A Guide to Iowa Medicaid and UnityPoint Health

If you are 19-64 years old, earn a low annual income, or manage a disability, you may not be able to afford conventional health insurance. Fortunately, Iowa Medicaid programs can provide the financial cushioning you need when seeking medical care.

According to HealthInsurance.org, Iowa Medicaid currently protects over 874,000 low-income and disabled residents. Many qualifying individuals receive their treatments through the 275 UnityPoint Health facilities scattered across Iowa and Illinois.

In this article, you will learn about Iowa Medicaid programs and how UnityPoint Health can provide accessible care when you need it most. Once you finish reading, partner with Insurdinary to explore ways to expand your coverage for the best protection. Insurdinary can optimize your coverage to include a more comprehensive range of benefits and services by way of private health insurance.

    What Is UnityPoint Health Coverage?

    UnityPoint Health is a network of doctors’ offices, hospitals, at-home health services, and other medical facilities. In 2018, this extensive healthcare system announced its renewed partnership with the Iowa Medicaid provider Amerigroup, so members could continue receiving affordable care at its facilities. Its mission is to provide accessible medical services to you and your fellow Iowa residents, even if you do not have a good insurance plan.

    According to the Iowa Business Council, UnityPoint Health is one of the nation’s most integrated health systems. It currently employs over 30,000 physicians, nurses, and medical industry personnel. UnityPoint Health is also the fourth largest nondenominational medical provider in the United States, providing ethical and inclusive care for Iowans of all ethnicities and beliefs.

    Insurance benefits provided directly through UnityPoint Health for team members include the following:

    • General medical care
    • Dental and vision reimbursement
    • Full-body health and wellness incentives
    • Healthcare for pregnant women
    • Mental health insurance for bereavement
    • Life insurance policies for members and children under 26
    • Disability treatment
    • $6,000 reimbursements for expenses related to legally adopted children
    • Critical illness coverage under 70
    • Health Savings programs to help build retirement funds

    Non-members can apply for alternative insurance plans through UnityPoint Health’s HealthPartners program. These benefits allow you to seek low co-pay medical treatment throughout the year. You can also use your membership with Amerigroup or other participating Iowa Medicaid providers to seek services at UnityPoint Health with little to no cost.

    AstraZeneca funds UnityPoint Health’s administrative costs. The state and federal treasuries subsidize and allocate funds toward participating Iowa Medicaid programs.

    What Is an Iowa Medicaid Card?

    Iowa Medicaid

    An Iowa Medicaid card provides physical verification of your membership with a Medicaid provider. The Iowa Department of Health and Human Services (DHS) will send this insurance card to you after confirming your eligibility for Medicaid.

    The type of card you receive corresponds to your chosen healthcare provider. For example, UnityPoint Health issues insurance cards through its HealthPartners program.

    Pay close attention to the information on your card. These documents typically provide:

    • Your membership ID number
    • Benefit expiration dates
    • Co-pays you should expect during visits to the doctor
    • Insurance provider contact information

    Applying for Iowa Medicaid

    Iowa offers over two dozen Medicaid programs. These provide benefits according to your medical history, special status, and family needs. You can apply by choosing a service and completing one of these options:

    1. Visit this link to begin the Iowa Medicaid pre-screening process. If you are ready to register for benefits, click “Apply For Assistance” to start the application.
    2. Print an "Application for Health Coverage and Help Paying Costs" form. After completing the information, mail it to your local DHS office.
    3. Enroll directly through a partnering provider’s website — UnityPoint Health, Iowa Total Care, Amerigroup, etc.
    4. Call 1-800-972-2017 to speak with a DHS representative to explore other ways to apply.

    You may wonder how to apply for UnityPoint Health insurance if you are a new employee. Simply visit the UnityPoint Health rewards page on the website to enroll for benefits. Complete these steps within 30 days of your hire date, or you must wait for open enrollment to apply.

    Be aware that you may need one or more of the following documents to apply for Iowa Medicaid:

    • A copy of your birth certificate
    • A driver's license or passport
    • A Social Security Number
    • Evidence of your income (W-2 or 1099 form)
    • Proof of other active health insurance memberships

    Make sure that all of your information is correct on your applications. This way, you can avoid delays in the acceptance process and seek medical care quickly.

    Eligibility Requirements

    Medicaid benefits are not available to everyone. To qualify, you must be one of the following:

    • Under the age of 21
    • 65 or older
    • Pregnant
    • Seeking treatment for cervical or breast cancer
    • Disabled
    • A legal resident of Iowa and the United States
    • A qualified legal immigrant living in Iowa
    • Earning an income at or below the Federally recognized poverty line

    You can call Iowa Medicaid Member Services at 1-800-338-8366 if you aren’t sure about your eligibility. A team member will review your status and discuss alternative options if you do not qualify.

    Getting an Iowa Medicaid Card

    As mentioned, Iowa’s Medicaid Membership Services, the DHS, or UnityPoint Health will send you a copy of your insurance card after accepting your application. You should receive your physical copy in the mail within two weeks of acceptance.

    You can also request an electronic copy via email. UnityPoint Health offers this solution, but other insurance providers may not.

    Keep your card in a safe location, especially when traveling. Your UnityPoint Health physician will request this information before billing you for service.

    Visit UnityPoint Health to see how you can apply for your card.

    Renewing or Replacing Your UnityPoint Health Card

    You can always request a new insurance card from UnityPoint Health if you lose your current one or it expires. Here is how to get a new card:

    • Log in to your UnityPoint Health HealthPartners account online.
    • Apply for a new card or renew an existing card.
    • If you need help applying online, contact HealthPartners support at 952-883-6000. A representative will walk you through the process.

    Once your Medicaid membership expires, the state must conduct a formal reassessment of your income and medical status. This process could take several weeks to complete. However, you can still access benefits and care through UnityPoint Health in the meantime.

    Iowa Medicaid Coverage

    Iowa Medicaid covers a wide range of medical services for members. However, it is important to understand that not all services are available through UnityPoint Health facilities. Here is what you can expect:

    Iowa Medicaid offers dental coverage through two carriers: Delta Dental and MCNA Dental. UnityPoint Health also provides these services if you are a Medicaid member or enrolled in Hawki programs for children.

    UnityPoint Health provides specialist dental offices throughout Iowa, allowing you to seek emergency care quickly.

    In general, these plans are capped at $1000 per fiscal year. For those who have more serious dental issues and anticipate requiring more visits to the dentists, investing in private dental plans in Iowa is advisable.

    Prescription Drugs

    The 340B Prescription Drug Program allows medicine manufacturers to distribute outpatient drugs to UnityPoint Health facilities at low cost. This advantage will enable you to access affordable refills if you earn below the maximum annual income limit.

    Iowa Medicaid also covers many over-the-counter prescriptions. Explore this list of approved drugs to see which prescriptions qualify.

    Extended Health Care

    UnityPoint Health and other participating Iowa Medicaid programs do not provide supplemental programs to provide medical care beyond the covered services. If you want to expand your healthcare options, visit Insurdinary.com to see which third-party options are available. Be sure to inform UnityPoint Health if you commit to another insurance provider.

    Travel and Out-of-State Coverage

    You cannot cover your healthcare expenses if you seek treatment outside Iowa unless it is a medical emergency.

    UnityPoint Health offers virtual doctor examinations. However, licensed physicians may only provide these services if you are in Iowa during your assessment. Contact your insurance provider if you have questions about out-of-state coverage. If you are traveling outside of Iowa for leisure, invest in proper travelers insurance.

    Students & Seniors

    Some Iowa schools, such as the University of Iowa, require you to have health insurance to enroll. You can seek Iowa Medicaid benefits if you qualify as a low-income individual and are not a listed dependent on anyone’s tax records. However, you cannot receive special benefits as a student.

    Iowa Medicaid covers seniors through its Elderly Waiver program. This solution is practical if you are over 64 and require long-term care. The Elderly Waiver program covers community assisted living, in-house services, and more.

    Coverage for Subgroups

    Certain subgroups receive special benefits when applying for Iowa Medicaid programs:

    Indigenous Americans and Native Alaskans

    UnityPoint Health provides greater access to care than those you might receive through Indian Health Services (IHS). If you qualify as a member of a registered Indigenous tribe, you can enjoy the following Medicaid benefits:

    • Cost sharing exemptions
    • Income bracket qualification exemptions
    • Estate recovery protection
    • Negotiated managed care protections

    These benefits also extend to children of tribal members.

    Military

    You may seek benefits through Iowa Medicaid even if you already receive VA benefits from the Iowa Department of Veteran Affairs. UnityPoint Health is proud to serve current and former members of the Armed Forces with high-quality care at a low cost.

    What Iowa Medicaid Programs Do Not Cover

    UnityPoint Health facilities may offer services that some Iowa Medicaid programs do not cover. Review this list to avoid paying out-of-pocket for certain procedures:

    Hawki does not cover early and periodic screenings or treatments
    Hawki and Iowa Health and Wellness do not cover clinical services for children
    Iowa Health and Wellness does not cover weight reduction surgery
    Hawki and Iowa Health and Wellness do not cover non-emergency transportation
    Hawki does not cover psychiatric rehabilitation
    Iowa Health and Wellness does not cover orthotics
    Hawki and Iowa Health and Wellness do not cover most long-term care services
    Funerals
    The permanently or temporarily injured

    Burial assistance may be offered by the State of Illinois to individuals who qualify under specific Medicaid categories. Considering the rising cost of burial and related fees in Iowa, ensure that your family is secured with comprehensive funeral insurance.

    Iowa Medicaid does provide some coverage for those who become injured or ill either in the short or long term. Depending on the nature of the injury or illness, it’s wise to explore disability insurance options to ensure no unnecessary out-of-pocket costs are incurred.

    Common Procedures and UnityPoint Health Eligibility

    Iowa Medicaid can be confusing to navigate. However, learning what UnityPoint Health covers is a practical place to start.

    Below is a list of common procedures you may access for free or low cost through UnityPoint Health facilities:

    Dental
    X-Rays and Exams Iowa Medicaid covers basic X-ray and dental exam services. UnityPoint Health dentists offer these services at most locations. They will accept the Dental Wellness Plan, but do not cover dental procedures under private insurance.
    Oral Surgery Iowa Medicaid covers cavity fillings, wisdom teeth removal, gum surgeries, and other oral procedures. UnityPoint Health administers all of these services at select locations.
    Vision
    Eye Exams Medicaid will cover routine eye exams for adults and children. You can only receive one exam a year. Otherwise, you must pay out of pocket.
    Corrective Vision You can receive one pair of glasses annually if you are 21 or older.
    Surgery Medicaid and UnityPoint Health will not cover most forms of cosmetic laser eye surgery. However, certain medical emergencies that require eye surgery may qualify for coverage. You may be able to access affordable eye surgery treatments through Avesis if you are a UnityPoint Health employee.
    Surgery
    Emergency Room Emergency surgery is available under all Iowa Medicaid programs. All ages qualify for coverage. UnityPoint Health facilities offer numerous emergency facilities across the state.
    Anesthetics All Iowa Medicaid programs cover anesthetics during surgery.
    Breast Reduction Most physicians consider breast reduction surgery cosmetic. Hence, Iowa Medicaid programs will not cover these procedures, even if UnityPoint Health clinics offer them. Still, you may be able to cover breast reduction or reconstruction if the surgery is necessary to treat breast cancer or part of post-mastectomy care.
    Hospital
    Hospital Stays You may need to stay in the hospital for several days following a procedure. Iowa Medicaid covers all inpatient stays and treatments — typically charging a small co-pay for each day of service.
    Medical Transportation Some UnityPoint Health centers may provide non-emergency transportation if you don’t have a reliable vehicle. However, not all Iowa Medicaid programs cover these expenses. Iowa Medicaid only covers emergency transportation, such as ambulance rides.
    Childbirth Medicaid covers many services that support the health of pregnant women and their children. These benefits include vaginal and cesarean childbirth expenses and hospital stays. Some programs even provide financial assistance to women for up to 60 days after labor.
    Lab Testing The DHS authorizes UnityPoint Health to bill the state for lab tests (blood, plasma, STD, skin, etc.). These services typically come with a zero-dollar co-pay, though some restrictions may apply. Iowa Medicaid also covers routine diagnostics services.
    Hospice Long-term and end-of-life care can add up quickly without the right insurance plan. Iowa Medicaid offsets some of the costs by providing coverage for hospice stays. However, Iowa law states that these benefits will expire after two periods of 90-day stays.
    Therapy and Counselling
    Iowa Medicaid programs cover mental health screenings, crisis response services, and counseling. Iowa Medicaid makes accessing substance abuse counseling and tobacco cessation services easy. Certain limitations under the AI Health and Wellness plan may apply. UnityPoint Health may provide several services to aid in alcohol and drug recovery. However, Medicaid may not cover all of these services.
    Sexual Health
    Sexual Performance Treatment Iowa Medicaid will not cover any sexual enhancement drugs or surgeries unless recommended as a medically necessary treatment.
    OB/GYN Mammograms, pap tests, and STD screenings are available at relatively low cost through Iowa Medicaid. Some treatments related to OB/GYN diagnoses may not apply.
    Fertility treatment Iowa Medicaid does not cover infertility treatments. However, UnityPoint Health insurance for employees may cover some procedures if deemed medically necessary. Contact your insurance provider for more information.
    Specialist Services
    Chiropractic Care Iowa Medicaid covers general chiropractic care under some limitations. Speak to a UnityPoint Health representative before seeking treatment to avoid surprise costs.
    Foot Specialists Routine foot care can be expensive without insurance. Fortunately, Medicaid covers most podiatry services. These benefits do not apply unless your foot care corresponds to treatment relating to other overarching medical conditions.
    Speech Therapists Iowa Medicaid programs will cover up to 60 speech therapy visits a year.
    Midwife Services Certified midwife services are affordable under Iowa Medicaid programs. These benefits extend to other prenatal and obstetric services as well.
    Allergy Treatments Expect to pay only a small fee for allergy serums and vaccinations under the Iowa Medicaid plan.

    Extending UnityPoint Health Coverage

    UnityPoint Health provides dozens of free and low-cost clinical treatments if you qualify for Iowa Medicaid programs. Still, these services may not be enough if you manage a chronic condition or require frequent visits to the doctor throughout the year.

    If you need to extend your coverage with third-party solutions, our team at Insurdinary can help. Other types of private insurance, such as life insurance, can help pay for medical costs Medicaid will not cover, especially in the event of your passing.

    We provide a comprehensive directory of private insurance companies. Use our easy-to-navigate website to compare and contrast premiums, customer reviews, and more to find the right provider for your needs.

    FAQ’s

    How long does it take to get approved for Iowa Medicaid?

    The approval process duration for Iowa Medicaid can vary based on individual circumstances. On average, it can take up to 45 days. Expedited processing is available for urgent cases.

    What are the methods to apply for Iowa Medicaid?

    You can apply for Iowa Medicaid through various means: online, in person, by mail, or at a local Iowa Department of Human Services office. Ensure you provide essential documents like proof of income, household size, and residency when submitting your application.

    Does Iowa Medicaid cover the expenses of funerals?

    No, Iowa Medicaid is primarily focused on providing healthcare coverage and does not include benefits for funeral expenses. If you're seeking assistance with funeral costs, you may want to explore alternatives like funeral insurance.

    Who is eligible for Iowa Medicaid?

    Eligibility for Iowa Medicaid is determined by factors such as income, household composition, and other considerations. Generally, the program extends coverage to low-income individuals, families, pregnant women, children, elderly individuals, and those with disabilities.

    What is Iowa Medicaid?

    Iowa Medicaid is a program designed to offer medical coverage to eligible low-income residents of the state. Funded through both federal and state resources, its goal is to ensure access to essential healthcare services for those in need.

    What other types of insurance does Insurdinary offer?

    Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following:

    References

    1. https://www.healthinsurance.org/medicaid/iowa/
    2. https://www.unitypoint.org/iowa-medicaid-changes.aspx
    3. https://www.iowabusinesscouncil.org/members/companydetail/22/
    4. https://uphtotalrewards.com/my-benefits/
    5. https://hhs.iowa.gov/ime/members/medicaid-a-to-z#:~:text=Iowa's%20SSA%20program%20covers
    6. https://dhsservices.iowa.gov/apspssp/ssp.portal
    7. https://hhs.iowa.gov/how-to-apply
    8. https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
    9. https://hhs.iowa.gov/ime/members/what-services-are-available
    10. https://www.iowalegalaid.org/resource/hawk-i-insurance-for-children
    11. https://www.unitypoint.org/desmoines/340b-drug-pricing-program.aspx
    12. https://hr.uiowa.edu/benefits/ui-student-insurance/student-health-insurance/student-health-insurance-plan-ship
    13. https://www.medicaidplanningassistance.org/iowa-elderly-waiver/
    14. https://hhs.iowa.gov/ime/members/FFS/AINA
    15. https://www.unitypoint.org/cedarrapids/services-dental-health-center.aspx
    16. https://hhs.iowa.gov/family-health/maternal-health
    17. https://www.legis.iowa.gov/docs/iac/rule/01-03-2018.441.78.36.pdf
    18. https://www.unitypoint.org/marshalltown/services.aspx
    19. https://www.unitypoint.org/homecare/speech-therapy.aspx
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