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Medical Assistance in Iowa - Overview

Medicaid provides medical assistance to families and children, pregnant women and to the aged, blind, or disabled. Persons may qualify for Medicaid because they meet eligibility factors for a specific Medicaid coverage group, due to receiving certain cash benefits, due to subsidized adoption or foster care, or due to eligibility for waiver services.

NOTE: Participants in the Family Investment Program (FIP), a cash assistance program, are no longer automatically entitled to Medicaid due to receipt of FIP because of the provisions of the Personal Responsibility and Work Opportunity Act of 1996. However, a determination of Medicaid eligibility is always made when FIP eligibility is determined. Eligibility criteria for Family Medical Assistance Program (FMAP) were derived from the July 16, 1996 FIP program.

·                Family and Children Coverage Groups. Coverage groups for families and children provide Medicaid for children under age 21, depending on the coverage group and may include parents or other specified relatives living with the child, depending on the coverage group, pregnant women, children in foster care and subsidized adoption.

Coverage groups for family and children derive most of their eligibility requirements from the Family Medical Assistance Program (FMAP).

·                SSI and SSI-Related Coverage Groups. Coverage groups for aged, blind, or disabled include SSI recipients, SSI-related coverage groups and State Supplementary Assistance recipients.

SSI-related coverage groups and State Supplementary Assistance eligibility criteria are based on general policies of the Supplemental Security Income (SSI) program.

A new provision, called Medicaid for Employed People with Disabilities (MEPD), allows individuals with disabilities who earn too much to have kept their Medicaid coverage under previous policies to keep their coverage by paying a sliding-scale premium.

Generally, persons eligible for Medicaid are entitled to full Medicaid coverage. However, there are some SSI-related coverage groups that provide only limited Medicaid benefits. See SSI coverage groups that provide limited benefits.

·        Medicaid Home and Community–Based Services (HCBS). There are six HCBS programs in Iowa which are special Medicaid coverage groups that provide services to maintain persons in their own homes or communities who would otherwise require care in medical institutions. Persons who are eligible for HCBS waiver programs are eligible for Medicaid. HCBS provides for additional services not covered by Medicaid or expands services that are provided for under Medicaid on a very limited basis.

See Also:

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees Manual

Title 8 Medicaid

·                        Chapter F Coverage Groups

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