Iowa Medicaid Program

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 government and is managed by the Iowa Department of Human Services. The Federal government establishes general guidelines for the administration of Medicaid benefits. Iowa Medicaid offers different types of coverage based on age, whether someone is a parent, pregnant woman, aged, blind, disabled, currently or formerly in foster care, has breast or cervical cancer, or is aged 19-64 and not receiving Medicare coverage and not a parent or caretaker of a minor child. The Iowa Department of Human Services completes an eligibility determination and gives the most complete coverage for which someone qualifies. Some coverage groups do require a small monthly premium that the member must pay.

A wide range of medical and health care services are available through the Medicaid program. Primary services funded through Medicaid are physician, hospital, and long-term care. Additional coverage includes prescription drugs, medical equipment, transportation, family planning, laboratory tests, and other medical services. These services are covered only if they are medically necessary. Most Medicaid members are covered under one of the managed care plans. Medicaid members must receive services through the provider network of the Managed Care Organizations (MCO) that they are enrolled in. Some services covered by Medicaid do require a small co-payment that the member must pay.