Iowa Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Iowa.
7.6 million Medicaid long-term care recipients nationwide
Iowa Department of Health and Human Services
Processing Time
30-45 days for nursing home Medicaid, 45-90 days for waiver programs
Iowa Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Iowa, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Iowa follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$2,982/month per applicant
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$162,660 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Iowa Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $7,150/month average (the average monthly nursing home cost in Iowa).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Iowa
Nursing Home Care
Medicaid pays 100% of nursing home costs in Iowa once eligibility is established. The average monthly cost is $7,150/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Elderly Waiver (Assisted Living Services): Iowa's Elderly Waiver allows participants to receive care services in assisted living facilities. The waiver covers personal care and support services but does not pay for room and board. Residents must pay for housing costs from their own income or other resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Iowa offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Elderly Waiver
Serves Iowa residents age 65+ who require nursing facility level of care. Provides adult day care, case management, homemaker services, respite care, home health aide services, nursing services, assisted living services, and consumer-directed attendant care. The Elderly Waiver will remain separate from the new HOME waivers.
Program Details →Adults with Disabilities Waiver (launching October 2026)
New waiver launching October 1, 2026, as part of the HOME project. Will replace the current Health and Disability, Physical Disability, and HIV/AIDS waivers for adults. Provides comprehensive services with personalized service plan limits (mySPL) based on individual needs.
Program Details →Brain Injury Waiver
Serves individuals with acquired brain injury who need specialized services. Will transition to the new HOME waiver system in 2027. Provides case management, supported employment, day habilitation, and residential services.
Program Details →How to Apply for Medicaid in Iowa
Iowa Medicaid applications typically take 30-45 days for nursing home Medicaid, 45-90 days for waiver programs. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Iowa through:
- Online at https://dhs.iowa.gov/ime/members
- Call Iowa Medicaid Member Services at 1-800-338-8366
- In-person at local Department of Human Services office
- Through hospital or nursing facility social worker
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Iowa from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Iowa-Specific Programs and Resources
Iowa Health Link
Iowa's Medicaid managed care program that coordinates health care services through managed care organizations (MCOs) for most Medicaid members.
Learn MoreNeed Help with Iowa Medicaid?
Contact Iowa Department of Health and Human Services for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-800-338-8366Application Helpline
1-800-338-8366