Iowa Medicaid Guidelines

Medicaid, like Medicare, is a national health insurance program in the United States. Both receive funding from the federal government and help users get affordable health care. But while Medicare is fairly standardized across the country, Medicaid programs can differ greatly from state to state. Iowa's Medicaid services, called the Iowa Medicaid Enterprise, are under the management of the state Department of Human Services.

Eligible Groups

• Medicaid is meant to help low-income individuals. However, the program is not open to everyone. The major groups who qualify for Medicaid in Iowa are pregnant women, the disabled, women with cervical or breast cancer, seniors aged 65 or older, minor children and parents of children under the age of 18. Other groups may be eligible for some restricted Medicaid assistance instead of full Medicaid. These include those with high medical bills who nevertheless do not qualify for Medicaid because of income, young women who want family planning assistance and employees who cannot afford the costs of their employer's private group insurance plans.

Income Guidelines

• To qualify for Medicaid, your income cannot exceed a certain maximum amount. Instead of having one maximum income level for all individuals, however, Iowa has different maximum income levels for different qualifying groups. These are based on the current federal poverty level guidelines. Pregnant women cannot make more than 300 percent of the federal poverty level, but families with children aged one through 18 years cannot make more than 83 percent.

Citizenship

• In order to qualify for any of Iowa's Medicaid programs, you must be able to establish that you are a resident of the state. You must also be a citizen of the United States or a legal alien. You will need to provide the Social Security numbers of everyone in your family applying for Medicaid, or proof of having submitted the paperwork to gain a Social Security number, as part of the application process. There is one exception to this, however. As of 2011, the state does offer aliens who do not have the proper legal status or documentation up to three days of Medicaid coverage for emergency services.

Programs

• Iowa Medicaid is offered in the form of different programs. Regular Medicaid covers all medically-necessary services. Users generally have their choice of health care providers, and services are usually offered at no charge to the patient but some services may require a small co-payment. The Medicaid for Employed People With Disabilities program to help working people with disabilities continue to have access to medical care, which, unlike regular Medicaid, requires a monthly premium. The state also features Medicaid for Kids With Special Needs, a separate program to help pay medical expenses for children with specific health problems.