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Frequently Asked Questions

What is Iowa Total Care?

Iowa Total Care will begin July 1, 2019, offering services to children, pregnant women, families with children, elderly, adults with disabilities and children with disabilities. Services will be provided by two (2) Managed Care Organizations (MCOs). Iowa Total Care is one of the MCOs providing services.

What is a Managed Care Organization (MCO)?

An MCO is an insurance company that contracts with providers and medical facilities to provide health care services to its members.

What services are covered under Iowa Total Care?

Iowa Total Care services include physical health, behavioral health, long-term care, and community benefits.

Who may be eligible for services?

In addition to meeting certain income levels, applicants must meet specific eligibility requirements to receive Medicaid coverage. Eligibility for programs and services is determined by the Department of Human Services (DHS). For more information on Iowa Medicaid eligibility, please contact the DHS Contact Center at 1-855-889-7985.

Do I have to pay to be enrolled in Iowa Total Care?

No. There is no cost to enroll in Iowa Total Care. Some members may pay minimal copayments for doctor visits, emergency room care and prescriptions.

How do I apply for services?

You can apply for services in several ways.

By Phone:

  • DHS Contact Center at 1-855-889-7985

Online:

Download a paper application (PDF) from the Iowa DHS, complete it, and mail it to: Imaging Center 4 PO Box 2027 Cedar Rapids, Iowa 52406 or fax to 515-564-4017.

If I have both Medicare and Medicaid, will I have to change my Medicare plan as part of Iowa Total Care?

No. Your Medicare services and doctors will stay the same. It’s the responsibility of your Medicaid MCO to make sure that they coordinate your services with your Medicare Primary Care Provider (PCP).

How do I know if my doctors are contracted with an Iowa Medicaid MCO?

Ask your doctors if they are contracted with Iowa Total Care.

You can check the Find A Doctor webpage on our website to view our online provider directory or our Provider Directory.

If you have questions about our doctors, contact Iowa Total Care Member Services at 833-404-1061 (TTY: 711).

Can I change my Primary Care Provider (PCP)?

Yes. You can change your PCP at any time.

I need to see a specialist, what do I need to do?

Iowa Total Care does not need a referral from your PCP to cover the service. The specialist may still need a referral from your PCP. This helps them give you the right treatment. They will tell you if they need a referral. If you would like additional information, you may contact Iowa Total Care Member Services at 833-404-1061 (TTY: 711).

What is a Community Benefit?

The “Community Benefit” is the name given to a set of services that help to keep people in their homes and communities. Some of these services include adult day health, respite care, and personal care services.