If you have Medicaid through the Iowa Health and Wellness Plan (IHAWP), new requirements are coming that could affect your health coverage.
Beginning December 1, 2026, some IHAWP members will need to meet new community engagement requirements.
This may include working, attending school or job training, volunteering, or a combination of these activities.
Not everyone on Medicaid will be affected. But if you have IHAWP coverage, there are some things you can do now to prepare.
What Should I Do Now?
You do not need to wait until December to start preparing.
1. Make sure Iowa Medicaid has your correct contact information
Check that Iowa Medicaid has your current:
- Mailing address
- Phone number
- Email address
This is important because Iowa Health and Human Services (HHS) will use your contact information to send you notices about your Medicaid coverage.
To report a change to Iowa HHS, call 1-877-347-5678.
2. Watch for letters, emails and messages from Iowa HHS
Iowa HHS has started sending information to Medicaid members about the upcoming changes.
Do not ignore letters or messages about your Medicaid coverage. Read them carefully and follow any instructions you receive.
3. Sign up for Medicaid text messages
Iowa HHS can send important Medicaid eligibility and renewal information by text.
To receive messages, text JOIN to 42447.
You can stop the messages at any time by texting STOP to the same number. Message and data rates may apply.
4. Keep track of your activities
If you work, attend school or job training, or volunteer, consider keeping track of your hours.
Iowa HHS also recommends gathering documents that may help show that you meet the new requirements or qualify for an exclusion.
FAQs (Frequently Asked Questions)
What Are Community Engagement Requirements?
Beginning December 1, 2026, certain IHAWP members will need to complete qualifying activities each month to enroll in or maintain coverage.
If the requirement applies to you, you generally must complete at least 80 hours each month through one or a combination of qualifying activities.
These may include:
- Work: Work at least 80 hours per month or earn at least $580 per month.
- Education: Attend high school, college, GED, career or technical education at least half-time.
- Job training: Participate in a qualifying job training or work program.
- Community service: Complete volunteer work.
- A combination: Combine qualifying activities to reach at least 80 hours per month.
For seasonal workers, income may be averaged over six months.
Who May Be Affected?
These changes apply to certain people enrolled in the Iowa Health and Wellness Plan, which provides Medicaid coverage to eligible Iowa adults ages 19–64.
Not everyone who has Iowa Medicaid will need to meet the community engagement requirements.
If you’re not sure whether you have IHAWP or whether these requirements apply to you, Iowa HHS has information available through its Self-Service Portal.
Who Does Not Have to Meet the Requirements?
According to Iowa HHS, some people enrolled in IHAWP will be excluded from the community engagement requirements.
This may include:
- American Indians and Alaska Natives
- People who are medically frail or have certain medical needs
- People who are pregnant or had a baby within the last 12 months while receiving Iowa Medicaid
- Caregivers of children under age 14 or people with disabilities
- People participating in a drug or alcohol treatment program
- People meeting certain SNAP or Family Investment Program (FIP) work requirements
- Veterans with a total disability rating
- People who are currently or were recently in jail or prison
Iowa HHS will determine whether an exclusion applies to you. Additional guidance about some exclusions, including medical exemptions, is still being developed.
When Do the New Requirements Start?
The timeline depends on whether you are applying for Medicaid or already have coverage.
Beginning December 1, 2026:
People applying for IHAWP on or after this date will need to meet the new requirements if they are not excluded.
For current IHAWP members:
The requirements will begin as members go through their Medicaid renewal process in 2027.
Iowa is also changing how often IHAWP eligibility is reviewed. Instead of once a year, eligibility reviews will occur every six months.
Will I Have to Send Proof of My Hours?
Iowa HHS says members should begin keeping track of work, school, job training and volunteer activities and gathering documents that could be used as proof.
However, the State has not yet released complete instructions for how members will report their hours.
We will update this page as more information becomes available.
What Happens If I Don’t Meet the Requirement?
If the requirement applies to you and you do not meet it, your Medicaid coverage may be denied or discontinued.
If you lose coverage, you can apply for Medicaid again. You may also have other health coverage options.
Because everyone’s situation is different, do not assume that you will lose Medicaid coverage simply because you receive a notice. Read the notice carefully and follow the instructions provided by Iowa HHS.
Can PHC Tell Me If I Qualify for an Exclusion?
PHC can help patients understand healthcare coverage resources and connect them with assistance.
However, Iowa HHS determines Medicaid eligibility and whether the community engagement requirements or an exclusion apply to you.
Some details about the new requirements are still being developed by the State. PHC will continue to share updated information as it becomes available.
Have Questions About Your Medicaid Coverage?
For questions about your Iowa Medicaid coverage, contact Iowa Medicaid Member Services:
- Toll-Free: 1-800-338-8366
- Des Moines Area: 515-256-4606
- Email: IMEmember@hhs.iowa.gov
You can also visit the Iowa HHS Community Engagement Requirements page for the latest information.
PHC will continue to update this article as Iowa HHS releases additional guidance.