Publications
 

Dental Wellness Plan Evaluation

McKernan, S.C.; Reynolds, J.C.; Pooley, M.J.; Damiano, P.C.; Momany, E.T.; Ingleshwar, A.; Kuthy, R.A.; McInroy, B.
03/2016

Abstract

The Iowa Health and Wellness Plan (IHAWP) was implemented on January 1, 2014 and expands coverage for low income Iowans through two new programs: The Iowa Wellness Plan and Iowa Marketplace Choice. IHAWP provides coverage for adults with incomes from 0 to 133% of the Federal Poverty Level (FPL) who are not otherwise eligible for Medicaid or Medicare. IHAWP replaced the IowaCare program with plans that offer more covered services and broader provider networks, along with expanded coverage to other low income adults in Iowa not previously enrolled in IowaCare. IowaCare did not cover dental services, except for emergency extractions at two locations in the state. 

The Wellness Plan covers adults aged 19 to 64 with incomes up to and including 100% of the FPL ($11,490 for individuals; $15,510 for a family of two). The Wellness Plan is administered by the Iowa Medicaid Enterprise (IME) and members have the option to enroll in a managed care or a fee-for service program.


The Marketplace Choice Plan covers adults aged 19 to 64 with incomes from 101 to 133% of the FPL ($11,491-$15,282 for individuals; $15,511-$20,628 for a family of two). Members can choose from certain commercial health plans available on the health insurance marketplace, with Medicaid paying the member’s premiums.


All members of the IHAWP receive dental benefits through the Iowa Dental Wellness Plan.


The Iowa Dental Wellness Plan (DWP) was implemented on May 1, 2014. This plan is operated by Delta Dental of Iowa (DDIA) as a fee-for-service plan, with IME making capitated payments to DDIA for administration of the plan.