Behavioral Health Benefits
What Services Are Covered by the Iowa Plan?
Medicaid Mental Health and Substance Abuse Services
- 24-hour crisis and emergency services (for a serious illness or problem). You may have to pay part of the emergency room cost if it is not an emergency.
- 24-hour mental health and substance abuse services in a hospital.
- Residential (live-in) substance abuse services by a licensed (approved) program.*
- Psychiatric Medical Institutes for Children (PMIC)*
- Outpatient services (not in a hospital or facility). These include some mental health services provided by non-psychiatric doctors.
- Intensive outpatient services. (There are more hours of service provided than regular outpatient care.)
- Consumer-run services, warm line and peer support (clients run these).*
- Mental health services through a community mental health center.
- Substance abuse services provided by a licensed substance abuse program.
- In-home mental health services.
- Targeted case management (setting up special care plans). This is for individuals with a chronic mental illness (possibly a life-long mental illness).
- Integrated (combined) mental health services and supports.*
- Assessment and evaluation. (This means finding out exactly what a client needs.)
- Behavioral Health Intervention Services (BHIS).*
- Habilitation services. *
*Some of the services above have an asterisk (*). These are not covered services under the Iowa Wellness Plan through the Iowa Plan for Behavioral Health.
IDPH Substance Abuse Services
- Residential (live-in) services.
- Intensive outpatient services (more hours of service than regular outpatient care).
- Outpatient services.
- Halfway house (helping clients recover from substance use).
- Assessment (finding out what a client needs, but not related to drinking and driving).
It is the Iowa Plan's job to see that you get medically necessary services. That means that any mental health or substance abuse services you get through the Iowa Plan must fit your needs. We will follow utilization management guidelines for our decisions about your care, including the type of service and how long the service should last, and so will Iowa Plan providers.