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Who is eligible for Idaho Medicaid? Household Size*Maximum Income Level (Per Year)2$26,2283$33,0644$39,9005$46,7374 more rows
For questions about Food stamps, Medicaid, TAFI, or ICCP, contact the benefits customer service at MyBenefits@dhw.idaho.gov or call 877-456-1233.
A written appeal request with all required documentation must be received by Medical and Utilization Review (UR) Appeals within 120 calendar days of the date of the decisions letter. HHSC Medical and UR Appeals may ask for additional documentation.
All claims must be submitted to Idaho Medicaid within twelve months (365 days) from the date of service.
For most services, Idaho Medicaid reimburses providers the lesser of the billed amount or the maximum allowable fee established by the Idaho Department of Health and Welfare, Division of Medicaid. Any code listed may have a service limitation associated with it or need prior authorization from Medicaid or its designee.
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You have 28 days from the date on your notice about the decision to file an appeal about Medicaid services.
After submission, application processing may take up to 45 days. We will let you know if additional documentation is needed. Other Medicaid programs (EPSDT, Katie Beckett, YES, and Childrens Developmental Disabilities) require additional forms to be completed.
All providers wishing to participate in the Idaho Medicaid Program must first register for a Trading Partner Account (TPA) at .idmedicaid.com. Select Register in the upper right hand corner to complete the TPA registration. Once complete, follow the link for the Provider Enrollment Application after logging in.

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