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Title 8: Medicaid Page 39 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Residency Revised October 10, 2025 Determining Residency for Persons Aged 21… • The current state of residence of the parent or legal guardian who files the application, if the person is institutionalized in that state, or • The state where the person is institutionalized, if the person has been abandoned by the person’s parents and a legal guardian has not been appointed. NOTE: In the first and second options listed above, if parental rights have been terminated, use the guardian’s state of residence instead of the parent’s. Also, under the first and second options, the client may have a choice of two different states of residency. Living in Iowa for Employment Purposes Legal reference: 42 CFR 435.403, 441 IAC 75.10(2), Iowa Code Section 249A.3 When a person enters Iowa for employment purposes, this fact, in and of itself, qualifies the person as a resident of Iowa for Medicaid eligibility. Entering the state for employment purposes means either having a job commitment or coming to Iowa to seek employment.

Ms. V moves to Iowa to look for a job. If she can find one in six months, she will stay in Iowa. Her intent is to live for a definite period for the purpose of seeking employment. She is an Iowa resident. This provision applies even if:  The person intends to return to another state once employment has ended, or  The person retains ownership of a homestead in the other state. A person could be eligible for Medicaid in two states at the same time. This occurs when a person is temporarily absent from a state and remains eligible in that state but is also eligible in another state where the person is living for employment purposes. However, a person cannot receive Medicaid in both states at the same time. Discuss with the person the pros and cons of eligibility in Iowa as opposed to the other state (i.e., use of Medicaid card between states, coverage provisions, etc.). The person can choose in which state the person would prefer Medicaid eligibility.