Medicaid Managed Care

IA Health Link

Medicaid Managed Care

On April 1, 2016, the Iowa Department of Human Services transitioned most Iowa Medicaid members to a managed care program called IA Health Link. Most Iowa Medicaid members are enrolled in IA Health Link, which provides coverage through two managed care organizations (MCOs) at this time. Providers who care for Medicaid members must contract with the MCOs.

Find more information about Iowa Health Link online:

Medical group

EPSDT Care for Kids

EPSDT Care for Kids is Iowa's Early and Periodic, Screening, Diagnosis and Treatment program for children who are enrolled in Medicaid. EPSDT Care for Kids services are free to children enrolled in Medicaid. EPSDT services include:

  • health history
  • physical exam
  • growth and development assessment
  • vision and hearing screening
  • dental screening and education
  • immunizations
  • developmental/behavioral screening
  • nutrition assessment and education
  • laboratory tests including blood lead testing
  • anticipatory guidance
  • referral for further diagnostic and treatment services

The EPSDT Care for Kids Informing and Care Coordination Handbook provides support for Title V Child & Adolescent Health agencies and their subcontractors to implement EPSDT informing and care coordination services.

Iowa HHS Medicaid Resources and Tools

The Iowa Department of Health and Human Services has a variety of tools to help providers determine member eligibility for services, and support the verification process, data interchange, and more. To understand how the Medicaid program operates in Iowa, download the Provider Reference Guide.

Visit the Medicaid Provider Services webpage and scroll down to find contact information, and link to resources and related tools.

Iowa's MCOs

Iowa Health Link provides health coverage through a Managed Care Organization (MCO) to children and youth who are eligible for EPSDT benefits. Iowa's three MCOs have a large network of health care providers across the state.

Iowa Total Care

Molina Healthcare of Iowa

Wellpoint Iowa, Inc.

Prior Authorization

All providers must follow prior authorization requirements for each MCO. MCOs are required to handle prior authorizations within 7 days. Prior authorizations for pharmacy benefits are handled differently.

Iowa Total Care

Molina Healthcare of Iowa

Wellpoint Iowa, Inc.

Iowa Medicaid PDL

The Iowa Medicaid Preferred Drug List (PDL) webpages include contact information, policy updates, FAQs, prior authorization forms, and more:

Grievance and Appeals

Providers may file claim disputes with the managed care organizations (MCOs). Each of the three MCOs has developed and implemented written policies and procedures for claim disputes. Follow these links to find information about policies and procedures for grievances and appeals:

Iowa Total Care

Molina Healthcare of Iowa

Wellpoint Iowa, Inc.

Contact the MCOs

Iowa HHS maintains information about the three Managed Care Organizations (MCOs) that currently serve Iowa's Medicaid Members. Learn more about Iowa's MCOs.

Iowa Total Care

Molina Healthcare of Iowa

Wellpoint Iowa, Inc.

Ombudsman Program for Managed Care

The Managed Care Ombudsman Program (MCOP) helps people navigate the managed care system. In addition to its focus on older Iowans, MCOP advocates on behalf of children and youth. Find reports, materials, and information for filing complaints on the MCOP webpage.

Website Accessibility

Iowa EPSDT is committed to making our information and materials accessible to everyone.

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