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Title 5: Centrally Administered Programs Page 78 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Premiums and Copayments July 3, 2009 Copayment Copayment A $25 copayment is imposed for each emergency room visit if the child’s medical condition does not meet the definition of emergency medical condition when family income is equal to or greater than 150 percent of the federal poverty level. The participating health and dental plan determines if the definition of emergency medical condition is met. A copayment shall not be imposed when family income is less than 150% of the federal poverty level for a family of the same size or when the child is an eligible American Indian or Alaskan Native. Case Maintenance Reporting Changes Legal reference: 441 IAC 86.10, 86.13(12), 86.2(2)“d” The hawk-i enrollee shall report any changes that may affect eligibility to the third-party administrator as soon as possible, but within ten working days, with day one being the date of the change. Ensure that all changes reported by the enrollee are acted upon no later than ten working days from the date the change is reported. ♦ Changes in Income Once initial eligibility is established, changes in income during the 12-month enrollment period do not affect the child’s eligibility to participate in the hawk-i program. If the family reports a decrease in income, determine if the change affects the premium obligation of the family. If the change is such that the family is no longer required to pay a premium, premiums will no longer be charged beginning with the month following the month of the report of the change. However, even if family income has decreased to below the Medicaid income limit, the children will not be moved to Medicaid until the next annual renewal.