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Serving uninsured children in Iowa

The Healthy and Well Kids in Iowa (hawk-i) Program generally provides free or low-cost health, prescription drug, and dental benefits to Iowa children in families whose income falls between 167 and 302 percent of the federal poverty level.


Coverage transitions to new carrier

Wellmark’s contract with the Iowa Department of Human Services (DHS) to administer hawk-i claims was scheduled to expire Dec. 31, 2015. On Sept. 30, 2015, DHS notified Wellmark that the contract would not be extended beyond Dec. 31, 2015. Earlier in 2015, DHS issued a request for bids for its Medicaid Modernization initiative. In mid-December 2015, DHS announced a delay to this initiative. DHS will communicate directly with Wellmark hawk-i enrollees informing them that their coverage will be transitioned to UnitedHealthcare beginning Jan. 1, 2016.

Please do not submit hawk-i claims to Wellmark for dates of service on and after Jan. 1, 2016. Instead, please work with the carrier indicated on the hawk-i member’s new ID card or supporting documentation for all matters regarding coverage and claims. Providers should not use Wellmark hawk-i ID cards for dates of service on or after Jan. 1, 2016. Please continue to submit your hawk-i claims for dates of service up to and including Dec. 31, 2015, to Wellmark.

If the member is an inpatient (i.e., receiving inpatient care in a hospital or nursing facility) on Dec. 31, 2015, the termination date of Wellmark’s coverage, facility benefits for the inpatient stay will continue with Wellmark for the lesser of 60 days or the member’s discharge from the facility. The extension for these split claims applies only to facility-related services. Professional provider services are driven by date of service, so professional claims for services rendered on and after Jan. 1, 2016, should not be submitted to Wellmark. For more guidance on inpatient dates of service that span years, please refer to the Claims Filing section of the Provider Guide.



Related Information

»   Accreditations
»   Provider Guides
»   Clinical Guidelines
»   Health Care Reform Preventive Care Update
»   Member Health Support and Wellness Programs
»   Preventive Care Guidelines
»   Member and Service Information section, Wellmark Provider Guide PDF
»   Referral Form for Out-of-Network Services PDF
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