comparison (November 2014)
Iowa Health and Wellness Plan vs. IowaCare Benefit Comparison (September 25, 2013)
Iowa Health and Wellness Plan Overview (July 2013)