New Iowa Medicaid rules begin December 1, 2026. Some adults will need to meet new work or activity requirements to get or keep their health coverage.

Not everyone will be affected. All Care Health Center is here to help you understand these changes and what you may need to do.

Applying for Medicaid?

Starting December 1, 2026, some adults applying for the Iowa Health and Wellness Plan must show they met the new requirements during the month before they applied.

For example, if you apply in December, you may need to show that you met the requirements in November.

You can still apply for Medicaid at any time.

Already Have Medicaid?

If you are already enrolled in the Iowa Health and Wellness Plan, the new requirements will begin applying at renewals scheduled for February 2027 or later.

You may need to show that you met the requirements for at least two months since your last application or renewal.

Some adults ages 19–64 must complete at least 80 hours each month of approved activities.

These activities include:

• Working: Work at least 80 hours or earn at least $580 per month.
• Going to School: Attend an approved school or education program at least half-time.
• Job Training: Take part in an approved job training program.
• Volunteering: Complete community service hours through an approved organization.

You can also combine activities to reach 80 hours.

For example, you could work 50 hours and volunteer 30 hours in one month.

Some people do not have to meet the new work requirements.

This may include people who:

• Are pregnant or recently had a baby.
• Care for a child under age 14 or someone with a disability.
• Have a disability or serious medical condition.
• Are in a qualifying drug or alcohol treatment program.
• Meet certain SNAP or FIP work requirements.
• Are American Indian or Alaska Native.
• Are veterans with a total disability rating.
• Are currently or were recently in jail or prison.

Not sure if you qualify for an exemption? Our enrollment specialists can help you understand your next steps.

Iowa Medicaid makes the final decision about exemptions.

There are steps you can take to prepare for these changes.

1. Check your mail. Iowa Medicaid may send you important information about your coverage.
2. Update your contact information. Make sure Iowa Medicaid has your current address, phone number, and email.
3. Keep track of your hours. Save pay stubs, school records, volunteer hours, or job training records.
4. Keep important documents. You may need paperwork showing that you qualify for an exemption.
5. Ask for help. If you’re unsure what these changes mean for you, talk with an enrollment specialist.

Iowa Medicaid will check available records and contact you if more information is needed.

Starting January 1, 2027, most adults covered by the Iowa Health and Wellness Plan will need to renew their Medicaid coverage every six months instead of once a year.

Watch for renewal notices and respond to requests for information by the deadline.

Missing your renewal could put your coverage at risk.

You don’t have to figure this out alone!

All Care Health Center’s enrollment specialists can help you:

• Apply for Medicaid.
• Renew your Medicaid coverage.
• Understand the new work requirements.
• Get help with questions about your enrollment.

You do not need to be an All Care patient to receive enrollment assistance.

Call All Care Health Center to schedule an appointment with an enrollment specialist.

For the latest state requirements, visit the Iowa Health and Human Services website.

IHAWP Community Engagement Requirements

Iowa Health and Wellness Plan Eligibility Changes

Iowa Health and Human Services Community Engagement Requirements