With all the news around Medicaid Protection, I wanted to take a few minutes to offer some information about who Idaho Medicaid serves across the state. Idaho Medicaid staff is working hard to provide about 425,000 vulnerable Idahoans, many of whom are children, with affordable healthcare when they don’t have other options. Medicaid serves about 40% of all the children in Idaho.
Medicaid is the main way in Idaho and nationally that home and community based services and behavioral health services are paid for. It plays an important role in keeping Idahoans safe, healthy, productive, and thriving in their communities.
To be eligible, a person must be a resident of Idaho and either a U.S. citizen or a qualified legal non-citizen.
Once those requirements are met, there are two ways someone can be eligible: based on income or based on age and disability. Eligibility requirements are typically reviewed annually.
- For income-based eligibility, adults must have income below 138 percent of the Federal Poverty Limit. For a family of four, this is $3,450 a month. Children must be below 190 percent of the Federal Poverty Limit.
- Medicaid also is available to people who are 65 years old or are blind or disabled. They must meet income and resource limits based on disability and other factors.
Medicaid administers three plans for adults and children.
The basic plan
The basic plan is for people who are in good health and don’t generally have disabilities or special health needs. This plan provides health, prevention, and wellness benefits. It includes the expansion population.
- Number of adults in this plan: 34,351
- Number of adults in this plan under Medicaid expansion: 134,538
- Number of children in this plan: 179,464
The enhanced plan
The enhanced plan is for people with more complex health needs and medical conditions, disabilities, or special health needs, and for those over the age of 65. The plan provides all the basic plan benefits, plus developmental disability services, children’s service coordination, and long-term care supports. This plan includes home and community based services through waivers for aged and disabled people and those with a developmental disability.
- Number of adults in this plan: 18,689
- Number of children in this plan: 26,877
The Medicare-Medicaid Coordinated Plan
The Medicare-Medicaid Coordinated plan (MMCP) is for people who are eligible and enrolled in both Medicare and Medicaid. This plan provides enhanced plan benefits, plus enrollment in a managed care plan to help coordinate Medicare and Medicaid benefits. These people also have access to a care coordinator.
- Number of adults in this plan: 31,598
- Number of children in this plan: None
I hope you have a safe and healthy weekend.
The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov.
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