To qualify for the benefit, the participant must be over the age of five, have Basic or Enhanced Medicaid coverage, and meet the following weight criteria:
You can check BMI by using the Centers for Disease Control (CDC) Child and Teen BMI Calculator.
Qualifying participants can earn up to $200 each year to help pay for services offered by PHA providers such as Fees for a weight management program, Healthy lifestyle classes, or nutrition classes or services. The benefit will start on the date of approval.
Primary Care Providers (PCP) will be initiating the process of filling out the WM Agreement Form. After the PCP fills out their portion of the form the participant is responsible for filling out their section of the form, choosing a WM Vendor, taking the form to the vendor for them to sign, and then submitting the form for approval.
Don't forget to complete all sections of the form before submitting it for approval or the form will be returned to the participant for completion and the process will be delayed.
Children's Wellness Benefit
The Wellness PHA is a program that provides parents of children on the Children's Health Insurance Program (CHIP) an additional benefit for keeping their children up to date on well child checks and immunizations.
Children's Health Insurance Program (CHIP) is a low-cost health coverage program for children under age 19 whose family income is too high to qualify for Medicaid. There may be a small monthly premium ($10 or $15, depending on your income) for each child enrolled in CHIP. To qualify for CHIP a child must:
Live in Idaho, be under the age of 19, be a U.S. citizen or legal resident, and be within the family income guidelines.
Children who have private health insurance do not qualify for CHIP.
If your child is on CHIP and you pay a monthly premium for your child’s Medicaid coverage, your child is eligible for the wellness PHA benefit. By keeping your child’s well-child checks and immunizations current you can qualify to receive a $10 deduction in your monthly premiums.
If you have additional questions about if your child is eligible for CHIP please contact (877) 456-1233.
Children should have a well-child check at the following ages:
Babies (up to 1 year) Toddlers (1-3 years)
1 Week - 1 Month 15 Months
2 Months 18 Months
4 Months 24 Months
6 Months 30 Months
Note: Please don't forget to do your 30 month check up.
Children ages 3-19
Children ages 3-19 need a check-up every year. You should also ask your doctor which immunizations your child needs and to enter the immunization record into IRIS - Idaho's Immunization Registry.
If you don't have a doctor for your child, call the Healthy Connections Unit at (888) 528-5861.
For more information about PHA, please call us toll-free at (877) 364-1843 or you can email us firstname.lastname@example.org
Our address is:
Department of Health & Welfare, Division of Medicaid
PO Box 83720
Boise, ID 83720-0009