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Frequently asked questions
About the Idaho Medicaid Plus Plan and the Medicare Medicaid Coordinated Plan
If you qualify for both Medicare and Medicaid, you may have questions. Here is some information that can help.
Dual members are Idahoans who get health insurance from both Medicare and Medicaid. This means dual members are:
- Over age 21
- Enrolled in Medicare Parts A, B and D
- Eligible for Idaho Medicaid’s Enhanced Plan
Idaho Medicaid offers 2 programs for dual members: Idaho Medicaid Plus (IMPlus) and the Medicare Medicaid Coordinated Plan (MMCP).
- Idaho Medicaid Plus supports dual members’ Medicaid benefits
- The Medicare Medicaid Coordinated Plan supports dual members’ Medicare and Medicaid benefits
Yes. Idaho Medicaid has contracts with health insurance companies (also called health plans) to provide benefits and support members.
The plans also support providers and pay them for services they deliver.
Idaho Medicaid Plus is mandatory in 34 counties. MMCP is voluntary.
Some dual members are not required to enroll in IMPlus.
- It is not mandatory for Idaho tribal members, pregnant women or members using the adult Developmental Disabilities (DD) waiver.
- It is not mandatory in counties with 1 participating Health Plan. But Idaho Medicaid will enroll dual members who live in non-mandatory countries in IMPlus unless they “opt out.”
Beginning June 1, 2025, IMPlus will be mandatory in:
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Idaho Medicaid cannot require anyone to enroll in a program that impacts their Medicare because Medicare is a federal — not state — program.
The MMCP covers all medically necessary and preventive benefits covered under Medicare Parts A, B and D (prescription drug coverage) as well as added services covered by Medicaid, including:
- Hospital visits, Medical costs, Prescription drugs
- Behavioral health, community-based rehabilitation services
- Nursing facility
- Aged & Disabled (A&D) Waiver Personal care services
- Care coordination
Idaho Medicaid Plus covers all medically necessary Medicaid benefits, including:
- Hospital costs after Medicare payment Medical costs after Medicare payment
- Behavioral Health, including community- based rehabilitation services
- Nursing facility after Medicare payment Aged & Disabled (A&D) Waiver
- Personal care services
- Care specialist
Yes. Blue Cross will offer MMCP and IMPlus until May 31, 2025, but not after that date. Molina will still offer MMCP and IMPlus after May 31.
Starting June 1, 2025, UnitedHealthcare Community Plan of Idaho will offer IMPlus. On January 1, 2026, UnitedHealthcare will offer both IMPlus and MMCP.
Members will have the option to choose another Medicare Advantage plan or they can revert to traditional Medicare.