Innovative health plan coordinates Medicare and Medicaid services

For a person enrolled in both Medicaid and Medicare, navigating those systems simultaneously can be a nightmare. But that is changing. Idaho Medicaid is learning from other states and implementing innovative solutions to better coordinate benefits and manage costs for people in those programs.

People who are eligible for benefits in both programs typically have more than four times the healthcare expenses than Medicare-only beneficiaries. They also have a higher prevalence of complex and chronic health conditions than the general population and must navigate two benefit systems that were not designed to work together.

Idaho Medicaid is proud to offer a coordinated health plan for most Idaho residents who are eligible and enrolled in Medicare Part A and B and full Medicaid coverage. This program, the Medicare-Medicaid Coordinated Plan (MMCP), offers one set of comprehensive benefits, one accountable entity to coordinate the navigation and delivery of services, and one care management team to develop care plans and coordinate benefits. 

The MMCP is administered by Blue Cross of Idaho. The name of this plan is True Blue Special Needs Plan, and it is designed to address member’s specific needs by providing a Care Coordinator to serve as a central point of contact to integrate each member’s healthcare needs. The True Blue Special Needs Plan covers all medically necessary and preventive services covered under Medicare Part A, Part B, and Part D prescription drug coverage as well as services covered by Medicaid, including:

  • Aged and Disabled Waiver
  • Personal care services
  • Nursing facility services
  • Intermediate care facilities for the intellectually disabled
  • Behavioral health
  • Community-based rehabilitation services
  • Developmental disabilities targeted service coordination*

*All other developmental disability services will continue to be administered by Medicaid.

The plan also covers additional services over and above original Medicare and Medicaid, such as:

  • Care coordination
  • Dental
  • Vision
  • 24-Hour nurse advice line
  • Fitness benefit

This plan is available to Idaho residents who are eligible and who are 21 or older who do not have Medicare as a result of having end-stage renal disease and live in one of these Idaho counties:

Ada Boundary Jefferson Payette
Adams Canyon Jerome Power
Bannock Caribou Kootenai Shoshone
Benewah Cassia Latah Twin Falls
Bingham Clark Madison Valley
Blaine Elmore Minidoka Washington
Boise Fremont Nez Perce
Bonner Gem Oneida
Bonneville Gooding Owyhee

Starting Jan. 1, 2016, the plan will be available in all Idaho counties except Franklin and Lemhi counties.

Eligible individuals may enroll at any time, and their coverage will begin the month after they enroll. Eligible Idahoans interested in enrolling or in learning more about the plan can call Blue Cross of Idaho at (888) 495-2583 or visit www.TrueBluesnp.com.

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