Medicaid and the Federal Public Health Emergency

On January 27, 2020, a Public Health Emergency (PHE) was issued because of COVID-19. Although we have not received a formal notice announcing the end date of the PHE, the White House has issued a statement which strongly indicates that the PHE will end on May 11, 2023. Based on that statement, we are preparing for some changes to occur on May 11, 2023.  We will post the official end date as soon as it is announced

Because of the PHE, Idaho Medicaid made changes to make sure you could safely get services when you needed them. We expanded our telehealth or virtual services policy. You will find more information about telehealth (virtual services) in our Frequently Asked Questions section as you scroll down this page.

For information about Medicaid coverage and Medicaid Protection, visit the Medicaid Protection web page.

Frequently Asked Questions

We have put together information to answer some of the most common questions about what will happen to Medicaid services and Medicaid policy after the end of the PHE. If you have questions which you do not see listed below, please email MCPTpolicyteam@dhw.idaho.gov.

Report Household Changes
You can report changes to your household by phone, email, or online.

All Participants

What is changing with the way I qualify for benefits?

DHW has been working under special rules during the COVID health emergency and Medicaid benefits may have stayed on when they normally would have ended. When the COVID health emergency ends, we may need to contact you to make sure you still qualify.

Will I have to start paying a premium or co-pay if I paid one before the COVID health emergency?

Yes. Before the COVID health emergency if you had to pay a premium or co-pay to receive your services, you will have to start paying those again.

If you have had a change in income or household size, this may change your requirement to pay premiums or co-pays.

Cost-sharing Information

Will I still be able to do phone calls with my provider instead of in-person visits?

Please contact your provider to discuss telehealth options.

Can I keep my medical alert device at the end of the COVID health emergency?

Yes. If you currently have one you will get to keep it. You will have to cover the service fees out of your budget.

Can I continue signing my service forms electronically at the end of the COVID health emergency?

Please work with your provider on options for signing documents.

Home and Community Based Service Participants

If I chose to suspend my Home and Community Based Services during COVID, will I lose services if I continue to suspend after the COVID health emergency ends?

You would need to access services as they were prior to the PHE days.

Can I continue signing my Home and Community Based Services documents electronically like my Person-Centered Service Plan when the COVID health emergency ends?

Please work with your provider on options for signing documents.

Can my child use a previous-years physical to qualify for benefits under the Home and Community Based Services Benefits for Children with Disabilities option when the COVID health emergency ends?

No. After the COVID health emergency ends, your child will need a new exam by their primary care physician to qualify for benefits. Due to physician wait times it may take a while to get an appointment, so please schedule your exam now. 

Developmental Disability Participants

As a Developmental Disabilities Waiver participant will I get to keep the extra benefits and a larger budget when the COVID health emergency ends?

No. Six months after the COVID health emergency ends, any additional benefits you received because of the COVID health emergency will end. Some of those services may include:

  • Additional hours of Developmental Therapy
  • Additional hours of Adult Day Health
  • Receiving Developmental Therapy in a location not identified on your plan
  • Homemaker Services
  • Supported Living staffing ratio adjustments
  • Being moved to Intense due to a diagnosis of COVID
  • Not needing a Healthy Connection referral to access Developmental Therapy
As a Developmental Disability Service participant if I don't finish my redetermination requirements will I lose my benefits at the end of the COVID health emergency?

If you don’t finish the redetermination requirements for Medicaid within six-months of the COVID health emergency ending, you will lose your benefits. You must be Medicaid eligible in order to access Developmental Disability Services. You can reach out to your plan developer to complete these.

Will I be able to continue having multiple families attend family education trainings at the end of the COVID health emergency?

We will allow up to five families to attend at once which is what was allowed prior to the COVID health emergency.

Are the ratios for staff to children with developmental disabilities in group settings going to go back to what they were prior to the COVID health emergency?

By and large, yes. Please work with your provider on this issue.

Can my child use a previous-years physical to qualify for benefits under the Home and Community Based Services Benefits for Children with Disabilities at the end of the COVID health emergency?

No. After the COVID health emergency ends, your child will need a new exam by their primary care physician to qualify for benefits. Due to physician wait times it may take a while to get an appointment so please schedule your exam now. 

Can I keep my medical alert device at the end of the COVID health emergency?

Yes. If you currently have one you can keep it but will have to cover the service fees out of your budget.

Can I continue to receive Home Delivered Meals at the end of the COVID health emergency?

Yes, if you meet the requirements that were in place before the COVID health emergency. Work with your plan developer to see if you qualify for home delivered meals.

Children's Developmental Disability 1915(i) Waiver Participant

If I had a prior authorization for a service on file will it still be active after the COVID health emergency ends?

Please contact FACS and they will help you with prior authorization needs.

Can I continue signing my Home and Community Based Services documents electronically, like my Person-Centered Service Plan, when the COVID health emergency ends?

Please work with your provider on options for signing documents.

Can a family member continue to provide Personal Care Services to a child when the COVID health emergency ends?

No. Please reach out to your agency and they will help you find a Personal Care Services provider.

Can I still have multiple families attend family education trainings after the COVID health emergency ends?

You will be able to have five (5) families attend at once which is what was allowed prior to the COVID health emergency.

Will the ratios for staff to children with developmental disabilities in group settings return to normal when the COVID health emergency ends?

Yes. They will return to one staff per three children.

As a independent respite provider can I continue to provide services to a group of more than three siblings after the COVID health emergency ends?

No. You will only be able to provide services to a group of three siblings at a time.

Can my child use a previous-years physical to qualify for benefits under the Home and Community Based Services Benefits for Children with Disabilities when the COVID health emergency ends?

No. After the COVID health emergency ends, your child will need a new exam by their primary care physician to qualify for benefits. Please schedule your exam ahead of time. 

Telehealth (Video or Telephone)

As an Aged and Disabled Waiver participant can I still use phone calls or video to meet with my provider when the COVID health emergency ends?

Please work with your provider on telehealth options.

As an Aged and Disabled Waiver participant can I still have my need for care assessed or changed by phone or video when the COVID health emergency ends?

Please work with your provider on telehealth options.

As a Developmental Disability Waiver participant can I still get services by talking with my provider on the phone when the COVID health emergency ends?

Please work with your provider on telehealth options.

As a Developmental Disabilities Waiver participant can I still get my evaluations, assessments, and person-centered service planning meetings through video instead of in-person when the COVID health emergency ends?

Please work with your provider on telehealth options.

Aged and Disabled (A&D) Waiver / Personal Care Services (PCS)

As an Aged and Disabled waiver and/or Personal Care Services participant can I still sign documents electronically when the COVID health emergency ends?

Please work with your provider on options for signing documents.

If I don’t use my Aged and Disabled Waiver services for more than a month will I lose these services or other benefits when the COVID health emergency ends??

Yes, six months after the COVID health emergency ends, our normal rules will apply and you may lose your Aged and Disabled Waiver benefits if you do not use your services at least once every 30 days.

Can I still get Aged and Disabled Waiver or Personal Care Services by telephone or video when the COVID health emergency ends?

Please work with your provider on telehealth options.

Can my spouse continue being a caregiver providing me Aged and Disabled Waiver or Personal Care Services when the COVID health emergency ends??

No. Please reach out to your agency and they will help you find a different caregiver.

Can I still be an employed Personal Care Services paid caregiver for my child or spouse when the COVID health emergency ends?

No. Please reach out to your agency and they will help you find a different caregiver for your child or spouse.

Can I still complete my annual level of care for Aged and Disabled Waiver or Personal Care Services eligibility by phone or video when the COVID health emergency ends?

Your Nurse Reviewer will discuss telephonic or video assessment options when they contact you to schedule your next assessment.