Medicaid appeals in Iowa: hearing deadline and keeping benefits
Iowa Medicaid (IA Health Link managed care; Iowa Health and Wellness Plan for expansion adults): you have 30 days to ask for a fair hearing.
Your Medicaid may continue while you appeal if you file before the effective date on the notice, or within 10 days after you receive the Notice of Decision.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (Iowa Medicaid (IA Health Link managed care; Iowa Health and Wellness Plan for expansion adults)) denials in Iowa
- Medicaid agency
Iowa Department of Health and Human Services (HHS)
- Who holds the hearing
Iowa HHS Appeals Section receives requests; hearings are held by the Administrative Hearings Division of the Iowa Department of Inspections, Appeals and Licensing
- Hearing deadline
30 days
The date of the notice of the action being appealed
- If you are late
If you file more than 30 days but less than 90 days after the date of the notice, HHS may still grant a hearing at its discretion if you show good cause, such as a serious illness or death in the family, a family emergency or disaster, or not receiving the notice for a reason beyond your control (not telling HHS you moved does not count). Send a written explanation with proof to HHS Appeals. HHS's How to Appeal page lists 90 days for Medicaid appeals.
- How to ask for a hearing
- Online: Appeal and Request for Hearing form: https://secureapp.dhs.state.ia.us/dhs_titan_public/appeals/appealrequest (Spanish version available)
- Phone: HHS Appeals 1-888-723-9637 (Medicaid appeals may be made by phone)
- Mail: Iowa Department of Health and Human Services, Appeals, 321 E 12th Street, Des Moines, IA 50319, or take it to your local HHS office
- Fax: 515-564-4044
- Email: Appeals@hhs.iowa.gov
- In person: At your local HHS office
- Mail address
Iowa Department of Health and Human Services, Appeals, 321 E 12th Street, Des Moines, IA 50319
- What to include
Write a letter explaining why you disagree with the Department's decision, or fill out the whole Appeal and Request for Hearing form. If you do not want benefits to continue while you appeal, say so on the form.
- Keeping your benefits during the appeal
Your Medicaid may continue while you appeal if you file before the effective date on the notice, or within 10 days after you receive the Notice of Decision. The notice is treated as received 5 days after the date on it unless you show otherwise. If HHS is found to be right, it may recover the cost of benefits you got while the appeal was pending.
Law: 441 IAC 2506.35 (eff. 7/1/2026); 441 IAC ch. 2506 (Contested Cases, ARC 0300D, eff. 7/1/2026), 2506.4(6)-(7), 2506.33, 2506.35
- When the hearing is held
Hearings are usually by telephone. All parties get written notice at least 15 days before the hearing. The administrative law judge usually issues a proposed decision about 30 days after the hearing; parties have 14 days to ask for a Director's Review, and otherwise the final decision is issued on the 15th day.
- Faster (expedited) hearing
You can ask HHS for an expedited (faster) hearing at any time in a Medicaid appeal. For a denied service after an expedited managed care appeal, the proposed decision is due within 3 working days after HHS gets the plan's case file; for an expedited Medicaid eligibility appeal, within 7 working days after HHS gets the request. HHS tells you quickly whether expedited review is granted.
Law: 441 IAC ch. 2506 (Contested Cases, ARC 0300D, eff. 7/1/2026), 2506.4(6)-(7), 2506.33, 2506.35
- Ombudsman
Medicaid health plan (managed care) in Iowa
- Appeal to the plan first
Appeal to your managed care plan (first level review) first, by mail, phone or email, within the time stated on the plan's notice. The plan must acknowledge your appeal within 3 working days and decide within 30 calendar days, or within 72 hours for an expedited appeal when waiting could seriously jeopardize your health or ability to maintain or regain maximum function. You must finish the plan appeal first; a hearing request filed too early is denied and sent to the plan. Then you can ask HHS Appeals for a state fair hearing within 120 days of the plan's Appeal Determination Letter. If a provider or representative appeals for you, you must sign form 470-5526. To keep services that are being reduced or stopped, appeal on or before the effective date or within 10 calendar days of receiving the plan's notice (treated as 5 days after its date), and ask for the services to continue.
- Then a state hearing
120 days
The date of the plan's Appeal Determination Letter
Law: 441 IAC 73.12-73.14 (eff. 7/1/2026); 441 IAC 2506.4(5)
Write my appeal: free letters
Sources
The official sources for Iowa are listed on the Iowa page.