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Iowa · Medicaid and SNAP

Iowa Medicaid work requirements: the 80-hour rule

Who to contact in Iowa

Keep your address current. Iowa sends notices by mail, and a letter that never arrives is one of the most common ways people lose coverage.

Who has to meet it

The rule (Iowa Health and Wellness Plan (IHAWP) — Community Engagement Requirements) applies to adults aged 19 to 64 covered through Medicaid expansion, unless you qualify for an exemption (below).

What counts toward the 80 hours

• Work at least 80 hours/month OR earn at least $580/month
• High school, college, GED, career or technical education at least half-time
• Qualifying job training or work program
• Volunteer/community service

You can mix them. Twenty hours of work and sixty hours of volunteering is 80 hours.

How and when it is checked

Iowa has not yet published how often it will check. Most states plan to check when your coverage comes up for renewal, every six months. We will update this page when Iowa says.

The state must look at payroll and other records it already has before it asks you. If those records do not show your hours — common for gig work, self-employment, school and volunteering — you will be asked to prove them. That is why it pays to keep pay stubs, school schedules and volunteer letters from now on.

Who is exempt

Under federal law you do not have to meet the 80 hours if any of these is true:

• You are pregnant or recently gave birth.
• You are a parent or caretaker of a child aged 13 or younger.
• You care for someone with a disability.
• You are “medically frail” — this includes serious mental illness, substance use disorder, and physical or mental conditions that limit daily life.
• You receive SSI or SSDI disability benefits.
• You are a member of a federally recognized tribe or eligible for Indian Health Service care.
• You are in a substance use disorder treatment program.
• You already meet the SNAP or TANF work requirement.
• You are incarcerated, or were released in the last 90 days.
• You are a veteran with a total disability rating.

Iowa has not adopted any of the optional short-term hardship exceptions that other states use (such as a stay in a hospital or nursing facility or living in a declared disaster area). Fewer ways out means keeping proof matters more here.

Being exempt is usually not automatic. You may have to tell the state, and show proof, before it counts.

SNAP has its own 80-hour rule — already in force

Since November 1, 2025, adults aged 18 to 64 without children under 14 at home must work, train or volunteer 80 hours a month to keep SNAP longer than 3 months in any 3 years.

• Parents of children 14 or older are no longer exempt.
• Veterans, people experiencing homelessness and former foster youth lost their exemption in 2025. This is the most common misunderstanding.
• Native Americans and people eligible for Indian Health Service care are now exempt at every age.

Good news: if you meet SNAP's 80 hours, that also counts for Medicaid. One log covers both.

What to do now

1. Check your mailing address at hhsservices.iowa.gov. Many people who lose coverage under rules like this are still eligible — they miss a letter.
2. Find your renewal date. It is on your last renewal letter, or ask the state. That is when your hours get checked.
3. See if you are exempt using the list above. If you are, tell the state now rather than at renewal.
4. Start keeping proof today. Pay stubs, class schedules, signed volunteer hours. A photo on your phone is fine.
5. Open every letter from the state the day it arrives. Deadlines can be short.

Common questions

When does the Medicaid work requirement start in Iowa?

Iowa starts early, on December 1, 2026 — a month before the national deadline.

How many hours do I need for Medicaid in Iowa?

80 hours a month of work, school, job training or community service, or a mix. Iowa also accepts $580 a month in earnings instead.

Who do I call about Medicaid in Iowa?

Call 877-347-5678. Or sign in online at https://hhsservices.iowa.gov/apspssp/ssp.portal.

Do veterans have to meet the SNAP work requirement now?

Yes, unless another exemption applies. The 2025 law removed the exemption for veterans, people experiencing homelessness and former foster youth.

Sources

• hhs.iowa.gov/medicaid/plans-programs/iowa-health-wellness-plan
• phciowa.org/iowa-medicaid-community-engagement-requirements
• hhs.iowa.gov/media/15850/download?inline=
• hhs.iowa.gov/medicaid
• kff.org/medicaid/medicaid-work-requirements-tracker-overview
• propel.app/snap/snap-work-requirements-full-guide

Rules last checked September 14, 2026; phone and website last checked October 2, 2026. Rules are still changing. If something here is wrong, tell us and we will fix it fast.