Medicaid and the Federal Public Health Emergency

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.

Cost-sharing Information

Please contact your provider to discuss telehealth 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.

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. 

For six months after the COVID health emergency ends, any additional waiver benefits you received because of the COVID health emergency will continue. 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

If you don’t finish the redetermination requirements for Medicaid within six-months after the COVID health emergency ending, you may 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.

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.

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

Please work with your provider on options for signing documents.

Idaho Medicaid has received approval for a six month extension of this flexibility until November 11, 2023. We continue to seek a permanent path for this

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.

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. 

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. 

Our nurse reviewer will discuss telehealth options with you.

Please work with your provider on telehealth options.

Please work with your provider on telehealth options.

Please work with your provider on telehealth options.

Please work with your provider on options for signing documents.

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.

Please work with your provider on telehealth options.

We're waiting federal approval on a two month extension of this flexibility. Please reach out to your agency to discuss options. For six months after the PHE, spouses may provide Attendant Care. We continue to seek a permanent path for this.

We're waiting federal approval on a two month extension of this flexibility. Please reach out to your agency to discuss options. We continue to seek a permanent path for this

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