Iowa Medicaid Income Limits 2026 (Iowa Health Link)

Iowa Medicaid covers approximately 800,000 Iowans as of 2026, roughly one in four state residents. Iowa expanded Medicaid under the Affordable Care Act effective January 1, 2014, through the Iowa Health and Wellness Plan. Today the program is administered by the Iowa Department of Health and Human Services (Iowa HHS) and delivered almost entirely through Iowa Health Link, a managed care model in which members choose from three contracted health plans: Iowa Total Care, Molina Healthcare of Iowa, and Wellpoint Iowa. The 2026 Federal Poverty Level of $15,960 for a single person and $33,000 for a family of four in the 48 contiguous states anchors every income threshold below, with Iowa HHS updating its published income chart annually, most recently effective April 1, 2026.

Iowa Medicaid eligibility splits into four main population groups for 2026. Adults ages 19 to 64 earning up to 138% FPL qualify under the ACA expansion group through the Iowa Health and Wellness Plan, with no asset test for this MAGI category. Pregnant women in Iowa qualify at 215% FPL with 12 months of postpartum Medicaid coverage, and Iowa HHS extended postpartum coverage beginning January 2025 under federal authority. Children ages 1 through 18 qualify for Iowa Medicaid at 167% FPL; the Hawk-i program (Healthy and Well Kids in Iowa, Iowa's CHIP) extends coverage to 302% FPL for children whose family income exceeds the Medicaid threshold. Infants under age 1 qualify at 300% FPL, one of the more generous infant coverage thresholds in the Midwest. Aged, Blind, and Disabled adults qualify under separate SSI-linked income and asset tests. Iowa also runs several Home and Community Based Services waivers for elderly and disabled Iowans who need long-term services and supports outside of nursing facilities.

The household-size table below shows the 2026 Iowa Medicaid income limits across the three main MAGI coverage groups. Iowa Medicaid uses Modified Adjusted Gross Income (MAGI) rules for the adult, child, and pregnancy groups, with no asset test for these categories. Iowa HHS applies the standard federal 5% MAGI income disregard, which effectively raises the adult threshold from the posted 133% FPL to the functional 138% FPL before comparing income to the published limit. If your household income exceeds the Iowa Medicaid adult limit but falls below 400% FPL, you likely qualify for ACA marketplace subsidies through the federally facilitated marketplace at healthcare.gov. If your child's family income exceeds 167% FPL, review Hawk-i enrollment through the same HHS portal at hhsservices.iowa.gov. Iowa residents age 65 and older with limited income should review the Medicare Savings Programs section below.

Iowa Medicaid (Iowa Health Link) income limits by household size (2026)

The 2026 Iowa Medicaid income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states and Iowa HHS published income charts effective April 1, 2026. Adult column = Iowa Health and Wellness Plan (138% FPL, covers adults ages 19 to 64 with or without dependent children). Children column = Iowa Medicaid for children ages 1 to 18 (167% FPL); Hawk-i CHIP extends coverage to 302% FPL. Pregnancy column = Iowa Medicaid for Pregnant Women (215% FPL, includes 12 months postpartum). Add roughly $9,486 of annual income per additional household member for the children's column.

Iowa Medicaid (Iowa Health Link) eligibility requirements (non-income)

Beyond income, Iowa Medicaid applicants must meet the following non-income requirements. MAGI categories (adults, parents, children, pregnant women) use federal MAGI rules with no asset test. Aged, Blind, and Disabled (ABD) and long-term care Medicaid categories apply separate SSI-linked income and asset rules. Iowa Health Link managed care enrollment follows after Iowa HHS determines eligibility.

• Iowa residency: the applicant must currently live in Iowa with the intent to remain. No minimum length of residence is required. Homeless individuals may use a shelter address or county-designated mailing address.
• U.S. citizenship or qualifying immigration status: U.S. citizens, lawful permanent residents (after the standard federal 5-year bar), refugees, asylees, trafficking victims, members of federally recognized tribes, and certain other qualified immigrants are eligible. Non-qualified immigrants may receive emergency Medicaid services only.
• Social Security Number: required for each household member applying for coverage. Individuals without an SSN due to immigration status may still apply for limited emergency Medicaid coverage.
• Household composition: determined under MAGI rules for adults, parents, children, and pregnant women. The MAGI household includes the applicant, their spouse (if living together), and any dependents claimed on the tax return. For pregnant women, the expected child counts as a household member for income-limit purposes. Aged, Blind, and Disabled and long-term care categories use SSI household-composition rules.
• Asset test: NOT applied for MAGI Iowa Medicaid populations (adults, parents, children, pregnant women). Asset test IS applied for Aged, Blind, and Disabled (ABD) Medicaid: the federal floor is $2,000 countable resources for an individual and $3,000 for a couple, excluding the primary home, one vehicle, and certain burial and retirement funds. Long-term care Medicaid has a 60-month lookback period for asset transfers and may trigger estate-recovery claims.
• Other insurance coverage: Iowa Medicaid does not require applicants to be uninsured. Iowa Medicaid acts as payer of last resort when other insurance exists. Members enrolled in Iowa Health Link with employer-sponsored insurance may coordinate benefits through their chosen MCO.
• Age and disability criteria for specialty categories: adults 19 to 64 qualify under the ACA expansion group. Children under 19 qualify under the MAGI child group. Pregnant women qualify regardless of age. Adults 65 and older qualify under aged Medicaid with separate income and asset tests. Disabled individuals must meet Social Security Administration disability standards for ABD Medicaid, or may qualify for Home and Community Based Services waivers administered by Iowa HHS.

What income counts for Iowa Medicaid (Iowa Health Link)

Iowa Medicaid uses Modified Adjusted Gross Income (MAGI) rules for adults, parents, children, and pregnant women, based on the household's projected annual income. Iowa HHS applies the standard federal 5% MAGI income disregard for the adult expansion group, which effectively raises the functional threshold from the posted 133% FPL to 138% FPL before comparing to the published limit. Aged, Blind, and Disabled (ABD) and long-term care Medicaid categories use SSI countable-income rules rather than MAGI. The lists below apply to MAGI categories, which handle the large majority of Iowa Medicaid applications.

Income sources included

• Wages, salaries, tips, and overtime pay (gross amount before payroll deductions or federal income tax withholding)
• Net self-employment earnings, 1099 income, and gig-economy income after allowable business expenses reported on Schedule C or Schedule SE
• Social Security retirement and survivor benefits; Social Security Disability Insurance (SSDI) benefits (note: Supplemental Security Income (SSI) is excluded from MAGI income)
• Unemployment compensation received from Iowa or another state, including any federal pandemic-era supplements if still payable
• Pensions, annuities, and taxable retirement-account distributions including IRA, 401(k), and 403(b) withdrawals
• Alimony received under divorce or separation agreements finalized before January 1, 2019. Post-2018 agreements follow TCJA rules under which alimony is not counted as MAGI income.
• Net rental income and investment income including interest, dividends, and capital gains as reported on the federal income tax return

Income sources excluded

• Supplemental Security Income (SSI) payments from the Social Security Administration. SSI is a federal cash-assistance program and is not counted toward MAGI income for Iowa Medicaid.
• Child support payments received, excluded from MAGI income under federal Medicaid rules (42 C.F.R. section 435.603)
• Federal tax refunds and refundable tax credits such as the Earned Income Tax Credit (EITC) and Child Tax Credit (CTC)
• Veterans Affairs (VA) disability compensation, VA pension benefits, and education benefits such as the GI Bill. These federal payments are excluded from MAGI income.
• SNAP food benefits, TANF cash assistance, and other means-tested public benefits
• Workers' compensation payments for work-related injury or illness, and most gifts, loans, and one-time inheritances received during the year

How to apply for Iowa Medicaid (Iowa Health Link) in Iowa

Iowa Medicaid applications go through the Iowa HHS Services Portal at hhsservices.iowa.gov. The same application covers Iowa Medicaid (including Iowa Health Link and the Iowa Health and Wellness Plan), Hawk-i CHIP, SNAP food benefits, and family investment program benefits. Iowa residents can apply any time because there is no Medicaid open enrollment window. You can also apply by calling 1-855-889-7985, in person at any Iowa HHS local office, by mail to Imaging Center 4 at PO Box 2027 Cedar Rapids IA 52406, or through a federally qualified health center or hospital enrollment worker.

1. 1. Gather your documents: photo ID for the head of household, Social Security cards or numbers for all household members applying for coverage, proof of Iowa residency, proof of citizenship or qualifying immigration status, and the last 30 days of pay stubs or self-employment records.
2. 2. Go to hhsservices.iowa.gov and create an account, or call 1-855-889-7985 to begin an application by phone with an Iowa HHS worker. Walk-in applications are also accepted at any local Iowa HHS office during business hours.
3. 3. Complete the application: list every household member, report all income sources from the previous month and expected annual income, and attach or upload supporting documents. The portal screens for Medicaid, Hawk-i CHIP, SNAP, and cash benefits in one submission.
4. 4. Sign the application and submit. You will receive a confirmation number. Iowa HHS may request additional information within 10 business days; respond promptly to avoid application denial.
5. 5. Receive your eligibility determination notice. Standard applications are typically decided within 30 to 45 days; pregnancy applications are processed within 15 days under federal expedited-processing rules. If approved, you will receive an Iowa Medicaid card within about 7 days.
6. 6. Choose your Iowa Health Link plan. Approximately 1 to 2 weeks after approval, you will receive an Iowa Health Link enrollment packet listing Iowa Total Care, Molina Healthcare of Iowa, and Wellpoint Iowa. You have 90 days to choose or change your plan; if you do not select one, Iowa HHS will assign a plan automatically.

Official portal: hhsservices.iowa.gov

Documents needed

• Photo ID for the head of household (Iowa driver's license, state ID, U.S. passport, or tribal ID card)
• Social Security Numbers or cards for every household member applying for coverage
• Proof of Iowa residency: utility bill, lease or rental agreement, mortgage statement, or official mail in the applicant's name with an Iowa address
• Proof of U.S. citizenship or qualifying immigration status: U.S. birth certificate, U.S. passport, Permanent Resident card (Green Card), refugee or asylee documentation, or Employment Authorization Document
• Last 30 days of pay stubs for each working household member, or 12 months of income records for self-employment and 1099 income
• Most recent federal income tax return or signed statement that no return was filed in the prior year
• For pregnancy applications: documentation from a health care provider confirming pregnancy and estimated due date

Processing timeline: Standard Iowa Medicaid applications are typically decided within 30 to 45 days of submission. Pregnancy Medicaid applications receive expedited processing and are usually decided within 15 days under federal rules. Disability-related ABD Medicaid applications may take 60 to 90 days because they require a separate medical determination from the Social Security Administration. Once approved, a Medicaid card arrives within approximately 7 days; an Iowa Health Link plan-selection packet follows within 1 to 2 weeks.

Common reasons applications get denied

• Income above the population-specific threshold, the single most common denial reason for Iowa Medicaid. Adults whose income exceeds 138% FPL ($22,025 for a single person) do not qualify for the adult expansion group, even if they have dependent children or other circumstances.
• Failure to respond to Iowa HHS requests for additional information within the 10-business-day window. Not providing requested documentation is a leading operational reason for application denials.
• Failure to meet Iowa residency requirements: applicant has moved out of Iowa, does not have a fixed address, or cannot document a current Iowa address.
• Immigration status not meeting qualifying criteria: non-qualified aliens are generally limited to emergency Medicaid services only and do not qualify for full Iowa Medicaid coverage.
• Application submitted with incorrect or incomplete household-income information, causing a determination that income exceeds the limit when it does not. Iowa HHS allows applicants to request a fair hearing within 90 days of a denial notice if they believe the determination was incorrect.

If your child's family income is above the Iowa Medicaid limit: Hawk-i covers up to 302% FPL

Hawk-i (Healthy and Well Kids in Iowa) is Iowa's CHIP program for children under age 19 in working families. Hawk-i picks up where Iowa Medicaid leaves off: children whose family income is above 167% FPL but at or below 302% FPL can enroll in Hawk-i at low or no cost. For a family of four in 2026, the 302% FPL Hawk-i upper limit is approximately $99,660 per year. Premiums are capped at $40 per household per month regardless of how many children are enrolled; families below approximately 200% FPL pay nothing. Hawk-i is run by Iowa HHS and covers comprehensive services including doctor visits, prescriptions, dental, and vision. Apply through the same Iowa HHS Services Portal at hhsservices.iowa.gov or call Hawk-i Member Services at 1-800-257-8563.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Iowa Medicare Savings Programs

Iowa runs three Medicare Savings Programs (MSPs) for low-income Iowans who have Medicare Part A and Part B. QMB (Qualified Medicare Beneficiary) covers Part A and Part B premiums, deductibles, and coinsurance for individuals with monthly income up to approximately $1,330 and limited resources up to $9,660. SLMB (Specified Low-Income Medicare Beneficiary) covers the Part B premium for individuals with monthly income up to approximately $1,596. E-SLMB (Expanded SLMB) covers the Part B premium for individuals with monthly income up to approximately $1,796. Iowa's MSPs are administered by Iowa HHS and use fee-for-service Medicaid rather than Iowa Health Link managed care. Dual-eligible individuals who qualify for both Medicare and Iowa Medicaid (about 120,000 Iowans) may enroll in a Dual Eligible Special Needs Plan (D-SNP) through an Iowa Health Link MCO. Apply for Iowa MSPs through hhsservices.iowa.gov or by calling 1-800-338-8366.

Read the Medicare eligibility guide

Frequently Asked Questions