Frequently Asked Questions



IMPORTANT UPDATE--TEMPORARY SUSPENSION OF MCO CHOICE

AmeriHealth Caritas Iowa, Inc. withdrew 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 transitioned 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.

The Frequently Asked Questions are updated regularly to reflect the latest questions from members and providers. Check this webpage regularly for the most up-to-date information on the IA Health Link managed care progra333m.

Amerigroup Suspension of MCO Choice

  • Why can't I change my MCO to Amerigroup?
  • Why isn't Amerigroup Iowa accepting new members?
  • What are my choices?
  • When will we have choice again?
  • Are there options other than UnitedHealthcare?
  • What if my doctor is with Amerigroup and is not with UnitedHealthcare?
  • Why did I get a letter confirming I was enrolled with Amerigroup?
  • I got a card from Amerigroup Iowa that says they are my MCO, but I heard they weren't taking new patients. Who do I have coverage through?

AmeriHealth Caritas Iowa, Inc. Withdraw

  • What happened?
  • Who is affected?
  • Does this affect me?
  • When did this happen?
  • Why did this happen?
  • Will the other plans leave Iowa?
  • Why was I assigned to UnitedHealthcare? Do I have to receive coverage through UnitedHealthcare?
  • Can I keep my current case manager?
  • Can I continue to see my doctor?
  • Where can I find more information?

What is the IA Health Link program? 

  • What is IA Health Link?
  • Will I still receive Iowa Medicaid coverage before I transition to an MCO?
  • Who is included in the IA Health Link program?
  • Who is exlcuded from the IA Health Link program?

Managed Care Organization (MCO)

  • What is a Managed Care Organization (MCO)?
  • Are there options other than UnitedHealthcare?
  • Will I get a new ID card?
  • When will my ID card arrive?

Benefits and Services

  • How do I know if a service is covered with IA Health Link or not?
  • Are my pharmacy services covered under managed care?
  • Are my dental services covered under managed care?
  • Do I have a copay?
  • What if I have an emergency and the hospital is not in my MCO’s network?
  • What about Urgent Care?
  • I have an upcoming appointment and need to schedule Non-Emergency Medical Transportation (NEMT), who do I contact?
  • Which NEMT company does my MCO use?
  • Even though my MCO is not covering my dental services, will transportation to my dental appointments still be provided by my MCO?
  • How do I arrange a ride for a dental appointment, or other Non-Emergency Medical Transportation (NEMT)?
  • I recently gave birth, will my newborn receive MCO coverage? If so, how do I enroll my newborn?
  • Are smoking cessation services still available with my MCO?
  • What is the Long Term Services and Supports (LTSS) Ombudsman program?
  • Who is the LTSS Ombudsman program for?
  • I am not in one of populations listed, can I receive help from the LTSS Ombudsman program?
  • Why would I contact the LTSS Ombudsman?
  • How do I contact the LTSS Ombudsman?

Prior Authorizations

  • How are prior authorizations handled?
  • What is the turnaround time for authorizations?   
  • What is the direct number for prior authorizations?

Providers 

  • My current provider is not in my MCO's network, can I continue to see my provider?
  • What if I choose an MCO and my provider chooses a different MCO? Will my visit still be covered or will I have to pay out-of-pocket?
  • A lot of patients are sent to Mayo Clinic in Rochester for services that are not offered in our state. Is my MCO contracted with these facilities?
  • If a member goes to Urgent Care or an emergency room, for something that is not determined to be ‘Urgent Care,’ will the member be charged?
  • If a member of IA Health Link sees a provider who is a registered FFS provider with IME, but not signed with any MCO and not willing to work with the MCOs, will the state pay?
  • Can patients be billed from providers who are not participating with the MCOs or Medicaid? 

Medicaid Programs

  • I am part of the Iowa Health and Wellness Plan, will I still need to finish my healthy behaviors?
  • Are members who identify as American Indian or Alaska Native (AI/AN) required to enroll with an MCO?
  • Members in Long Term Care programs, and in nursing facilities, are required to have their Level of Care evaluated. Who will determine a member's Level of Care?

Resources

  • How do I contact the MCOs?
  • Where can I find important documents?
  • Where can I find new announcements and updates to the IA Health Link program?
 
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.