Healthy Connections is the Idaho Medicaid program that helps members connect with a Primary Care Provider (PCP)/clinic who will coordinate your healthcare needs.
- Your PCP will coordinate your care, including giving referrals to other providers to allow medically necessary services to occur.
- Healthy connections follows a fixed enrollment process
- You will stay enrolled with your PCP unless you qualify for a reason to change.
- You can change your PCP for any reason during Open Enrollment every July and August.
If you need additional information you can contact Healthy Connections at 888-528-5861 or by email at hccr7@dhw.idaho.gov.
Enrollment in Healthy Connections will be with a clinic, not a specific provider. The clinic will work with you to determine your specific primary care provider or primary care team.
When searching for a Healthy Connections Primary Care Provider, the results will show a Healthy Connections Tier 1, 2 or 3 next to the clinic. The provider requirements for those tiers are listed below:
Healthy Connections Tier I:
- Provide primary care including monitoring and coordinating patient care
- Provide timely referrals to medically necessary services
- Provide 24 hour, 7 days a week availability of information, referral, and treatment for emergency medical conditions
Healthy Connections Care Management Tier II:
- Provide all requirements listed in Healthy Connections Tier I
- Provide additional access to care, which may include:
- Being open 46 hours or more each week
- Having a patient portal
- Offering telehealth
- Provide patient outreach and education activities
- Provide quality improvement activities
- Provide care coordination
- Track and follow-up on referrals
- Exchange patient-level information with other healthcare systems
Healthy Connections Medical Home Tier III:
- Provide all requirements listed in Healthy Connections Care Management Tier 2
- Be nationally recognized as a Patient-Centered Medical Home
Resources
View member Healthy Connections forms.
View information and resources for Healthy Connections providers.
Learn more about your Medicaid ID card, recertification, reporting requirements, and proof of health coverage.
Learn more about your Medicaid ID card, recertification, reporting requirements, and proof of health coverage.
Learn how to choose a primary care provider for your child, use your Medicaid ID card, and report changes.
Your child's healthcare is important. Find a primary care provider who accepts Idaho Medicaid and will provide the best treatment
Learn more about your Medicaid ID card, recertification, reporting requirements, and proof of health coverage.