Idaho pays for home health care through Medicaid and a state waiver program, depending on the  needs and eligibility criteria of the beneficiary. Seniors in Idaho with low income and assets can get no-cost home health services through either a state-authorized agency or on their own, via a self-directed care option.

Medicaid in Idaho

Medicaid is available for Idaho seniors who meet income and asset thresholds. Medicaid covers all medically necessary services and supplies for beneficiaries. Under traditional Medicaid in Idaho, home health aides are a covered benefit if the beneficiary has a doctor’s referral and an active plan of care identifying home health as medically necessary. Medicaid benefits are comprehensive, which means medically necessary services, equipment and medical supplies are covered as needed.

Idaho’s Home and Community Based Support (HCBS) Waiver

Idaho’s Home and Community Based Support (HCBS) waiver allows seniors to get long-term home health care, which allows for both facility- and self-directed care plans. Seniors can apply directly for an HCBS waiver without an agency or doctor’s referral. As part of the application process, new enrollees must verify they meet the financial eligibility standards of Medicaid and have either an ongoing disability or a medical need for home health care, which may be verified by an intake worker.

Once approved, beneficiaries can designate a personal caregiver, who may be a family member or personal friend, or apply to a state-approved agency for a qualified home health worker. Covered services include medical supports such as personal nursing care, home health aides, medical equipment and supplies and health education. Non-medical support services, such as transportation and attendant care, are also available under the HCBS waiver.

The Managed Care Option

Idaho offers a comprehensive managed care plan for seniors who qualify for both Medicaid and Medicare. Dual-eligible seniors can enroll in the managed care option and have all of their medical benefits, including their Medicare Parts A and B, plus their Medicaid supplemental coverage, gathered into a single point of contact.

This plan delivers full-spectrum coverage that includes the initial doctor’s visit to get a referral for home health care, the services themselves, all needed equipment and supplies and the non-medical support services that supplement the medical supports for seniors aging in place. The managed care plan can also help seniors with the cost of residential and long-term facility care, if they ever transition into a nursing home or memory care facility.