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Serving Uninsured Children in Iowa

The Healthy and Well Kids in Iowa (hawk-i) Program 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.

hawk-i Coverage Options

Blue Access® coverage from Wellmark Health Plan of Iowa is available to hawk-i eligible children in all 99 counties (view the current health plan coverage area ). A hawk-i member living in a county with a new offering or multiple options can change coverage only on his or her anniversary date.

PCPs and Referrals 

  • Members do not select a Primary Care Provider (PCP).
  • Preventive care is a benefit when received from a network PCP-type provider (includes general and family practice physicians, internal medicine physicians, pediatricians, gynecologists, physician assistants, nurse practitioners).
  • No referral is necessary to receive specialist services within the network.
  • No benefits outside the network unless the services are either:
    • A medical emergency and provided in an emergency room
    • Pre-approved by Wellmark through the referral process

hawk-i Identification Cards

Each child with Wellmark coverage has his or her own ID card that identifies hawk-i as the group. The cards display the Blue Cross and Blue Shield as well as the product logo, and include the alpha prefix XQW.

Benefits and Eligibility

To check benefits or eligibility:

1)     Log into the provider section of Wellmark.com and use the View Eligibility and Benefits tool; or

2)     Call Provider Service at 800-355-2031 or 515-246-6297.

hawk-i Pharmacy Benefits

There is no cost to hawk-i members who take generic drugs. Members are responsible, however, for the full cost of branded medications not included on the hawk-i Wellmark Drug List unless a medical exception is made.

 

To request a medical exception, submit a Medical Exception Request 

 

If the request is denied, Wellmark will send a letter to you and the member.

More Information


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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