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Title 8: Medicaid Page 1 Iowa Department of Health and Human Services Employees’ Manual Chapter B: Application Processing Overview Revised October 17, 2025

Overview This chapter explains the procedures for processing Medicaid applications. The mechanics of filing and handling applications are covered first, followed by interview and verification procedures. Timelines for processing applications and effective date of eligibility are given in the next sections. The remaining pages of the chapter address eligibility for the retroactive period, referrals to Child Support Services (CSS) and representation. Filing a Medicaid Application Legal reference: 42 CFR 435.403, 435.906, 435.908, Iowa Code Section 249A.3, 441 IAC 76 (Rules in Process) and 86.3(2) All people have the right to apply, without delay, for Medicaid for themselves or on behalf of another. Give an application to anyone who asks for one regardless of the person’s county of residence. If the request is by mail or telephone, send the application in the next outgoing mail. See 8-F, FMAP-Related Coverage Groups- Express-Lane Eligibility for children under age 19 who are eligible without an application under the express-lane eligibility process. An application for SSI benefits is automatically considered an application for Medicaid if SSI is approved. A denied SSI application is not considered a Medicaid application, and the filing date is not protected for Medicaid purposes. See Collecting Eligibility Information from SSI Recipients. When requested, assist the applicant with completing an application. Applicants can authorize other people to represent them during the application process. Other people can also help the applicant during the application process. An application may be filed on behalf of a deceased person. Eligibility is based on whether the person would have been eligible had application been made on or before the date of death and whether there are unpaid medical bills. However, eligibility cannot be established any earlier than three months before the month of application. An application may be filed on behalf of a person temporarily out of the state. This situation usually happens when someone is visiting outside the state and has an accident or sudden illness. Apply all of Iowa’s policies regarding application processing