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Medicaid for Employed People with Disabilities - Premium Amount - Iowa

¨    A set premium amount is established for six months at a time.

·     The premium amount cannot be increased due to an increase in income in the six-month period.

·     The premium amount can be decreased if income goes down.

To find out the amount of premium you would be expected to pay, total your gross earned income and your gross unearned income and compare the amount to the chart below.

Remember that if you are required to pay a premium, your premium must be paid by the due date in order to receive Medicaid coverage.

PREMIUM SCHEDULE (Year 2001)

Income of the eligible person above:  Monthly Premium

150% of federal poverty level ($1,074)     $20

174% of federal poverty level ($1,246)     $38

198% of federal poverty level ($1,418)     $56

222% of federal poverty level ($1,590)     $74

246% of federal poverty level ($1,761)     $92

270% of federal poverty level ($1,933)    $110

294% of federal poverty level ($2,105)    $128

318% of federal poverty level ($2,277)    $146

342% of federal poverty level ($2,449)    $164

366% of federal poverty level ($2,620)    $182

390% of federal poverty level ($2,792)    $201 

This chart is a guide only. They are based on Federal poverty levels, which are determined on an annual basis. Changes in the poverty levels will change the income range for premiums.

Payment Rules:

¨    Beginning months bill: You will receive a bill for the two months immediately following the month of approval. Payment for both months is due by the 14th of the first month following the month of approval.

¨    Ongoing months bill: You will be billed monthly thereafter with premiums due by the 14th of the month prior to the month the premium is to cover.

¨    Initial months bill: A separate billing will be sent for the month of approval and any prior months included in the premium period. Payment is due within 60 days.

¨    Retroactive months bill: You will receive a bill for the retroactive months (the three months prior to the month you filed your application.) Payment is due within 60 days.

What happens when I do not pay the premiums?

¨    Beginning month: If you do not pay for the first beginning month by the due date, no Medicaid card will be issued.

¨    If you do not pay for the second beginning month by the due date your Medicaid will be canceled. If you do not pay the premium billed for ongoing months, your Medicaid will be canceled.

If you do not pay premiums billed with 60 days to pay you will lose Medicaid eligibility for any months not paid.

Premiums may be paid in advance on a quarterly or semi annual basis for months within a premium period upon request.

See Also:

·           Medicaid for Employed People with Disabilities - Overview

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees Manual

Title 8 Medicaid

·                        Chapter F, Coverage Groups, Medicaid for Employed People with Disabilities

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