Idaho Medicaid Waivers & Home and Community Based Programs Overview

Idaho, known as The Gem State, has a well-structured Medicaid Waiver and Home and Community-Based Services (HCBS) system that provides long-term care alternatives for individuals with disabilities, seniors, and those with chronic health conditions.

Administered by the Idaho Department of Health and Welfare (DHW), Division of Medicaid, the state’s waiver programs allow participants to receive services in their homes or community settings instead of institutional care. Key waiver programs include the Aged and Disabled (A&D) Waiver, which offers personal care, respite, and homemaker services to seniors and individuals with physical disabilities, and the Developmental Disabilities (DD) Waiver, which provides habilitation, employment support, and therapeutic services for individuals with intellectual and developmental disabilities (IDD).

Idaho also offers Self-Direction options under the DD Waiver, allowing participants to manage their care and hire their own caregivers.

Regulatory oversight in Idaho is managed through DHW, Medicaid’s Bureau of Long-Term Care (BLTC), and the Idaho Division of Licensing and Certification, which ensures compliance with state and federal Medicaid regulations. Medicaid services in Idaho operate under both fee-for-service and managed care models, with Healthy Connections Value Care (HCVC) coordinating primary care for Medicaid beneficiaries.

The state has implemented Electronic Visit Verification (EVV) for personal care services, enhancing service accountability and fraud prevention. Additionally, providers must comply with rigorous Medicaid billing, provider enrollment, and regulatory requirements to participate in Idaho’s HCBS programs.

With a focus on person-centered planning, rural healthcare access, and cost-effective service delivery, Idaho’s Medicaid waiver system is designed to maximize independence while ensuring that individuals receive high-quality, community-based long-term care services tailored to their needs.

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Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

Browse Policy & Procedure Manual for This State's Programs and Services