The Iowa CHIP program provides comprehensive health coverage for children with families that have income that is too high for Medicaid benefits, but too low to afford individual or work-provided healthcare. CHIP insurance serves the purpose of increasing the number of children who are enrolled in health and dental care coverage and, therefore, improving the health and dental outcomes of children throughout Iowa. Funded by both the federal and state governments, this program has been available in Iowa since 1998, serving thousands of insured children each year. Historically, Iowa has been among the states with the lowest uninsured rate among children, in part due to this program.
This children’s health insurance program is divided into three parts in Iowa: Medicaid expansion, hawk-I and dental-only plans. Statistically, most children (64 percent) qualify for hawk-i plans while 31 percent qualify for Medicaid expansion plans. Only five percent of members only receive dental care through this program.
What is CHIP in Iowa?
CHIP Medicaid began in Iowa in 1998 as a means to provide comprehensive health insurance coverage to the thousands of uninsured children throughout the state. The program is designed to provide coverage to children who have no other means of health insurance, but do not qualify for traditional Medicaid due to family income. By providing health insurance for kids, the state has sharply reduced the number of children that go without affordable health care each year.
In Iowa, CHIP is split into three parts. Therefore, it is important to learn more about each part of this program in order to familiarize yourself with the program and get a better idea of the plan that your child may be eligible for. The main difference between these plans involves the income of the household. Iowa CHIP insurance plans include:
- Medicaid expansion. An expansion of traditional Medicaid, this plan provides benefits that are on par with the state Medicaid program. The plan provides health coverage to children between the ages of 6 and 18 whose family income is between a certain range for the current year’s Federal Poverty Line (FPL), as well as infants with family income between certain percentages of the FPL.
- Hawk– The most common CHIP plan in Iowa, hawk-i provides coverage to children under the age of 19 whose family gross income is less than or equal to a certain percent of the FPL. This plan uses the Modified Adjusted Gross Income (MAGI) methodology when determining eligibility based on income.
- Dental–only plans. Implemented in 2010, Iowa created a dental-only plan for children that meet most of hawk-i program guidelines, but are not eligible for full coverage because the child already has another form of health insurance. Dental-only plans may be obtained, regardless of whether or not a child under the age of 19 has other forms of insurance coverage, so long as the family is between zero and 302 percent of the FPL.
Who does Iowa CHIP cover?
Before submitting a CHIP application in Iowa, you may review eligibility requirements in order to save yourself time and hassle as well as gain a better understanding about the program and whether or not your child may be eligible for coverage. To receive a child health insurance plan, your child must be under the age of 19 and a resident of Iowa. In order to apply for benefits, the child must live with you. In most cases, children may not have any other form of health insurance (except if applying for a dental-only plan) and the child cannot qualify for Medicaid.
To meet CHIP Eligibility requirements, a family must meet income limits that have been determined by the federal poverty line. Income limits are different by household size as larger households will have larger income limits. If you have previously been denied Medicaid, you may still qualify for this program as income limits are higher than that of traditional Medicaid. As stated previously, income levels will determine the type of plan that your child may be able to receive coverage through. The plan that your child becomes eligible for will determine your potential out of pocket costs for the insurance.
How to Apply for CHIP in Iowa
To apply for CHIP benefits in Iowa, you have the option of applying online or in person at your local office. An online application is generally considered the easiest way to apply. An online application can be completed in an average of 30 minutes from the comfort of your own home. Alternatively, you can also visit your local office to submit an application in person. After your application has been processed, you may receive a request for additional documentation to support the information you have supplied on your application, such as proof of income.
What is included with Iowa CHIP coverage?
If approved for CHIP coverage in Iowa, your child will receive comprehensive health insurance benefits. If your child qualifies for a Medicaid extension, your child will be given the same covered services as traditional Medicaid through existing Medicaid providers. If your child qualifies for hawk-i, services include, but are not limited to:
- Preventative care, including immunizations.
- Well-child visits with a physician.
- Emergency care services.
- Prescription medications.
- Dental care.
- Vision care.
- Mental health and behavioral services.
- Physical and speech therapy.
Iowa CHIP benefits can differ slightly from other state programs. Each state has the ability to make a number of determinations about the program available within the state, including costs and coverages.
How much is CHIP health insurance in Iowa?
Iowa CHIP has the goal of providing comprehensive health insurance to otherwise uninsured children at an affordable cost to parents. By providing affordable health care, children have the opportunity to grow up healthier and gain access to medical services when needed. Some families receive CHIP insurance at no cost, however, most families will have a small monthly premium fee that must be paid in order to continue coverage. It is worth knowing that families will not exceed the maximum fees that are permitted within the state as well as federal laws that detail that a family shall not exceed 5 percent of their annual income in fees each year.
How long do CHIP benefits last in Iowa?
After being approved for CHIP in Iowa, benefits will generally last for a 12-month beneficiary period. However, there are instances where benefits could end prematurely, including a lack of premium payments, if a child turns 19 years of age or if the child moves to another state.
When your child’s CHIP insurance coverage is nearing its end, you will receive a notice by mail that will provide instructions on renewing your child’s coverage. You will need to complete a renewal application, provide any requested documentation such as proof of income and submit this information within a timely manner in order to avoid any lapses to your child’s health insurance coverage. If your child is deemed to be still eligible to receive benefits, coverage may be extended for an additional 12 months. You can renew coverage as many times as your child remains eligible. To learn more about CHIP benefits, download our comprehensive guide to CHIP today.