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Title 5: Centrally Administered Programs Page 26 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Nonfinancial Eligibility Factors Revised August 20, 2010 Ineligibility for Medicaid

2. Mrs. L receives hawk-i coverage for her children, ages 12 and 17. The 17-year-old becomes pregnant and applies for Medicaid so that, when her child is born, it will automatically be eligible for Medicaid until the child’s first birthday. Medicaid is approved beginning June 1. The hawk-i program is notified of the approval via the Medicaid match. Coverage under hawk-i is canceled for the 17-year-old with a timely notice. Children Voluntarily Excluded From Medicaid Children voluntarily excluded from the Medicaid household due to the child’s income or resources can participate in the hawk-i program if otherwise eligible. Children voluntarily excluded from the Medicaid household for other reasons than the child’s income or resources are not eligible for hawk-i.

1. Ms. M applies for Medicaid for herself and her two children. One of the children, Sally, receives $750 monthly Social Security benefits because Sally’s father is deceased. The Social Security benefits, when added to Ms. M’s other income, make both Ms. M and her children eligible only under Medically Needy with a spenddown. Ms. M chooses to exclude Sally from the Medicaid eligible group so that Ms. M and her other child can be eligible for Medicaid without a spenddown. Sally is referred to hawk-i. If all hawk-i eligibility factors are met, Sally can receive benefits through the hawk-i program. 2. Ms. N applies for Medicaid for herself and her two children, Tim and Jane. Tim and Jane have different fathers. Ms. N does not want to cooperate with the Child Support Recovery Unit regarding Tim’s father. Ms. N chooses to exclude Tim from the Medicaid eligible group. Tim cannot be referred to hawk-i, since he has been voluntarily excluded for a nonfinancial reason. Dependents of State Employees Legal reference: 441 IAC 86.2(8) A child is not eligible for the hawk-i program if the child is eligible for health insurance coverage as a dependent of a state of Iowa employee and the state contributes at least $10 per month toward the cost of the dependent’s coverage.