Monthly Contributions

How do I know if I have a monthly contribution?

Iowa Medicaid will send you a monthly billing statement. The statement will be sent near the end of each month, for the next month's coverage.
 
Please make sure that Iowa Medicaid has your most up-to-date address information so that mail is sent to the correct address. To verify that Iowa Medicaid has your correct address on file, please contact Iowa Medicaid Member Services at 1-800-338-8366 or 515-256-4606 (when calling from within the Des Moines area), Monday - Friday, 8 a.m. to 5 p.m.
 
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.
 

Why am I being charged?

Members in the Iowa Health and Wellness Plan receive *free health coverage in their first year of eligibility. Members must complete their Healthy Behaviors in the first year, and every year after, to continue to receive free health services the following year.
 
*There are no copayments for health care services and prescriptions. There is an $8 copay for using the emergency room for non-emergency services. However, this charge may vary slightly depending on your MCO.
 

How much is the monthly contribution?

There are no charges for health services during a member's first year of enrollment. Beginning in the second year of enrollment, small monthly contributions may be required, depending on a member's family income.
  • Individuals with income 0-50 percent of the Federal Poverty Level: No contribution, per state legislation.
  • Individuals with income 51-100 percent of the Federal Poverty Level: $5 monthly contribution, or $60 annually.
  • Individuals with income 101-133 percent of the Federal Poverty Level: $10 monthly contribution, or $120 annually.

Who is not required to pay the monthly contribution?

Some members are not required to complete their Healthy Behaviors or pay a monthly contribution but, they are still encouraged to complete their Healthy Behaviors.
 
Excluded Members
  • Medically Exempt
  • American Indian/Alaskan Native
  • Members with an income 0-50 percent of the Federal Poverty Level

Do my contributions stop if I complete my Healthy Behaviors mid-year?

No. You are able to complete your Healthy Behaviors now but, they will count for the following year. Your contributions would not end until your next annual enrollment date.
 
NOTE: Members have 12 months to complete their Healthy Behaviors. Members are given an additional 30 day grace period when their contributions initially begin to complete their Healthy Behaviors.
  • If a member completes their Healthy Behaviors during the 30 day grace period, their contributions for the year will be waived.
  • If the member does not complete their Healthy Behaviors during the 30 day grace period, they will have monthly contributions.
Example: If you were initially enrolled in the Iowa Health and Wellness Plan July 1, 2017, your initial 12 months of coverage would be between July 1, 2017 and June 30, 2018. If you do not complete your Healthy Behaviors, your contriutions would begin July 1, 2018. Your 30 day grace period would begin June 30, 2018 and end on July 31, 2018.
 

I never received notice that I would be charged a monthly contribution.

Iowa Medicaid may not have your most up-to-date address on file. To verify that Iowa Medicaid has your correct address on file, please contact Iowa Medicaid Member Services at 1-800-338-8366 or 515-256-4606 (when calling from within the Des Moines area), Monday through Friday between 8 a.m. to 5 p.m.
 
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.
 

My income has changed; does this change my monthly contribution?

Any changes in income may impact your Medicaid eligibility. Please call the DHS Call Center at 1-877-347-5678 to update your eligibility information.
 

Will I lose my Medicaid coverage if I do not pay the monthly contribution?

Members who do not complete their Healthy Behaviors and do not pay their monthly contribution after 90 days, depending on their income, may be disenrolled from the Iowa Health and Wellness Plan.
 
If you are not able to make your monthly contribution payment, you may claim financial hardship. To claim financial hardship, you can check the hardship box on your monthly statement and return the payment coupon or, call Iowa Medicaid Member Services at 1-800-338-8366 or 515-256-4606 (when calling from within the Des Moines area), Monday through Friday, 8 a.m. to 5 p.m. 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.
 
 

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.