Iowa Medicaid Office

Iowa Medicaid office (HHS)

An Iowa Medicaid application is the start of an eight-step pipeline at the Iowa Department of Health and Human Services. HHS determines eligibility, mails the Medicaid eligibility card within seven days of approval, sends an enrollment packet that names the member's managed care organization and dental-plan assignment, and opens a 90-day window during which the member can switch plans for any reason — with an annual choice period after that. Iowa Medicaid serves over 700,000 people each year through this pipeline.

Two lines, two audiences

HHS splits its contact lines by audience. Members and applicants call Iowa Medicaid Member Services; providers call a separate line. Both run during standard Iowa business hours.

• Iowa Medicaid Member Services — 1-800-338-8366 toll free, 515-256-4606 in the Des Moines area, fax 515-725-1351, email IMEmember@hhs.iowa.gov. Open Monday through Friday from 8 a.m. to 5 p.m. Central. Help is available in multiple languages.
• Iowa Medicaid Provider Services — 1-800-338-7909 or 515-256-4609, email IMEprovideroutreach@hhs.iowa.gov.
• Relay Iowa TTY — 1-800-735-2942 for callers who are deaf, hard of hearing, deaf-blind, or have difficulty speaking.

Where applications happen

Members apply through the HHS Services Portal at hhsservices.iowa.gov, by phone at 1-855-889-7985, or in person at any local HHS office. Local HHS offices also accept paper applications, drop-offs, and case questions.

Who qualifies for Iowa Medicaid?

Iowa Medicaid eligibility runs through a financial test and a non-financial test in parallel. Most members fall into one of nine population buckets HHS publishes on its eligibility page, plus a "Medically Needy" spend-down path for households whose income exceeds the standard limit but whose medical bills are large.

Who qualifies, per HHS

• A child under the age of 21
• A parent living with a child under the age of 18
• A pregnant woman
• A child in foster care, subsidized guardianship, or subsidized adoption up to age 21
• A child formerly in foster care (up to age 26)
• A person in need of treatment for breast or cervical cancer or precancerous conditions
• A person who is elderly (age 65 or older)
• A person who is disabled according to Social Security standards (or blind)
• An adult between the ages of 19 and 64 whose income is at or below 133% of the federal poverty level (the ACA expansion population — implemented in Iowa as the Iowa Health and Wellness Plan)
• A resident of Iowa and a U.S. citizen or qualified alien; non-qualified aliens may be eligible for limited Medicaid for emergency services only

Postpartum coverage extension pending implementation

HHS announced on January 7, 2025 that it had federal approval to extend Medicaid postpartum coverage from the current 60 days to 12 months for families within 215% of the Federal Poverty Level. The implementation date has not yet been announced. Check the current HHS guidance before relying on a specific postpartum window.

Medically Needy spend-down for over-income households

Parents, caretakers, children under 18, and SSI-related individuals whose income is too high for standard Medicaid may still qualify through the Medically Needy (Spend Down) program. The household obligates excess income to allowable medical expenses; once the spend-down amount is met, Medicaid pays for the remainder of the period.

Presumptive Eligibility for fast-start coverage

Presumptive Eligibility (PE) provides Medicaid for a limited time while HHS makes a formal determination. A qualified entity enters the applicant's information into the Medicaid Presumptive Eligibility Portal; if the applicant likely qualifies, temporary coverage starts that day. PE is available for children under 19, pregnant women, parents and caretakers of children under 19, adults aged 19 to 64, former foster care children under 26, and individuals diagnosed through BCCEDP needing breast or cervical cancer treatment.

Home and Community-Based Services waivers

HHS administers seven HCBS waivers, each tied to a specific population:

• AIDS/HIV waiver
• Brain Injury (BI) waiver
• Children's Mental Health (CMH) waiver
• Elderly (EW) waiver
• Health and Disability (HD) waiver
• Intellectual Disability (ID) waiver
• Physical Disability (PD) waiver

Iowa Medicaid income guidelines

HHS publishes Iowa Medicaid income guidelines as annual gross income tables, broken out by program track. The figures below are verbatim from the HHS Medicaid Income Guidelines page and are effective as of April 1, 2026. Verify the current chart before relying on a specific dollar amount.

Children ages 1 to 18 — 167% of the federal poverty level

Infants under age 1 — 300% of the federal poverty level

Pregnancy and Postpartum — 215% of the federal poverty level

If pregnant, include the unborn child in the household size.

Other Iowa Medicaid programs

Adults 19 to 64 in the Iowa Health and Wellness Plan use the 133% FPL standard. Other tracks (Medically Needy spend-down, Medicare Savings Programs, HCBS waivers, Workers with Disabilities) carry their own income tests; check the individual program page on hhs.iowa.gov for current figures.

How to apply for Iowa Medicaid

Iowa Medicaid accepts applications through five channels, and the same application screens applicants for free or low-cost coverage through Medicaid or CHIP/Hawki. HHS recommends applying online for the fastest path through the eight-step enrollment process.

Five ways to apply

• Online (fastest) — apply at the HHS Services Portal, or apply through the federal portal at Healthcare.gov.
• By phone — call 1-855-889-7985.
• In person — at any local HHS office or at a federally qualified health center (FQHC) in Iowa.
• By mail — send the completed paper application (form 470-5170 in English, 470-5170S in Spanish) to Imaging Center 4, PO Box 2027, Cedar Rapids, IA 52406.
• By email or fax — to any local HHS office.

What HHS asks for on the application

• Social Security numbers (or document numbers for legal immigrants who need insurance)
• Employer and income information for everyone in the family (pay stubs, W-2 forms, wage and tax statements)
• Policy numbers for any current health insurance
• Information about any job-related health insurance available to the family

What happens after approval — the eight-step process

HHS publishes the post-approval workflow as an explicit pipeline:

1. HHS determines initial and ongoing eligibility.
2. The Iowa Medicaid eligibility card arrives about seven days after the eligibility decision.
3. An Iowa Medicaid enrollment packet arrives one to two weeks after the decision, naming the assigned managed care organization and dental plan and including a form to change either.
4. Members may submit a choice by phone, fax, email, or mail.
5. Members who switch from their initial assignment receive a confirmation letter naming the new plan and effective date.
6. The MCO and dental plan begin sending outreach and the member ID card within seven days of receiving enrollment information.
7. Coverage begins with the selected or assigned plan.
8. Members have 90 days from the choice-period end date to change plans for any reason; after that, the member must show "good cause" (e.g., provider not in network). An annual choice period repeats at the enrollment anniversary.

What Iowa Medicaid covers

Iowa Medicaid covers more than 700,000 people each year, and HHS delivers most member care through contracted managed care organizations and a separate dental-plan administrator. The state-federal funding split runs Iowa Medicaid: HHS sets state policy within federal Medicaid rules, and both governments share program costs.

Programs that sit alongside standard Iowa Medicaid

• Iowa Health and Wellness Plan (IHAWP) — Medicaid for adults aged 19 to 64 at or below 133% of the federal poverty level. This is Iowa's ACA Medicaid expansion implementation.
• Hawki (Healthy and Well Kids in Iowa) — the Children's Health Insurance Program for children under 19 in families with too much income to qualify for Medicaid.
• Medicaid for Kids with Special Needs (MKSN) — coverage for children with qualifying medical needs not otherwise eligible.
• Iowa Family Planning Program (FPP) — limited-scope coverage for family planning services.
• Health Insurance Premium Payment (HIPP) — pays the premium for employer-sponsored insurance when at least one person on the policy is a Medicaid member.
• Family Medical Assistance Program (FMAP) — Medicaid for low-income families with dependent children.
• Breast and Cervical Cancer Treatment — full Medicaid for women diagnosed through the BCCEDP screening program who need treatment.

Long-term services, supports, and PACE

The Elderly waiver covers home-based care settings for older adults. The Program of All-Inclusive Care for the Elderly (PACE) is available for residents age 55 and older to blend Medicaid and Medicare funding when both programs cover the same person.

State Supplementary Assistance for SSI recipients

SSI beneficiaries are automatically eligible for Medicaid in Iowa — the Social Security Administration determines SSI eligibility and HHS adds Medicaid automatically. State Supplementary Assistance supplements the income of aged, blind, or disabled persons who receive federal SSI.

EPSDT for children

Children under 21 enrolled in Iowa Medicaid receive Early and Periodic Screening, Diagnostic, and Treatment benefits — a federal mandate that pays for any medically necessary service for a child, including dental, vision, hearing services, and behavioral health services adult Medicaid does not always cover.

Other state Medicaid pages