If you suspect that someone is misusing their Medicaid benefits or someone who is not your provider requests your Medicaid information, please call The U.S. Department of Health & Human Services at 1-800-447-8477 or call Member Services at 1-800-338-8366 or locally (Des Moines area) at (515) 256-4606. View this Medicaid Fraud flyer for more information on how to report suspected Medicaid fraud.
HIPAA and Protected Health Information
HIPAA regulations ensure the privacy and security of your patient information. Learn more about HIPPA protections here: HIPPA Policy
You may ask for a hearing if you disagree with a decision that the Department of Human Services has made. The appeal must be filed within 90 days of the date of the notice. Learn more about the appeal process here: Appeals
Exception to Policy
You may request an exception to policy for an item or service that Medicaid would not otherwise cover. Learn more about the process see the exceptions to policy webpage.
Estate Recovery Law
Estate recovery means that after your death the state will recover the cost of your medical bills that Medicaid paid. The state will collect from the assets you have at the time of your death. Estate recovery applies to all persons who get Medicaid on or after July 1, 1994, and are age 55 or older or who live in a medical facility and will most likely not be able to return home. Learn more about the estate recovery law webpage.
When an Iowa Medicaid Recipient is injured as a result of an accident and there is a third party that is liable; Iowa Medicaid can recover payment for those related medical claims via a medical assistance lien. The injury may be a result of a vehicle accident, worker's compensation claim, medical malpractice suit (incident dates of July 1, 2011 and after) or slip and fall. The insurance adjuster or attorney shall notify the department of the claim or suit.
Medicaid trusts, which include Special Needs Trusts and Income Trusts, are created to allow a person to become Medicaid eligible despite having too much income or resources to meet regular eligibility limits. Income Trusts are for persons whose income is more than eligibility limits, but less than needed for health care needs. Special Needs Trusts, including Pooled Trusts, are for disabled persons who have resources over eligibility limits that can be placed in a trust. Learn more about Medicaid Trusts here: http://www.iowa-medicaidtrusts.com/
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