| Q: |
Where can I go to receive services? My regular clinic says they're not enrolled in IowaCare. |
| A: |
To get covered health care services, IowaCare members need to go to either Broadlawns Medical Center (Polk County residents only), or all Iowa residents can go to the University of Iowa Hospitals and Clinics in Iowa City. To get inpatient mental health services under IowaCare, members need to go to one of the state's four Mental Health Institutes. The state Mental Health Institutes are located in Cherokee, Clarinda, Independence, and Mt. Pleasant. Admissions to the MHIs continue to be processed through the county central point of coordination.
Important: IowaCare will not pay for care you get at any provider other than those listed above. You will be billed for the services you get from other providers. |
| Q: |
What services are covered? |
| A: |
The following services may be covered:
- Inpatient and outpatient hospital care. Inpatient care is when you are admitted to a hospital and stay overnight. Outpatient care is when you have tests or a procedure done in a hospital and you are able to go home the same day.
- To be covered, these services need to be ordered by a provider. If you have questions about whether specific procedures are covered, ask your provider.
- Doctor and nursing services at the hospital.
- Some dental services.
- Transportation to and from the University of Iowa Hospitals and Clinics, by appointment only.
- Prescription drugs are not covered unless they are prescribed as part of a covered inpatient or outpatient stay. Exception: If you were on the State Papers Program between July 1, 2004 and June 30, 2005 and have a chronic health condition that has been certified by the University of Iowa Hospitals and Clinics and approved by the Department of Human Services, you may get prescriptions for the chronic health condition.
Important: Providers do not have to offer all of the services on the above list. It's a good idea to ask about specific coverage when you make an appointment. |
| Q: |
Once I am approved for IowaCare, what do I need to do to get an appointment? |
| A: |
- Broadlawns: If you live in Polk County and want to make an appointment at Broadlawns, call the hospital at 515-282-2331.
- University of Iowa Hospitals and Clinics: Any Iowa resident who wants to make an appointment at the University of Iowa Hospitals and Clinics should call the hospital at 319-353-7381.
- Transportation to the University of Iowa Hospitals and Clinics: To schedule transportation from your home to the University of Iowa Hospitals and Clinics and back, call 319-356-2346 or 319-356-2518 to schedule an appointment. If you have to stay overnight, you must pay the cost of any lodging and meals.
- Inpatient mental health services: Persons who need inpatient mental health services must work through their current mental health provider and their county's mental health department central point of coordination (CPC), or one of the county authorized mental health evaluation centers.
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| Q: |
I was told I have to pay a premium for the IowaCare program. Is this true? |
| A: |
Yes. When you applied for the IowaCare Program you signed an agreement to pay premiums if you are found eligible for IowaCare. Your premium is based on your income at the time you applied. Premium payments are due by the end of each month and should be sent to:
Iowa Medicaid Enterprise
IowaCare Premiums
P.O. Box 10391
Des Moines, IA 50306-0391
* Please mail your billing statement with your payment and write your IowaCare number on your check or money order. A self-addressed, stamped envelope to mail your premium was included with your bill. The DHS offices also have them. If you need one, you can stop by the local office and pick one up.
When you are approved for IowaCare, you must stay in the program and pay any premiums that you owe for at least the first four months. Even if you drop out of the program, you still owe premiums for the first four months unless you declare hardship. |
| Q: |
What if I can't afford to pay the premium? |
| A: |
If you cannot afford to pay the premium for a month, be sure to tell the Iowa Department of Human Services. This is called "declaring hardship". To declare hardship, all you have to do is sign the statement on the premium payment notice telling us you cannot pay and mail it back to DHS.
Important: You must declare hardship and mail the form back to the Iowa Department of Human Services by the end of each month or you will have to pay the premium for that month and you may be dropped from the program. |
| Q: |
What if I drop out of the program and want to reapply later? |
| A: |
If you drop out of the program and decide to reapply later, you must pay any past due premiums before your application will be approved.
Once the first four-month period is over, you can drop out of the program without further obligation by calling your local county DHS Income Maintenance Worker and asking to have your IowaCare benefits cancelled. |
| Q: |
Do I have to pay any other costs when I am on IowaCare? |
| A: |
You will be charged a co-payment for any prescriptions that are covered by IowaCare. The co-pay amount is $1.00 to $3.00 for each prescription, depending on the cost of the medication. |
| Q: |
Who can I call if I have questions about IowaCare? |
| A: |
Your local DHS office is a good source of information about the program. The telephone number and address can be found in the Government Listings section of your phone book or on the DHS website at http://www.dhs.state.ia.us/. Questions can also be directed to the Iowa Medicaid Enterprise Member Services at (515) 725-1003 (local Des Moines and cell phones with 515 area code) or (800) 338-8366. |
