Qualifications for Medicaid in Iowa

State officials determine who is eligible for Medicaid in Iowa largely through income and personal requirements. Recently, the expansion of Iowa Medicaid eligibility requirements has increased coverage to more individuals in need of reduced cost health insurance. The adjusted guidelines for how to qualify for Medicaid provides coverage to any adult that meets the income requirement, even if the individual is younger than 65 years of age, able-bodied and without dependents. This change in Medicaid benefits eligibility in Iowa awards health care coverage to thousands of residents in need of health insurance. In reference to what are the income requirements for Medicaid in Iowa, the figure fluctuates by household size, disability, age and the presence of dependent family members. Other than household income, the factors that make up what are the Medicaid application guidelines in Iowa is also contingent upon several other specific requirements.

To find out what are the requirements for Medicaid in Iowa, read the topics below:

  • General Medicaid eligibility requirements in Iowa

  • Income requirements for Medicaid in Iowa

General Medicaid Eligibility Requirements in Iowa

What are the requirements for Medicaid in IA? In terms of what are the Medicaid application guidelines, the state expanded its Medicaid eligibility requirements to include adults younger than 65 years of age without dependents or disabilities. The state of Iowa is unique by recognizing that adults that fall outside of the standard Medicaid benefits eligibility requirements may still be in need of health care assistance. In general terms of how to qualify for Medicaid in Iowa, an individual must first be a legal resident of Iowa, a United States citizen and have a valid Social Security Number. Medicaid eligibility requirements in IA begin with proof of residency and identity, but there are many equally important qualifying factors. Besides income verification, an applicant who is eligible for Medicaid in IA is a legal resident of Iowa in addition to being:

  • A child younger than 21 years of age.

  • An elderly adult older than 65 years of age.

  • Disabled with a condition recognized by Social Security.

  • A Pregnant female.

  • Awaiting treatment for breast of cervical cancer.

  • An adult living with a child younger than 18 years of age.

  • Any adult between 19 and 64 years of age.

Although Medicaid benefits eligibility in Iowa extends to all adults who meet income requirements, adults who do not meet any medical criteria will have to meet a much lower income threshold. For example, an able-bodied adult without dependents interested in obtaining Medicaid may need a household income that is significantly less than an eligible pregnant woman. Figuring out which Medicaid benefits eligibility category the petitioner falls under will help determine what are the income requirements for Medicaid because the income guidelines vary depending on covered group. The income threshold for Medicaid benefits eligibility in IA may not be the same for each demographic, so always be sure to provide accurate information on the Medicaid application.

Income Requirements for Medicaid in Iowa

What are the income requirements for Medicaid in IA? The income limit for Medicaid benefits eligibility in Iowa is higher than other states, in part due to reforms. In most states, who is eligible for Medicaid is largely determined by the presence of dependents, disability and older age. Generally, Medicaid denies single adults without dependents or disabilities health coverage. Currently, adults with no dependents may still meet the Medicaid eligibility requirements in Iowa if they meet the income guidelines, though the maximum qualifying income threshold is much lower for this demographic.

Medicaid is a financial need based program, meaning that income verification is an essential part of eligibility since Medicaid provides health care at little to no cost to residents who need it the most. The income limit for Medicaid benefits eligibility in Iowa may vary greatly depending on a few different factors, including disability status, age, pregnancy and many others.

To determine what are the income requirements for Medicaid in IA, a hard figure is attainable by using the Federal Poverty Level (FPL). The FPL is a fixed income amount based on the proportion of household size and household income calculated by the United States government. The Federal Poverty Level represents the income of a household with financial need. This figure adjusts annually to correspond with the costs of living. Other than Medicaid, the FPL commonly determines income eligibility for various government assistance programs based on financial necessity. As of 2017, the Federal Poverty Level for:

  • A household size of one, $11,880

  • A household size of two, $16,020

  • A household size of three, $20,160

  • A household size of four, $24,300

  • A household size of five, $28,440

  • A household size of six, $32,580

  • A household size of seven, $36,370

  • A household size of eight, $40,890

For each additional family member after eight, add $4,160. After determining a petitioner’s FPL based on household size is determined, calculating the income qualifications for Medicaid benefits eligibility follows. The threshold for income eligibility is rarely the FPL, but rather a figure between 100 and 400 percent of the FPL. In specific regards to what are the income requirements for Medicaid in Iowa, the household maximums are:

  • 375 percent of the Federal Poverty Level (FPL) for children younger than one year of age

  • 167 percent of the FPL for children between the one and 18 years of age

  • 375 percent of the FPL for pregnant women

  • 133 percent of the FPL for all other adults (excluding disabled or elderly individuals)

Note: Children living in households that do not meet the income requirements for Medicaid benefits eligibility in Iowa may qualify for other financial assistance programs



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