What You Pay

If you get Medicaid through the Iowa Health and Wellness Plan (IHAWP), you may pay a small monthly premium, depending on your situation. You may also have to pay copayments for certain services.

Premiums

Everyone who qualifies for the Iowa Health and Wellness Plan can get Medicaid coverage without paying a monthly premium by doing two specific health-related activities, called Healthy Behaviors, every year. The two Healthy Behaviors are:

• Getting a physical (a wellness exam) from your doctor or getting a dental exam, and
• Doing a health risk assessment (a short survey) with your managed care organization.

Healthy Behaviors are optional, but if you don't do them, you may have to pay a small premium starting in your second year of coverage ($10 per month or less).

You don't need to pay premiums even if you don't do Healthy Behaviors if you are:

• Determined Medically Exempt, or
• An American Indian in a federally recognized tribe or an Alaksa Native.

Copayments

If you get Medicaid through the Iowa Health and Wellness Plan, the only time you need to pay a copayment is if you visit the emergency room and the visit is not considered an emergency. The copayment is $8.

You do not need to make copayments if you are:

• Under 21 years old
• Pregnant, or
• An American Indian in a federally recognized tribe or an Alaska Native.