Iowa Health and Wellness Plan
At Amerigroup, we’ll help you live as well as you can, in the best way for you.
Whether you live at home, in a community setting or in a comfortable facility, we’ll help you live as well as you can, in the best way for you. We’ll also focus on your behavioral and social health needs and provide long-term services and supports.
If you’re eligible for the Iowa Health and Wellness Plan, you can join Amerigroup. We’ll cover all your regular Health and Wellness Plan benefits like:
- A primary care provider (PCP) to manage all your health care needs
- Hospital and lab services
- Behavioral health services
- Substance abuse services
- Therapy services
- Skilled nursing facility services
- Podiatry services
- Vision care
- Plus lots of extras you can really use to take care of your health
If you have questions or want to learn more, you can call us at 1-800-600-4441 (TTY 711).
You can view the 2016 Comparison of the State of Iowa Medicaid Enterprise Basic Benefits Based on Eligibility Determination chart for more information.
To keep getting free Amerigroup benefits under the IA Health and Wellness Plan, you must complete both of the following requirements each year:
Health risk assessment (HRA) (sometimes called the initial health screener). You may complete it:
- Online by going to Complete it now!
- By phone at 1-800-600-4441 (TTY 711), Monday through Friday from 7:30 a.m. to 6 p.m. Central time
- On paper by filling out the form that was in your welcome packet and returning it in the envelope provided
Wellness exam or dental exam
- Call your primary care provider (PCP) or dentist to schedule your wellness checkup or dental exam. Tell your dentist or PCP it’s a Healthy Behaviors activity for your IA Health and Wellness Plan.
You must complete your Healthy Behaviors activities each year. If you don’t, you may be charged a monthly contribution, depending on your family income. You must pay the contribution to keep your insurance. If you don’t pay the contribution, you may be disenrolled from the Iowa Health and Wellness Plan.
Complete your Healthy Behaviors every year to keep your free coverage!
- Extra personal care attendant support to help you stay at home
- Extra respite care hours to give your caregiver time off
- $250 a year for assistive devices, like long-reach and non-slip items, to help you with daily living tasks
- $200 a month for certain durable medical equipment and supplies, including assistive technology
- $2,500 one-time allowance when you move from a nursing facility to a home-based setting
- Free prep course for the high school equivalency test – we’ll pay for the test, too
- Help with your job search
- Travel training to help you get around town and access community resources
- Free membership in certain self-advocacy groups and annual allowance to attend an event
- Free dental supplies
- Video chats with doctors using LiveHealth Online
- Amerigroup Community Resource Link to help you find community services near you
- Free mobile phones, plus bonus minutes*
- Free post-discharge kit and home-delivered meals after you leave the hospital*
- Free stop-smoking program
- Free weight-management program
- Free exercise kit to help you get and stay fit
*Different eligibility rules apply to each benefit. Call us at 1-800-600-4441 (TTY 711) or check out the member handbook to learn more.
We work with Express Scripts to provide your pharmacy benefit. We cover a wide range of prescriptions and many over-the-counter medicines.
You don’t pay any pharmacy copays.
Getting your prescription filled is easy!
You can go to any pharmacy in our plan. Use the pharmacy locator tool to find a pharmacy close to you.
- Give the pharmacist your written prescription or have the doctor call it in
- Show your Amerigroup ID card
What is the Preferred Drug List (PDL)?
The PDL is a list of preferred and nonpreferred drugs Amerigroup covers. Non-preferred drugs may require a prior authorization. You’ll need approval from us to get these medicines. Your provider will ask us for one. Your request will be sent to our Pharmacy team for review and decision.
For the latest PDL, visit: www.iowamedicaidpdl.com
Pharmacy Formulary Exception Request
If you’re taking a drug that isn’t listed on the PDL, you or your authorized representative can ask for an exception to keep taking it.
To ask for an exception, email: firstname.lastname@example.org.
Mixing Drugs and Side Effects
Learn more about what drugs you can and can’t take together or side effects on the Express Scripts Drug Information Website
Express Scripts Prescription Drug Reimbursement Form
Express Scripts Online Registration Instructions
- Express Scripts Online Registration Instructions - English
- Express Scripts Online Registration Instructions - Spanish
For answers to some of your prescription drug coverage questions, go to our Frequently Asked Questions page or call Member Services.
Your member handbook is your go-to guide for health services. It tells you how you can get the most from Amerigroup. Read it to find out about:
- Your benefits
- Special programs and services, including case management, service coordination and our Health Home program
- Your rights and responsibilities as an Amerigroup member
- How to choose a primary care provider
- How to get help after your doctor’s office closes
- Renewing your coverage
- How to reach Amerigroup Member Services if you have questions
Download your member handbook below:
Do things that are good for your health and get rewards!
Healthy Rewards is a program that pays you for taking control of your health. You can earn $10, $20 or $30 for completing these healthy activities:
For all members:
- Complete the health risk assessment within 90 days of enrolling with Amerigroup
- Complete your annual wellness visit
- Get a flu shot
- Complete well-child visits within the first 15-months of life
- Get the HPV vaccine
- Complete blood sugar (A1c) screening
- Complete a breast cancer screening
- Complete a cervical cancer screening
- Go to prenatal and postpartum visits
- Fill your smoking cessation medications and participate in the Amerigroup smoking cessation program or Iowa’s Tobacco Quit Line
- Fill antidepressant, schizophrenia, or bipolar disorder medications
- Complete a diabetes screening when prescribed an antipsychotic medicine for schizophrenia and/or bipolar disorder
- Go to a behavioral health hospitalization follow-up visit
- Complete certain LTSS educational modules
To learn more and enroll, call 1-877-868-2004 or read your member handbook to learn more. You can also call Member Services at 1-800-600-4441 (TTY 711) and ask for a copy of the member handbook to be mailed to you.
To register, go to www.myamerigroup.com/HealthyRewards.