On January 27, 2020, a Public Health Emergency (PHE) was issued because of COVID-19. The PHE ended on May 11, 2023.
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 happened 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 MCPT@dhw.idaho.gov
All Participants
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.
- If you have questions about accessing coverage or ensuring Idaho Medicaid pays for your healthcare services received during your active enrollment through the public health emergency, please contact Gainwell Technologies.
Idaho Medicaid Member Resources:- Participant Services Phone: 1 (866) 686-4752 (Toll-free), 1 (208 373-1432 (Local)
- Participant Service E-mail: idparticipantservices@gainwelltechnologies.com
- Participant Information Website: https://healthandwelfare.idaho.gov/services-programs/medicaid-health
- If you have questions about your Medicaid coverage, please contact DHW using the information below:
- Phone: 1 (877) 456-1233
- E-mail: MyBenefits@dhw.idaho.gov
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.
Please contact your provider to discuss virtual care options.
Yes. If you currently have one you will get to keep it. You will have to cover the service fees out of your budget.
Please work with your provider on options for signing documents.
Home and Community Based Service Participants
You would need to access services as they were prior to the PHE days.
Please work with your provider on options for signing documents.
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
Any additional waiver benefits you received because of the COVID health emergency were available for six months after the COVID health emergency ended. These additional benefits ended on November 11, 2023.
You must be Medicaid eligible in order to access Developmental Disability Services. If you didn’t finish the redetermination requirements for Medicaid by November 11, 2023, you may lose your benefits. You can reach out to your plan developer to complete these.
Up to five families may attend at once which is what was allowed prior to 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.
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
Please contact FACS and they will help you with prior authorization needs.
Please work with your provider on options for signing documents.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow the parents of minor children and spouses to be caregivers. Please work with your provider for information on how to access these services.
You will be able to have five families attend at once which is what was allowed prior to the COVID health emergency.
Yes. They will return to one staff per three children.
No. You will only be able to provide services to a group of three siblings at a time.
By and large, yes. Please work with your provider on this issue.
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.
Virtual Care (Video or Telephone)
Our nurse reviewer will discuss virtual care options with you.
Please work with your provider on virtual care options.
Please work with your provider on virtual care options.
Please work with your provider on virtual care options.
Aged and Disabled (A&D) Waiver / Personal Care Services (PCS)
Please work with your provider on options for signing documents.
Yes, after November 11, 2023, 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.
Please work with your provider on virtual care options.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow spouses to be caregivers. Please, work with your provider for information on how to access these services.
Yes, Idaho has submitted an amendment to its 1115 demonstration waiver to allow the parents of minor children and spouses to be caregivers. Please, work with your provider for information on how to access these services.
Your Nurse Reviewer will discuss telephonic or video assessment options when they contact you to schedule your next assessment.