The Medicare Medicaid Coordinated Plan (MMCP), as the name suggests, coordinates both Medicare and Medicaid services for dual eligible Idaho residents. A “dual eligible” individual is a recipient of both Medicare (Parts A, B, & D) and Medicaid coverage. While this program is available to adults 21 years of age and older, this program is most relevant to seniors.
MMCP is intended to coordinate one’s Medicaid and Medicare benefits into one system, streamlining the process of receiving services, as well as managing the costs of services. A number of benefits, such as medical, behavioral health, dental, and prescription drugs, are available via MMCP, as well as long-term care services, such as adult day care, chore / homemaker services, respite care, etc., via Idaho’s Home and Community Based Services Aged and Disabled Waiver.
Unfortunately, MMCP is not currently available statewide. The counties in which it is available are listed under the Eligibility Guidelines section below. Depending on the county in which one resides, one’s health plan benefits are available through one of the private health care institutions contracted with the state.
In order to be eligible for MMCP, the following requirements must be met:
Medicaid eligibility is complicated, but generally speaking, senior Idaho residents must meet income and asset qualifications.
As of 2023, those who are 65 years of age and older, blind or disabled have an income limit of $967 a month. Couples are allowed $1,391 a month For those who require long-term care services via the Aged and Disabled Waiver, the income limit is higher at $2,762 a month, as of 2023. The couple limit is $5,504.
Assets are limited to $2,000 for individuals and $3,000 for couples, but several assets are exempt, meaning they do not count toward Medicaid’s asset limit. Examples include one’s home, given the applicant lives in the home (or a non-applicant spouse lives in the home) and his / her equity interest is not over $750,000, household items, personal effects, and an automobile.
Through the Medicare Medicaid Coordinated Plan, care coordination is provided, in addition to all services available under Medicare Part A, Part B, and Part D, as well as a variety of Medicaid services. Below is a list of services one might receive via MMCP.
In addition to these services, supplemental services are also available based on one’s health plan. These services might include vision exams, nurse advice lines, non-medical transportation, nutrition counseling, over-the-counter medications, gym membership, transitional meal services, and podiatry care.
Applicants not currently on Medicaid must first apply for Medicaid. One can do so through several options:
For additional information on the Idaho Medicare Medicaid Coordinated Plan, click here.