Iowa Medicaid and the Children’s Health Insurance Program (CHIP)

Medicaid and the Children’s Health Insurance Program (CHIP) provide health coverage to many families in Iowa. Iowa was one of the states that opted for the Medicaid Expansion Program, offering coverage to more individuals and families. According to the Kaiser Family Foundation, 27% of Iowans are considered low income. Medicaid and CHIP provide healthcare coverage for 632,000 children, pregnant women, adults, seniors, and people with disabilities in Iowa.

To qualify for Medicaid in Iowa, a person over 18 must fall at or below 133% of the federal poverty level. For a single individual, their annual income can be $16,040. A single parent of one child could make $21,599 per year. A family of four could have a combined income of $32,718 or less and be eligible for coverage. Some individuals sign up for Medicaid during a gap in employment, but there are many families who access the program that are working full-time but whose limited income simply makes it unaffordable to purchase healthcare.

Medicaid has an ongoing signup period, so individuals can apply at any point in the year. With so many applying for the government healthcare programs at any given time, and the recent developments in changing from three Managed Care Organizations (MCOs) to two MCOs, the call centers have been inundated with questions, concerns and applications. Some of our patients grow frustrated with knowing what numbers to select on the automated system to get to a call center representative. Others have difficulty expressing their questions or understanding notices they receive in the mail. Some patients have experienced challenges in getting the most up to date information given all the recent developments or applications have had difficulties in getting processed.

At His Hands we are here to help our patients navigate the Medicaid system, from applying to understanding coverage to connecting with a Primary Care Provider. We can assist patients with making phone calls to follow up on applications or to understand questions/concerns with getting started with the program. Medicaid provides valuable services to many in our community. However, sometimes there can be challenges in the application process. One patient applied for coverage for her children last November. She is still in process. It has taken two applications, a number of phone calls, leaving messages for a supervisor, and we are still waiting to see if her children are approved. She applied once and was denied prior to last fall. Then there was a change in the household number and income, so she reapplied in November. Medicaid saw that she applied two times closely together and denied her automatically. Since December she has been told several times by representatives that they will research her case and get back to her. This very evening we had a 45-minute appointment on the phone with three different individuals who all shared the same information we were given on November 17th of last year-that there was an oversight in processing the application but that they will need to talk to someone else about rectifying it. However, persistence pays off, and the benefits of the program are well worth the work. Yet, patients can find it useful to have support and accountability in following up. The government program is processing so many applications at any given time, I always tell patients not to wait for them to contact you, but to be diligent in following up with them if you do not hear back. After all, it is their family’s healthcare, and it is important!

We are always excited here at the clinic when our patients are able to establish quality healthcare coverage. It is our pleasure to be able to assist patients in apply for and navigating the government healthcare system.

Amy Delay
Patient Advocate