A dual eligible beneficiary is someone over 21, enrolled in Medicare parts A, B, and D, and has Medicaid enhanced plan benefits. If you fall into this category, there are two programs available for you, the Medicare Medicaid Coordinated Plan (MMCP) and the Idaho Medicaid Plus Program (IMPlus).
United Healthcare and Molina are contractually obligated to honor all prior authorizations authorized by the previous health plans for up to 90 days.
2025 Program Updates
There are changes coming to Idaho Medicaid duals' programs this year. The department is sending additional program updates via mail and email. Updates are also shared on this page.
March 17, 2025
Duals Program Options and Worksheet - Information and resources to support duals in choosing a program and plan.
February 20, 2025
Duals Informational Flyer - Updates for June 2025 - Plan options for duals and information about enrollment choices.
February 11, 2025
Program Updates Frequently Asked Questions - Common questions about duals' programs and upcoming changes.
February 5, 2025
Medicaid Information Release MA25-03 - UnitedHealthcare will offer Idaho Medicaid Plus in June.
December 17, 2024
Medicaid Information Release MA24-29 - Blue Cross of Idaho duals' contracts are ending.
May 6, 2025
Member - 12:30pm
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Provider - 3:30pm
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Some mobile devices may ask attendees to enter a numeric password.
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Join from a video system or application
Dial 28280482553@idhw.webex.com
You can also dial 207.182.190.20 and enter your meeting number
The following dates will have information posted as soon as it's available. Check back for updates.
May 12, 2025
Provider: 3:00 pm
Member: 4:00 pm
May 19, 2025
Provider: 8:00 am
Member: 11:00 am
Duals Program Options
The MMCP is a voluntary program that integrates both Medicare and Medicaid coverage into one single plan, at no cost to to you, which means you'll have:
- One set of comprehensive benefits.
- One accountable entity to coordinate delivery of services.
- One care management team to coordinate care.
- Receive additional supplemental benefits over and above original Medicare and Medicaid.
- Member Medicare premiums are paid by Medicaid.
- Access to the health plans network of providers.
Idaho Medicaid operates a mandatory managed care program, Idaho Medicaid Plus (IMPlus). This program covers all Medicaid enhanced plan benefits and will give you the option to choose your Medicare health plan if you live in one of the mandatory counties listed below and aren’t enrolled in the MMCP.
Idaho Medicaid Plus = Medicaid Benefits Only! With no changes to your Medicare coverage.
Beginning January 1, 2025, IMPlus is mandatory in the following counties (if you aren't enrolled in the Medicare Medicaid Coordinated Plan): Ada, Adams, Bannock, Benewah, Bingham, Blaine, Boise, Bonner, Bonneville, Boundary, Canyon, Cassia, Clark, Clearwater, Elmore, Freemont, Gem, Gooding, Jefferson, Jerome, Kootenai, Latah, Lincoln, Madison, Minidoka, Nez Perce, Owyhee, Payette, Power, Shoshone, Twin Falls, Valley, and Washington.
Idaho Medicaid Plus is open for voluntary enrollment if you live in Idaho County. If you live in this county, you can choose to opt-out of Idaho Medicaid Plus. If you choose to opt out of IMPlus , your services will remain with fee-for-service Idaho Medicaid. Fee-for-service benefits are not managed by a health plan.
How to Enroll in MMCP or IMPlus
Molina Healthcare of Idaho offers the Medicare Medicaid Coordinated Plan in many of Idaho's counties. Give them a call if you’d like to enroll or receive additional information. UnitedHealthcare Community Plan of Idaho will begin offering MMCP benefits January 1, 2026.
Molina Healthcare of Idaho: 866-403-8293
The MMCP combines all services covered under Medicare parts A, B, and D (prescription drug coverage) and all services in the Medicaid enhanced plan. Developmental disability services, non-emergency medical transportation, and dental benefits are available through Idaho Medicaid, separate from the MMCP.
The MMCP offers additional services over and above original Medicare/Medicaid. You can contact the health plans for the full listing of all supplemental benefits available through the Medicare Medicaid Coordinated Plan.
If you are a dual, you may select Molina Healthcare of Idaho or UnitedHealthcare Community Health Plan of Idaho for your IMPlus plan. You have 90 days before the program effective date to select a health plan and an additional 90 days after the effective date of your program to change your health plan. After the initial enrollment period there will be an Annual Open Enrollment (October 15 through December 7) in which you can change plans if you want.
- Call us toll free at 833-814-8568 to speak with our contract monitoring team, or email us at IdahoDuals@dhw.idaho.gov
- When you receive your IMPlus Selection Notice in the mail, just complete the enclosed IMPlus Enrollment form and mail it in the envelope provided.
The Bureau of Long Term Care hosts an online Complaint Submission System. This system is available to all stakeholders and allows you to enter a complaint and provide us with all the details to help us investigate and resolve your concerns. Once the complaint is received, it is routed directly to our triage team and the health plan, who are responsible to prioritize and manage all submitted complaints.