Iowa Medicaid is administered by Iowa Health and Human Services (HHS), the department formed by the state's 2023 merger of the former Department of Human Services and Department of Public Health. Most Iowa Medicaid members are covered through managed care under the IA Health Link brand, delivered by three MCOs: Iowa Total Care, Molina Healthcare of Iowa, and Wellpoint of Iowa. IA Health Link integrates physical health, behavioral health, and long-term services and supports into a single managed care benefit. Iowa's Section 1115 demonstration, the Iowa Health and Wellness Plan (IHAWP), covers the state's Medicaid expansion population under a five-year term running January 1, 2026 through December 31, 2030; a companion IHAWP work-requirements amendment took effect January 1, 2026. Iowa is in the middle of a significant HCBS waiver restructuring: the HOME (Hope and Opportunity in Many Environments) project is consolidating four of the state's six disability-based Section 1915(c) waivers into two new, age-based waivers, targeting an October 1, 2026 implementation date.
IA Health Link is delivered by three MCOs: Iowa Total Care (203,393 members in 2024), Wellpoint of Iowa (222,782), and Molina Healthcare of Iowa (177,800). IA Health Link covers roughly 95 percent of Iowa Medicaid members and integrates physical health, behavioral health, and long-term services and supports into one managed care benefit rather than carving any of the three out separately. All three MCOs' contracts run through a shared June 30, 2031 end date.
Long-term services and supports are integrated directly into IA Health Link; medical and long-term care coverage run through the same three MCOs, not a separate carve-out or contract. Outside managed care, Iowa runs six disability-based Section 1915(c) HCBS waivers (AIDS/HIV, Brain Injury, Children's Mental Health, Elderly, Health and Disability, Intellectual Disabilities, and Physical Disability), all currently codified under 441 IAC Chapter 83. Iowa HHS is consolidating four of these (AIDS/HIV, Children's Mental Health, Health and Disability, and Physical Disability) into two new, age-based waivers under its HOME (Hope and Opportunity in Many Environments) project: a Children and Youth Waiver and an Adults with Disabilities Waiver, both targeting implementation on October 1, 2026. The Brain Injury and Elderly and Intellectual Disabilities waivers are not part of this first phase; their own transition into the HOME structure is targeted for 2027.
Integrated into managed care
Behavioral health is delivered through IA Health Link's three MCOs alongside physical health and LTSS, not carved out to a separate vendor or administrative services organization. Iowa's own public Mental Health and Disability Services (MHDS) system, a separate, county-funded structure that interacts with but is distinct from Medicaid managed care, consolidated its 32 regions into 7 districts effective July 1, 2025.
Carved in
Dental coverage runs through a separate program, the Dental Wellness Plan (DWP), rather than through the three IA Health Link MCOs. Delta Dental of Iowa and DentaQuest are the DWP's two current dental plans.
Optum Rx is Iowa Medicaid's current Pharmacy Benefit Administrator, covering point-of-sale claims adjudication, prior authorization, and pharmacy clinical/utilization management for the fee-for-service population.
Noridian Healthcare Solutions operates Iowa Medicaid's Core MMIS Services.
Last updated: Aug 29, 2026
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