Medicaid is a government health insurance program that helps people with low income get health care services at a lower cost. There are several different Medicaid programs in Iowa, each serving a different group of people. The program for people who are older (age 65+), blind, or living with a disability is called the Aged, Blind, and Disabled (ABD) Medicaid Program.

What does Iowa Aged, Blind, and Disabled (ABD) Medicaid cover?

ABD Medicaid pays for routine and acute health care services. This includes:

• Visits to health care providers (including physicians and nurse practitioners)
• Inpatient and outpatient hospital services
• Early and periodic screening, diagnostic, and treatment services
• Preventive care (e.g., vaccinations)
• Lab tests and X-rays
• Dialysis services
• Mental health services
• Substance use treatment
• Rural health clinic services
• Medical transportation
• Long-term care (e.g., nursing facility care, home health services)

Most states also cover optional services such as:

• Physical, respiratory, and occupational therapy
• Home- and community-based care
• Case management
• Prescription drugs
• Dental and vision care

Since the program serves those with limited income and resources, people with Iowa ABD Medicaid pay few to no out-of-pocket costs. To get coverage once you are enrolled, you must go to health care providers that take part in the Medicaid program.

In Iowa, the Medicaid program is administered by the Department of Health and Human Services (HHS). Call HHS at 1-800-972-2017 to learn more about the coverages provided.

How do I know if I qualify for ABD Medicaid in Iowa?

ABD Medicaid covers people who are age 65+, blind, or living with a disability who also have limited income and resources. In general, to be eligible, you must:

• Be an Iowa resident
• Be a U.S. citizen or a qualified non-citizen
• Meet the income and/or asset limit for your coverage group

If you need help with your health care coverage and costs, you should apply for Medicaid even if you think you are over the income limit or your assets are too high. This is because:

• Not all types of income are counted toward the income limit.
• Not all types of income are counted toward the income limit.
• You may qualify for a different form of health care assistance. For example, if you have Medicare, you may qualify for a Medicare Savings Program (MSP).
• If you are over the income limit, but you have very high medical costs, you may be able to qualify for Medicaid through the Medically Needy Spend-Down Program.

What is the Medically Needy Spend-Down Program?

If your income puts you over the limit to qualify for Medicaid, you may still be able to get coverage if you have very high medical expenses. You would “spend down” your income on your medical expenses until you qualify for ABD Medicaid in Iowa. The amount you pay depends on your income and household size. Some examples of medical expenses you can use to meet your share of cost include:

• Unpaid medical bills that have not been used to meet the share of cost before
• Health insurance premiums
• Medical bills you paid within the last three months
• Medical bills that will not be paid by health insurance (or any other source)
• Co-pays for medical bills
• Medical services prescribed by your doctor
• Transportation by ambulance, bus, or taxi to get health care services

How do Medicare and Medicaid work together?

Medicaid pays for some services not covered by Medicare. If you get Medicare, you may also be able to get help from Iowa ABD Medicaid. Millions of Americans have both Medicare and Medicaid coverage. This is called being "dual eligible."

If you have Medicare and qualify for full ABD Medicaid coverage, the state will pay your Medicare Part B (Medical Insurance) monthly premiums. Depending on the level of Medicaid you qualify for, the state might also pay for:

• Your share of Medicare costs, like deductibles, coinsurance, and copayments
• Part A (Hospital Insurance) premiums, if you have to pay a premium for that coverage

If you have both Medicare and Medicaid in Iowa, you should show both cards to your health care provider each time you receive services. In addition, if you are dual-eligible for Medicare and Medicaid:

• You will automatically be signed up for the Low-Income Subsidy (LIS)/Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.
• You can get your coverage through a Medicare Advantage Special Needs Plan (SNP) instead of having original Medicare with separate Medicaid coverage. This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

Note: SNPs are not available in every community. To find out if there is an SNP in your area, visit the Medicare website or call 1-800-633-4227 or 1-877-486-2048 (TTY).

How do I prepare to apply for Iowa ABD Medicaid?

When you apply for Medicaid, you’ll be asked for important information to help determine if you qualify for benefits. Before you start, gather some basic information to make your application process easier: 

• A document that shows your age, such as your birth certificate or driver’s license
• A Social Security card
• Pay stubs for anyone in your household who has earned income
• Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)
• Information about your financial assets, such as bank account or investment account statements
• Documentation of medical expenses

How do I apply for AABD Medicaid in Illinois?

There are a few different ways you can apply for Medicaid in Iowa. Read below to learn more about which option might be right for you.

The quickest and easiest way to apply for ABD Medicaid in Iowa is online through the HHS Services portal . When you get to the site, you have two options: A pre-screening or clicking on 'Apply For Assistance'. If you apply, all your personal information is kept 100% confidential and protected by special security technology.

Apply for Iowa ABD Medicaid

You can download and print a paper Medicaid application, complete it, and mail it to:

Imaging Center 4
P.O. Box 2027
Cedar Rapids, Iowa 52406

You can also:

• Drop it off in person at your local HHS office.
• Fax it to 1-515-564-4017.
• Email it to imagingcenter4@dhs.state.ia.us.

How can I get help with my application?

• Contact your local HHS office directly or call 1-800-972-2017.
• Visit a Benefits Enrollment Center (BEC), if there’s one near you. See if there’s one in your area.
• NCOA also has a HelpLine you can call to get free support. To get started today, call 1-800-794-6559.