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Title 5: Centrally Administered Programs TABLE OF CONTENTS Chapter E: Healthy and Well Kids in Iowa (hawk-i) Revised August 20, 2010 Page 1 Page Iowa Department of Human Services Employees’ Manual General Administration ................................................................................... 1 Definitions ................................................................................................. 2 Responsibilities of the Department ................................................................ 4 Responsibilities of the hawk-i Third-Party Administrator ................................... 4 Confidentiality ............................................................................................ 6 Nondiscrimination ....................................................................................... 6 Appeals ..................................................................................................... 7 Health or Dental Services Appeal Process ................................................ 8 Application Processing .................................................................................... 9 Who Can Apply ........................................................................................... 9 Joint Custody ..................................................................................... 10 Application Form ........................................................................................ 12 Who Must Sign the Application .............................................................. 12 Where the Application Can Be Filed ....................................................... 13 Date of Application .............................................................................. 13 Withdrawal of Application ............................................................................ 14 When an Application Is Not Required ............................................................ 14 Referrals from Medicaid to hawk-i ......................................................... 15 Information and Verification ........................................................................ 16 Preferred Language ............................................................................. 16a Medicaid Screening and Referral Process ....................................................... 16a Referrals From hawk-i to Medicaid ......................................................... 17 Cooperation With Medicaid ................................................................... 18 Medicaid Match ................................................................................... 19 Application Processing Timeframes ............................................................... 20 Effective Date of Coverage .......................................................................... 20 Nonfinancial Eligibility Factors ...................................................................... 21 Age ......................................................................................................... 21 Alien Eligibility ........................................................................................... 21 Citizenship and Alien Status ........................................................................ 21 Residency ................................................................................................. 22 Uninsured Status ....................................................................................... 22 Health Insurance Data Match ................................................................ 23 Verification of Insurance Cancellation ........................................................... 23 Individual Plans .................................................................................. 24 Employer Group Plans ......................................................................... 24 Ineligibility for Medicaid .............................................................................. 25 Applications and Renewals ................................................................... 25 During the hawk-i Enrollment Period ...................................................... 25 Children Voluntarily Excluded From Medicaid .......................................... 26 Dependents of State Employees ................................................................... 26