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Title 8: Medicaid Page 43 Iowa Department of Health and Human Services Employees’ Manual Chapter F: Coverage Groups MAGI-Related Coverage Groups Revised October 10, 2025 People Who are Ineligible for FMAP

10. Ms. Z and her children have received transitional Medicaid for five months (December - April) when Mr. Z, the children’s father, returns to the home. Ms. Z reports to the worker on April 10 that Mr. Z returned home April 2. She also reports that Mr. Z is working. Mr. Z is added to the transitional Medicaid group effective April 1. If an adult is a mandatory member of the eligible group and is not eligible for Medicaid (ineligible adult alien, sanctioned adult, etc.), the adult remains a member of the eligible group as a “considered” person. TM Review Requirements Legal reference: 441 IAC 76.7(249A) Households receiving transitional Medicaid do not have any review or reporting requirements other than those explained in the section Requirements After Eligibility Is Established. After transitional Medicaid households lose their eligibility under this coverage group and establish eligibility under another coverage group, they are again subject to review and reporting requirements as explained in 8-G, Additional MAGI-Related Case Maintenance. The ELIAS system will issue a Medicaid/Hawki Review, form 470-5168 by the fifth of the month prior to the review month. If this review form is not returned on time, transitional Medicaid certification will end and no further action is required by the worker. Iowa Health and Wellness Plan (IHAWP) Legal reference: 441 IAC 74; 441 IAC 75(Rules in Process) The Iowa Health and Wellness Plan (IHAWP) coverage group is available to persons who are age 19 through age 64 who meet the following eligibility requirements:  Are not eligible for medical assistance in a mandatory MAGI-related or non- MAGI-related coverage group; and  Have countable income at or below 133 percent of the federal poverty level for their household size; and  Are not entitled to or enrolled in Medicare benefits under Part A or Part B of Title XVIII of the Social Security Act; and