HEALTH CARE - Bureau of Financial, Health and Work Supports

What's Available?

Medicaid (Title 19) is described (below) on this page.

Click on these links to learn about each of these health care services:

Medicaid (Title 19)

Medicaid is a program that pays for covered medical and health care costs of people who qualify. The Medicaid program is funded by federal and state governments and is managed by the Iowa Department of Human Services.

Note: Anyone who gets or applies for Medicaid needs toshow proof of U.S. citizenship and identity. In most cases, if you were born in the United States you are a U.S. citizen. Information on proving U.S. citizenship and identity is available here. If you wish to view this information in a PDF, click here.

A wide range of medical and health care services is available through the Medicaid program. These services are covered only if they are medically necessary. Medicaid recipients have free choice of a doctor, dentist, pharmacy, and other providers of services. However, in many counties, some people covered by Medicaid are required to get certain medical services through a managed health care provider (either a health maintenance organization (HMO) or a MediPass doctor). These people have the opportunity to select a provider, however, if they do not select one they will be assigned to a provider. A provider that chooses to participate in the Medicaid program must accept the payments that Medicaid makes and make no additional charges to the recipient for services covered under the program. However, some services covered by Medicaid do require a small co-payment be paid.

Eligibility groups are a category of people who meet certain common eligibility requirements. A broad range of these groups are listed under "Who can get Medicaid" below. Some Medicaid eligibility groups cover additional services, such as nursing facility care and care received in your home. Some Medicaid eligibility groups have higher income and resource limits, charge a premium, only pay the Medicare premium or cover only expenses also paid by Medicare, or require you to pay a specific dollar amount of your medical expenses. The worker who processes your application will determine which eligibility group you are eligible for.

Who can get Medicaid?

Medicaid is available to certain, low income people. You must be one of the following to get Medicaid. These are called eligibility groups.

  • A child under age 21;

  • A parent living with a child under age 18;

  • A woman who is pregnant;

  • A woman who needs treatment for breast or cervical cancer and who has been diagnosed through the Breast and Cervical Cancer Early Detection Program;

  • A person who is aged (over 65);

  • A person who is blind or disabled;

  • Certain Medicare beneficiaries; or

  • A person whomeets Social Security disability requirements and is employed.

To get help from most Medicaid programs, you must:

  • Be a U.S. citizen or a legal qualified alien. As of July 1, 2006, anyonewho gets or applies for Medicaid needs to show proof ofcitizenship and identity. In most cases, if you were born in the United States you are a U.S. citizen.If you have questions or need help with proof of citizenship and identity you can call us toll-freeat 1-877-937-3663 or you can contact your worker.For examples of how to prove U.S. citizenship and identity and for more resources on this topic please click here.

  • Live in Iowa.

  • Provide a social security number or proof of application for a number.

  • Meet income and resource limits (these vary from program to program).

  • Provide all information needed to determine eligibility and benefit level.

  • Exceptions:

    • Up to 3 days of Medicaid is available to pay for the cost of emergency services for aliens who do not meet citizenship, alien status, or social security number requirements. The emergency services must be provided in a facility such as a hospital, clinic, or office that can provide the required care after the emergency medical condition has occurred. .

    How do I apply?

    You can apply online for Medicaid and Health Care at the DHS Services Portal.

    You can also apply by filling out a paper application form. Staff in the county Department of Human Services office determine eligibility for most people. There are a few exceptions:

    • The district office of the Social Security Administration determines eligibility for people who may be eligible for SSI.

    • Presumptive Medicaid eligibility determinations for pregnant women and women who need treatment for breast and cervical cancer are made by certain providers who are authorized by the Department.

    If you have access to a printer, you can print an application from this website (see links below). Complete the application by hand then return it to the DHS office serving the county where you live.

    You can also get an application form from any county Department of Human Services (DHS) office. Click on County DHS Office Locations to find the location of the county DHS office nearest you.

    Links to Program Applications

    If you want to apply for just Medicaid (Title 19), click on the link below:

    English

    Medical Assistance (Title 19 or Medicaid)

    Need legal size paper to print

    Application for Health Care Coverage and Help Paying Costs

    Espanol

    Medical Assistance (Title 19 o Medicaid)

    Necesite papel legal de tama

    Solicitud de Servicios

    If you want to apply forother DHS Services such as Food Assistance and/or Family Investment Program (FIP) click on the link below:

    English

    Family Investment Program (FIP), Refugee Cash Assistance, Child Care Assistance, or Food Assistance

    Financial Support Application

    Espanol

    Family Investment Program (FIP), Refugee Cash Assistance, CHild Care Assistance, or Food Assistance

    Solicitud de Apoyo de Financiero

    When can Medicaid start?

    Medicaid eligibility may start up to three months before the month you apply in (called the retroactive period) if:

    • You have paid or unpaid medical expenses for covered medical services which were incurred during the 3 months before you applied, and

    • You would have been eligible for Medicaid in those months if you had applied for Medicaid (whether or not the person is alive when the application is actually filed).

    You don't have to be eligible now for Medicaid to be eligible in any month of the retroactive period.

    What if I Have Questions?

    Any county DHS office can answer questions about the programs and services described here. Contact the county DHS office serving the county where you live (County DHS Office Locations).

    The county DHS office serving your county is also listed in the State or County Government section of your local phone book, under "Department of Human Services" or just "Human Services".

    For Nursing Facility Care:1-877-344-9628 Phone or515-564-4040fax. General information and Frequently asked questions click here

    To report changes to an existing Family Medicaid. case, call 1-877-347-5678 orfax 515-725-9019.

    You may also contact the Department's Field Office Support Unit by calling (515) 281-6899 or 1-800- 972-2017.

    Links to Medicare Programs

    To find out about Medicare, click on the link below:

    The Official U.S. Government Site for People with Medicare

    To find out about the Medicare-approved Drug Discount Card program, the Medicare Prescription Drug program, and other assistance programs through Medicare, click on the link below:

    Prescription Drug and Other Assistance Programs (Including Medicare-Approved Drug Discount Cards)

    Images of people and children