What’s changing with Iowa Medicaid?
We’ll help you understand the new rules and how to stay covered
Starting December 1, 2026, some Iowa Health and Wellness Plan (IHAWP) members will need to complete at least 80 hours of approved community engagement requirements each month. These are activities like employment, volunteering, attending school, or participating in a job training program. Meeting these requirements can help you keep your IHAWP coverage.
Everything you need to know
Use the links for helpful information for understanding Medicaid coverage.
Do these requirements apply to me?
How do I keep my IHAWP coverage?
What if I lose my Medicaid coverage?
Resources to help you meet Medicaid requirements
When will the rules take effect?
Current IHAWP members
If you're already enrolled, you won’t need to meet the community engagement requirements until your regular renewal in February 2027.
Future IHAWP members
If you're applying for coverage, you may need to meet the community engagement requirements before your coverage begins.
Do these work requirements apply to me?
You may need to meet the community engagement requirements if you:
- Are between the ages of 19 and 64
- Get your health insurance through Iowa Health and Wellness Plan (IHAWP)
- Are not eligible for Medicare
- Are not pregnant
- Are a U.S. citizen or meet immigration rules
You may need to meet these requirements soon if you:
- Are turning 19
- Gave birth to a baby in the past 12 months (12 months postpartum)
- Have aged out of foster care and are turning 26
- Are a parent or caregiver with your youngest dependent turning 14
Who doesn’t have to meet the community engagement requirements?
You may not need to meet the community engagement requirements if you are:
- Under age 26 and aged out of foster care
- An American Indian or Alaska Native who is eligible for Indian Health Service (IHS)
- A parent or caregiver of:
- A child age 13 or younger
- Someone with a disability
- A veteran with a total disability rating
- Medically frail or have serious health needs, such as:
- Blindness or disability
- Serious mental health conditions
- Substance use disorder
- Major physical or developmental disabilities
- Already meeting Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF) work requirements
- In drug or alcohol treatment
- Incarcerated or have been recently released (within 90 days)
- Pregnant or gave birth to a baby less than 12 months ago (12 months postpartum)
The Iowa Department of Health and Human Services (HHS) will review your information and determine whether you qualify for an exemption. An exemption is an approved reason why the community engagement requirements do not apply to you. HHS may contact you if additional information is needed.
Note: You may need to tell HHS if any of these possible exemptions apply to you.
What do I need to do now?
Visit the Iowa HHA Services Portal to make sure your contact information is up to date and accurate.
How do I keep my IHAWP coverage?
You may need to complete at least 80 hours of approved community engagement requirements each month to keep your IHAWP coverage. This can include:
- Work (or earn at least $580 per month)
- School (attending at least half-time)
- Job training
- Volunteering
If your work is seasonal, your average earnings over six months must be at least $580 per month (or $6,960 per year).
You can mix and match community engagement requirements to reach 80 hours per month. For example, you can:
- Work 50 hours as a barista and volunteer 30 hours at al local food bank
- Be enrolled in an electrician program at least half-time
- Volunteer 72 hours with an animal shelter and work 8 hours as a grocery clerk
How do I report my community engagement requirements?
When it's time to renew your IHAWP coverage, you may need to report your community engagement requirements.
HHS will first review information it already has. If HHS needs more information, you'll receive a notice by mail or through your Iowa HHS Services Portal explaining what to submit. If you're asked to provide information, be sure to respond within 30 days to avoid delays or potential loss of coverage.
HHS may ask for:
- Pay stubs
- School records
- Proof of volunteer hours or work program hours
You can send this information online, in person, or by mail. If HHS doesn’t contact you, there is nothing you need to submit.
How do I renew my Iowa Health and Wellness Plan (IHAWP)?
As Medicaid changes, you may need to renew more often and provide updated information — including work or activity details. You will receive a notice when it’s time to renew your coverage.
Renewing your IHAWP benefits is as easy as Ready. Set. Renew.
Step 1: Ready
Get your information ready before you start. This can help you finish faster and avoid delays.
Step 2: Set
Make sure your form is complete and up to date. You can renew using the option that works best for you:
- Online: Visit the Iowa HHS Services Portal to complete your renewal.
- By mail: Send the completed forms to the address on your notice.
- In person: Visit a local HHS office.
- By phone: Call 800-338-8366 for help completing your renewal.
Step 3: Renew
Submit your renewal and wait for updates. You’ll get a notice from HHS letting you know if your coverage has been renewed.
What can I do if I lose my IHAWP coverage?
If your IHAWP coverage recently ended, you may still be able to reapply and get your benefits back.
What can you do next?
Follow each step to get your renewal on track.
Step 1: Find out why your coverage ended.
Step 2: Complete your renewal or submit a new application.
Step 3: Submit missing documents:
- Income
- Household
- Work hours
- Proof of exemption
Step 4: Wait for confirmation
What if my situation changes?
Report any changes in your life as soon as possible to HHS. Certain life changes could affect whether you qualify for IHAWP or need to meet community engagement requirements, including:
- A change in your income or job
- A new address
- Someone moving in or out of your home
- Family changes including marriage, divorce, pregnancy, or adoption
If HHS asks you for information, or if you need to report a change, you can contact Iowa Health and Human Services (HHS):
- By phone: 800-403-0864
- By email: IMEmember@hhs.iowa.gov
- By website: Iowa Health & Human Services (HSS) site
You can also report changes, apply for benefits, and complete reviews at through the HHS Portal.
Resources to help you meet the community engagement requirements
If you need help finding work, job training, or other support services, these Iowa resources may be able to help.
Frequently Asked Questions
Review our frequently asked questions (FAQs) for additional help with understanding Medicaid requirements.