1. a. Effective July 1, 1998, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, an eligible child under the age of nineteen whose family income does not exceed one hundred thirty-three percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.

 b.  Effective July 1, 2000, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, an eligible infant whose family income does not exceed two hundred percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.
 c. Effective July 1, 2009, and notwithstanding any medical assistance program eligibility criteria to the contrary, medical assistance shall be provided to, or on behalf of, a pregnant woman or an eligible child who is an infant and whose family income is at or below three hundred percent of the federal poverty level, as defined by the most recently revised poverty income guidelines published by the United States department of health and human services.

Terms Used In Iowa Code 514I.8

  • board: means the entity which adopts rules and establishes policy for, and directs the department regarding, the hawk-i program. See Iowa Code 514I.2
  • Child: includes child by adoption. See Iowa Code 4.1
  • Cost sharing: means the payment of a premium or copayment as provided for by Tit. See Iowa Code 514I.2
  • Department: means the department of human services. See Iowa Code 514I.2
  • Eligible child: means an individual who meets the criteria for participation in the program under section 514I. See Iowa Code 514I.2
  • following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
  • plan: means health insurance coverage provided by a participating insurer under this chapter. See Iowa Code 514I.2
  • program: means the healthy and well kids in Iowa program created in this chapter to provide health insurance coverage to eligible children. See Iowa Code 514I.2
  • Rule: includes "regulation". See Iowa Code 4.1
  • state: when applied to the different parts of the United States, includes the District of Columbia and the territories, and the words "United States" may include the said district and territories. See Iowa Code 4.1
  • United States: includes all the states. See Iowa Code 4.1
  • year: means twelve consecutive months. See Iowa Code 4.1
 2. A child may participate in the hawk-i program if the child meets all of the following criteria:

 a. Is less than nineteen years of age.
 b. Is a resident of this state.
 c. Is a member of a family whose income does not exceed three hundred percent of the federal poverty level, as defined in 42 U.S.C. § 9902(2), including any revision required by such section, and in accordance with the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3. The modified adjusted gross income methodology prescribed in section 2101 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, shall be used to determine family income under this paragraph.
 d. Is not eligible for medical assistance pursuant to chapter 249A.
 e. Is not currently covered under a group health plan as defined in 42 U.S.C. § 300gg-91(a)(1) unless allowed by rule of the board.
 f. Is not a member of a family that is eligible for health benefits coverage under a state health benefits plan on the basis of a family member’s employment with a public agency in this state.
 g. Is not an inmate of a public institution or a patient in an institution for mental diseases.
 3. In accordance with the rules adopted by the board, a child may be determined to be presumptively eligible for the program pending a final eligibility determination. Following final determination of eligibility, a child shall be eligible for a twelve-month period. At the end of the twelve-month period, a review of the circumstances of the child’s family shall be conducted to establish eligibility and cost sharing for the subsequent twelve-month period. Pending such review of the circumstances of the child’s family, the child shall continue to be eligible for and remain enrolled in the same plan if the family complies with requirements to provide information and verification of income, otherwise cooperates in the annual review process, and submits the completed review form and any information necessary to establish continued eligibility in a timely manner in accordance with administrative rules.
 4. Once an eligible child is enrolled in a plan, the enrollee may request to change plans within ninety days of initial enrollment for any reason and at any time for cause, as defined in 42 C.F.R. §438.56(d)(2). Otherwise, an enrollee may change plan enrollment once a year on the enrollee’s anniversary date.
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