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.
What's available?
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 who is disabled and working.
To get
help from most Medicaid programs, you must:
·
Be a U.S. citizen or a legal qualified alien.
·
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?
To
get most of our services, you must fill out an application
form. Staff in the county Department of Human Services
office determines 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:
If you
want to apply for Medicaid (Title 19), Food
Assistance
and/or Family Investment Program (FIP) click on the
link below:
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".
You may
also contact the Department's Field Office
Support Unit by calling (515) 281-6899 or
1-800- 972-2017.
