Iowa Department of Human Services

Amerigroup Suspension of MCO Choice

Why can't I change my MCO to Amerigroup?

Amerigroup Iowa is one of the IA Health Link Managed Care Organizations (MCOs). However, they are not currently accepting new IA Health Link members.
 

Why isn't Amerigroup Iowa accepting new members?

Amerigroup Iowa does not currently have the capacity to accept additional members to their covered population. UnitedHealthcare is confident in their ability to provide services and is expanding their network and staff to accommodate the new members. Amerigroup Iowa is building their capacity. The state continues to actively monitor their capacity.
 

What are my choices?

Right now UnitedHealthcare is the only MCO available to new IA Health Link members. In the future you will be able to choose from multiple MCOs. You will be notified when an option is available. Until then, you must have a 'good cause' reason to change your MCO.
 
Members enrolled in an MCO may not change to Iowa Medicaid Fee-for-Service for reasons of 'good cause.'
 

When will we have choice again?

The Department has put in place a suspension of MCO choice to Amerigroup. In the future you will be able to choose from multiple MCOs. You will be notified when that choice is available. Until then, you must have a 'good cause' reason to change your MCO. 
 

Are there options other than UnitedHealthcare?

At this time, UnitedHealthcare is the only MCO available to new IA Health Link members.
 

What if my doctor is with Amerigroup and is not with UnitedHealthcare?

This would be a 'good cause' reason to change your MCO. You must first file a grievance with UnitedHealthcare and see if your provider can contract with UnitedHealthcare. If you are not satisfied with the resolution, you may then contact Iowa Medicaid Member Services to request a 'good cause' change.
 
Examples include:
  • Lack of access to providers experienced in dealing with your health care needs.
  • Lack of access to services covered under the contract.
  • Poor quality of care given by your MCO.
  • The MCO plan does not cover the services you need due to moral or religious objections.

Why did I get a letter confirming I was enrolled with Amerigroup?

Iowa Medicaid allowed members to make a choice prior to receiving their letters with their tentative assignment. As soon as that choice was made, a letter was automatically sent to members with that choice. That was before Amerigroup notified the Department that they would not be taking any new members. Until Amerigroup has capacity, you will have coverage through Iowa Medicaid Fee-for-Service.
 

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?

If you were previously enrolled with AmeriHealth Caritas and chose to enroll with Amerigroup by November 16, 2017, you will be covered through Iowa Medicaid Fee-for-Service (FFS) until Amerigroup has capacity.
 
You may have received an ID card from Amerigroup Iowa, as your choice triggered cards to be mailed. However, Amerigroup Iowa is not accepting new members.  
 
You will have coverage through Iowa Medicaid FFS and will receive a notice in the mail from DHS confirming your coverage. You will show your Iowa Medicaid Assistance Eligibility Card when you receive services.
 
 
 
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.