The BasicsIs it Right for You?What it CoversWhat You PayHow to Sign UpFAQsPitfallsNext Steps

Iowa Health and Wellness Plan (IHAWP)

Try It

    Iowa Health and Wellness Plan (IHAWP)

    Is it Right for You?

    Almost everyone should be able to get health coverage. The question is, which plan is right for you and your family?

    This page looks at whether you might qualify for Medicaid based on your family's income through the Iowa Health and Wellness Plan (IHAWP). If you do, it is your best choice and you won’t qualify for subsidized individual coverage. You can see if you qualify at the Iowa HHS Benefits Portal or HealthCare.gov.

    If you don’t qualify for Medicaid, consider other options we will introduce, including Medicare and private health insurance.

    Different ways to qualify for Medicaid if you have a disability

    If the Social Security Administration (SSA) says you are disabled, you may have additional ways of qualifying for Medicaid, depending on your situation. Read DB101’s Disability-Based Medicaid article.

    Iowa Health and Wellness Plan Basic Eligibility Requirements

    To qualify for Medicaid through the Iowa Health and Wellness Plan, most people must meet several basic requirements:

    Note: If you are 65 or older or are eligible for Medicare and are the parent or caretaker of a child, you may qualify for Medicaid through a program for families, which is different than the Iowa Health and Wellness Plan. Talk to your local Health and Human Services (HHS) office to see if you may qualify.

    Under Age 65

    The Medicaid rules on this page are for people under age 65. However, seniors may qualify for disability-based Medicaid. If you are 65 years old or older and have low income, talk to your local Health and Human Services (HHS) office about whether you qualify for Medicaid.

    If you are under 65, continue reading this article.

    Not Eligible for Medicare

    Medicaid’s eligibility rules are different for people who are eligible for or enrolled in Medicare. If you are eligible for or getting Medicare, read DB101’s Medicare article or contact your local Health and Human Services (HHS) office.

    Note: If you are enrolled in Medicare and are pregnant, you may still qualify for Medicaid. Pregnant women get Medicaid through a different program, not the Iowa Health and Wellness Plan, and can have Medicare at the same time.

    If you are not on Medicare, keep reading this article.

    Citizenship or Residency

    You must be a U.S. citizen or meet specific noncitizen requirements to be eligible for Medicaid:

    If you are a U.S. citizen or meet the noncitizen requirements for Medicaid, continue reading this article.

    Income

    To qualify for the Iowa Health and Wellness Plan, your family's income must be at or below 138% of the Federal Poverty Guidelines (FPG) ($1,800 per month for an individual in 2026, $3,697 for a family of four).

    Children and pregnant women get Medicaid through different rules and can have higher incomes:

    • Children under 19 may get Healthy and Well Kids in Iowa (Hawki) coverage if their family's income is 307% of FPG or less ($8,225 per month or less for a family of four).
    • Pregnant women may get Medicaid if their family's income is 220% of FPG or less. (For the purposes of calculating a pregnant woman’s family income, the unborn baby is counted as a family member.) Medicaid coverage lasts for a year after giving birth.

    There are no limits to how much money or other resources you can have.

    The Iowa Health and Wellness Plan counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medicaid eligibility.

    Is Medicaid’s income limit 133% or 138% of FPG?

    You may see the income limit for the Iowa Health and Wellness Plan listed as 133% of the Federal Poverty Guidelines (FPG) in some places. However, when Medicaid counts your income, they’ll knock 5% of FPG off your income if you make more than 133% of FPG. That's why we show the limit as 138% of FPG, because it more accurately shows how much you could make and still get Medicaid.

    If you cannot get Medicaid because your income is too high, consider buying an individual plan through HealthCare.gov. See DB101’s article about Buying Health Coverage on HealthCare.gov.

    Health Coverage Income Limits for Your Family

    The bottom line: If you meet the four main requirements described here, Medicaid is a great program that you should sign up for. We explain how to sign up later in this article.

    More ways to qualify for Medicaid if you have a disability

    If you have a disability, you may qualify for Medicaid in more than one way. The good thing is that when you apply for Medicaid, the people reviewing your application will automatically figure out which Medicaid eligibility rules are right for you.

    Reasons you might qualify for disability-based Medicaid instead of the Iowa Health and Wellness Plan:

    • Your income is higher than the 138% of FPG limit. Disability-based Medicaid doesn't count all of your earned income, so you may make more and still qualify. Furthermore, people with disabilities who work and have higher income may qualify through Medicaid for Employed People with Disabilities (MEPD).
    • You also get Medicare. The Iowa Health and Wellness Plan isn’t available to people getting Medicare, but disability-based Medicaid is. It may even help pay your monthly Medicare premiums.

    Reasons you might qualify for the Iowa Health and Wellness Plan, even if you have a disability:

    • Your disability does not meet Social Security’s definition of disability. Disability-based Medicaid is only for people who have disabilities meeting this standard.
    • Your resources are greater than disability-based Medicaid allows. Disability-based Medicaid has a resource limit, meaning that if you have too much money in the bank or in any other type of account, you do not qualify.

    To learn more, read DB101’s articles about disability-based Medicaid and Medicaid for Employed People with Disabilities (MEPD), or contact your local Health and Human Services (HHS) office.

    Medicaid and Private Health Coverage

    If you qualify for Medicaid, you should sign up for it. Here we will look at what signing up for Medicaid might mean if you have or want private coverage.

    Medicaid and Employer-Sponsored Health Coverage

    If you qualify for Medicaid, it will always be your best choice, even if your employer offers health insurance. That’s because Medicaid has no monthly premium and the copayments for services are usually much lower than copayments required by employer-sponsored plans. Also, Medicaid may cover some services that your employer-sponsored coverage does not pay for.

    If you have Medicaid and you want to enroll in a health plan through an employer (either your own or a family member's), you may qualify for Iowa's Health Insurance Premium Payment (HIPP) program. If you have HIPP, Medicaid pays your plan's premium and the other costs of getting medical care, like the copayments and the deductible. (Note: For Medicaid to pay these extra costs, you must go to a Medicaid health care provider.) You are not enrolled in a Medicaid managed care plan; instead, your employer's health plan is your main health coverage.

    You must apply separately for HIPP after you are approved for Medicaid. If the state of Iowa sees that it is cost-effective to pay for your private coverage, you may qualify. Learn more about HIPP and how to apply.

    If you don't qualify for HIPP, you can have both types of coverage at the same time, but you will have to pay your employer-sponsored coverage costs yourself.

    Example

    Nelson is a single father living on his own with his two daughters. He makes $13 an hour repairing shoes and works 30 hours a week, so he makes a total of about $1,700 a month. Because he works 30 hours a week, his employer offers him and his daughters health insurance, but to get it, he would have to pay a $400 premium each month.

    Nelson decides to go to his local Health and Human Services (HHS) office to see if his family would qualify for Medicaid, because he doesn’t have enough money to pay the monthly premium for health coverage offered through his job. The case worker looks at his income and explains that he does qualify for the Iowa Health and Wellness Plan, because his income is less than 138% of FPG for a family of three.

    Once he is approved for Medicaid, he can apply for HIPP to see if Medicaid may pay for his employer-sponsored health plan. Otherwise, he will be enrolled in a Medicaid managed care plan. Either way, he will not have to pay a monthly premium.

    Medicaid and Individual Plans

    If you are eligible for Medicaid, then you will not be eligible to get government help to pay for a private insurance plan. That means the private insurance plan would be expensive for you. If you qualify for Medicaid, it will always be a better option for you than paying for an individual plan.

    Learn more

    Supplemental Nutrition Assistance Program (SNAP)

    SNAP helps people with low income pay for groceries and other food items.

    Buying Health Coverage on HealthCare.gov

    You can get private health coverage on HealthCare.gov. The government may help you pay for it.

    Employer-Sponsored Health Coverage

    Your job, your parent's job, or your spouse's job may offer private health coverage as a benefit.