Healthy Behaviors



IMPORTANT UPDATE--TEMPORARY SUSPENSION OF MCO CHOICE

AmeriHealth Caritas Iowa, Inc. is withdrawing from the IA Health Link managed care program effective November 30, 2017. AmeriHealth Caritas members have been assigned to UnitedHealthcare. The department has put in place a temporary suspension of Managed Care Organization (MCO) choice.
 
Previously the Department notified members they would be able to choose Amerigroup Iowa. Due to concerns with capacity, Amerigroup Iowa is not accepting any additional members at this time. This also includes all new IA Health Link members. In the future members will be able to choose from multiple MCOs. Members will be notified when that choice is available. 
 
AmeriHealth Caritas’ members will transition to UnitedHealthcare effective December 1, 2017. Learn more by reading the sample member letter, the Press Release and the FAQs below.   
 

FAQ for Members

FAQ for Providers

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

 

Complete your Healthy Behaviors. 
Keep your free coverage!

What are Healthy Behaviors?
Members in the Iowa Health and Wellness Plan can receive free healthcare if they choose to take specific steps to protect their health and complete what are known as Healthy Behaviors. Read the Healthy Behaviors Factsheet for more information. To continue receiving free coverage under the Iowa Health and Wellness Plan, you must complete your Healthy Behaviors. There are two Healthy Behaviors requirements you need to complete each year: 
 
1. You must complete a Health Risk Assessment (HRA)
If you are part of the IA Health Link managed care program, contact your Managed Care Organization (MCO) to complete your HRA.
  • Amerigroup Iowa, Inc. 1-800-600-4441
  • AmeriHealth Caritas Iowa, Inc. 1-855-332-2440
  • UnitedHealthcare Plan of the River Valley, Inc. 1-800-464-9484
If you are NOT part of the IA Health Link managed care program, you can complete your HRA by calling 1-800-338-8366 or visit www.AssessMyHealth.com and use code MBR11.
 
2. You must get a Wellness Exam OR a Dental Exam
 
Wellness Exam
  • Call your primary care provider (PCP) to schedule your wellness exam
  • Tell your PCP this is one of your healthy behaviors for your Iowa Health and Wellness Plan
Dental Exam
  • Call your dentist to schedule a dental exam 
  • Tell your dentist this is one of your healthy behaviors for your Iowa Health and Wellness Plan
All members will have the first 30 days of each annual enrollment period to complete or self-report completion of healthy behaviors for the previous enrollment period.
 
There is a copay for using the emergency room for non-emergency services. This charge may vary slightly depending on your MCO. 
 
What is the monthly contribution?
There are no charges for health services during a member’s first year of enrollment. Beginning in the member’s second year of enrollment, small monthly contributions may be required, depending on a family income. There are no copayments for health care services and prescriptions.
 
  • Some members will contribute $5 per month. 
  • Some members $10 per month.
  • Members with individual earnings less than 50 percent of the Federal Poverty Level ($5,835 per year for an individual, or $7,865 for family of two in 2014) will not have monthly contributions.
Financial Hardship
If a member is unable to pay their contribution, they may check the hardship box on their monthly statement and return the payment coupon OR call the Iowa Medicaid Enterprise (IME) Member Services at 1-800-338-8366. 
 
Important: Claiming financial hardship will apply to that current month's amount due only. Members will still be responsible for amounts due from past months. Members will also be responsible for amounts due in future months unless they claim hardship in those months. Any payment that is more than 90 days past due will be subject to recovery and, depending on their income, may be disenrolled.
 
What about the wellness exam or dental exam? Why visit a doctor or dentist if I am not sick?
An annual wellness exam or “physical” refers to a medical exam you receive from a health care provider that is aimed at preventing health problems before they occur. An annual dental wellness exam is a checkup from your dentist which aims to prevent dental problems before they occur. In the physical exam, the health care provider will do things like check your pulse and blood pressure, listen to your lungs with a stethoscope, recommend preventive screenings or take a blood sample to check your cholesterol. This is different from the type of exam you might get when you visit a health care provider because you are sick or hurt and have specific health problems that need to be addressed. 
 
A routine physical exam keeps your provider updated about your health so you can get the care you need and gives you a chance to talk to your health care provider about any health concerns. Even if you do not feel sick, you should get a physical exam from your health care provider every year.
 
In a dental exam, your dentist will go over your dental health. You may receive a cleaning or basic x-rays. It’s important to maintain a healthy mouth. It’s a key part of overall health. Remember, under the Iowa Health and Wellness Plan, you will not be charged for check-ups and preventive screenings. 
 
Notice: Dental Wellness Plan members also have Healthy Behaviors to complete for dental coverage. Find information on these ‘Healthy Behaviors’ for Dental Wellness Plan here.
 

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.