Iowa Department of Human Services
Published on Iowa Department of Human Services (https://dhs.iowa.gov)

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Hawki Resources

Below you will find a list of useful information resources, documents, and links to help you in getting a better understanding of the Hawki program, in determining eligibility, and in helping you through the application.

General Resources

  • Comparison of Medicaid Benefits [1]
    • Versión Español [2]
  • Hawki Income Guidelines [3] (Medical and Dental Only)
    • Versión Español [4] (2022 edition coming soon / 2022 edición próximamente)
  • Hawki MCO Health Plan Comparison [5]
  • MCO Hawki member ID cards [6]
  • Delta Dental Benefits Summary Sheet for Hawki [7]
  • Hawki MCO Enrollment Form [8]
    • Versión Español [9]

New Member Enrollment Materials

  • Welcome letter [10]
  • Hawki MCO Enrollment Form [8]
    • Versión Español [9]
  • Hawki MCO Health Plan Comparison [5]
  • Hawki Dental only welcome letter [11]

Annual Choice Period Materials

  • Hawki Annual Choice Period Letter [12]
    • Versión Español [13]
  • Hawki MCO Enrollment Form [8]
    • Versión Español [9]
  • Hawki MCO Health Plan Comparison [5]
  • Hawki Dental-Only Renewal Letter [14]

Other Notifications

  • Disenrollment Sample Letter [15]
  • Dental-Only Disenrollment Sample Letter [16]
  • Reinstatement Sample Letter [17]
  • Confirmation of MCO Choice Sample Letter [18]

MCO Member Handbooks 

  • Amerigroup Iowa, Inc. [19]
  • Iowa Total Care [20]

Health Plan / Dental Carrier Websites

  • Amerigroup Iowa, Inc. [21]
  • Iowa Total Care [22]
  • Delta Dental [23]

Application

  • DHS Services Portal [24]
  • Application for Health Coverage and Help Paying Costs [25] (Form 470-5170)
  • Solicitud de cobertura médica y asistencia para abonar el costo [26] (Form 470-5170S)

​Hawki e-News

  • Issue 1 | Volume 1 [27] (April 1, 2016)
  • Issue 2 | Volume 1 [28] (October 21, 2016)
  • Issue 1 | Volume 2 [29] (July 12, 2017)
  • Issue 2 | Volume 2 [30] (December 1, 2017)
  • Issue 1 | Volume 3 [31] (October 15, 2018)
  • Issue 1 | Volume 4 [32] (November 1, 2019)

Outreach Coordinator Resources

  • Hawki Enrollment By County Reports [33] (Monthly)
  • Hawki Grassroots Outreach Coordinators List [34]
 

Hawki Member Services (Monday to Friday from 8 a.m. to 5 p.m.)
1-800-257-8563 (Toll Free) 

Hawki@dhs.state.ia.us [35]
 
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.
 

 

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Source URL: https://dhs.iowa.gov/hawki/resources

Links
[1] https://dhs.iowa.gov/sites/default/files/Comm519.pdf?092120211338
[2] https://dhs.iowa.gov/sites/default/files/Comm519S.pdf?092420211910
[3] https://dhs.iowa.gov/sites/default/files/Iowa_Medicaid_and_Hawki_Income_Guidelines_5.22.pdf
[4] https://dhs.iowa.gov/sites/default/files/Hawki_Income_Guidelines_Spanish.pdf?040120211803
[5] https://dhs.iowa.gov/sites/default/files/Comm514.pdf
[6] https://dhs.iowa.gov/sites/default/files/Comm487.pdf
[7] https://www.deltadentalia.com/assets/docs/hawki/hawki_benefit.pdf
[8] https://dhs.iowa.gov/sites/default/files/470-5570.pdf
[9] https://dhs.iowa.gov/sites/default/files/470-5570S.pdf
[10] https://dhs.iowa.gov/sites/default/files/470-5579.pdf?062720191615
[11] https://dhs.iowa.gov/sites/default/files/470-5567.pdf
[12] https://dhs.iowa.gov/sites/default/files/470-5569.pdf
[13] https://dhs.iowa.gov/sites/default/files/470-5569S.pdf?080620201717
[14] https://dhs.iowa.gov/sites/default/files/470-5566.pdf
[15] https://dhs.iowa.gov/sites/default/files/470-5565_0.pdf?062720191618
[16] https://dhs.iowa.gov/sites/default/files/470-5584.pdf?070520191332
[17] https://dhs.iowa.gov/sites/default/files/470-5564_0.pdf?062720191619
[18] https://dhs.iowa.gov/sites/default/files/470-5568_0.pdf?062720191619
[19] https://www.myamerigroup.com/ia/iaia_caid_memberhandbook_eng.pdf
[20] https://www.iowatotalcare.com/content/dam/centene/iowa-total-care/PDF/Updated-ITC_MemberHandbook2020_ENG.pdf
[21] https://www.myamerigroup.com/ia/iowa-home.html
[22] https://www.iowatotalcare.com/
[23] https://www.deltadentalia.com/dwp/hawki/
[24] https://dhsservices.iowa.gov/apspssp/ssp.portal
[25] https://dhs.iowa.gov/sites/default/files/470-5170.pdf
[26] https://dhs.iowa.gov/sites/default/files/470-5170S.pdf
[27] http://conta.cc/2fancJp
[28] http://conta.cc/2famBre
[29] http://conta.cc/2vcQn50
[30] https://conta.cc/2zTlae6
[31] https://conta.cc/2P9KbIo
[32] https://myemail.constantcontact.com/Hawki-e-News--Changes-to-Online-Payment-System.html?soid=1123163422953&aid=pX6oK8yeAW8#fblike
[33] https://dhs.iowa.gov/hawk-i/resources/enrollment-by-county
[34] https://dhs.iowa.gov/sites/default/files/Hawki%20current%20map%20September%20-%202017_0.pdf
[35] mailto:Hawki@dhs.state.ia.us
[36] https://dhs.iowa.gov/dhsuser