Medicaid Member Benefits


Medicaid members behavioral healthcare is covered by their Medicaid benefits. This page calls out a few Medicaid benefits that are important for you to be aware of. For more information about these and other Medicaid benefits, please call the Idaho Department of Health and Welfare Division of Medicaid at 1-877-456-1233 (TTY 711).

Family planning

IBHP members who have Medicaid can get free family planning services and supplies. You do not need a referral from your primary care provider (PCP). You can get family planning services from your PCP or a clinic that accepts Medicaid. The provider/clinic does not need to be in the Magellan network. Magellan cannot require you to get a referral before you choose a family planning provider.

Behavioral Healthcare for Ages 18 to 21 Through EPSDT

If youth have Medicaid, they can get mental health and substance use disorder care up until their 21st birthday through the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit.

The EPSDT benefit allows youth under 21 to receive medically necessary services that exceed the limits of the Idaho Medicaid plan. The EPSDT benefit is provided to ensure physical conditions or mental illnesses, which can affect a youth’s growth or development are found and treated early. EPSDT includes:

  • Screening services (well-child checks, vaccines, and lead and developmental screenings) 
  • Lab tests
  • Health education
  • Vision services
  • Dental services
  • Hearing services
  • Rehabilitative services
  • Personal care services
  • Diagnostic Services
  • Treatment (physical or mental illnesses or conditions)
  • Transportation to and from medical appointments

To get EPSDT services, talk to your young adult’s provider. They must get a pre-authorization from Magellan for your child to get EPSDT services.

For more information:

Medicine

Over-the-counter medicines are not covered by the IBHP but may be covered by Medicaid. For more information, call the Idaho Medicaid Pharmacy Program at 1-866-827-9967 (TTY 711). 

Some prescription medicines may be covered by Medicaid instead of the IBHP unless they are covered by another insurance such as Medicare. For more information, call the Idaho Medicaid Pharmacy Program at 1-866-827-9967 (TTY 711).

Some types of medicines and some brand-name prescription drugs covered require pre-authorization. Your provider or pharmacy will know which medicines need pre-authorization and will ask for it for you.

Non-Emergency Medical Transportation

How to get Non-Emergency Medical Transportation

Medicaid members who have an appointment with a behavioral health provider but do not have a way to get there can request transportation through MTM. MTM is Medicaid’s contractor for non-emergency medical transportation (NEMT). For more information about non-emergency medical transportation for Medicaid members, please visit: https://www.mtm-inc.net/idaho/.

  • Trips can be scheduled for appointments 24 hours a day, seven (7) days a week
  • You must schedule your trip at least two (2) business days before your appointment, unless your trip is urgent, or you are discharged from a hospital. 
  • Call MTM 24 hours a day, seven (7) days a week at 1-877-503-1261 (toll free) (TTY 711) to request transportation, including gas mileage reimbursement. You can also use the MTM Link web portal or mobile app to request a ride at any time. For more information about MTM Link, please visit https://www.mtm-inc.net/mtm-link/.

Gas mileage reimbursement in a private vehicle

Medicaid members who have a car to drive to behavioral health provider appointments may be reimbursed for mileage. A friend or family member who takes you may also be reimbursed. Call MTM at 1-877-503-1261 (TTY 711). For more information about reimbursement, please visit: https://www.mtm-inc.net/idaho/members.

Complaints about the NEMT service

If you have a comment or complaint about NEMT, please call MTM at 1-866-436-0457 (toll free) (TTY 711) or visit https://www.mtm-inc.net/contact/.

Digital Emotional Wellbeing Program

Digital Emotional Wellbeing, powered by NeuroFlow, empowers you to take an active role in your health. It has assessments, activities and digital cognitive behavioral therapy programs. You can learn more about conditions like anxiety, depression, insomnia and substance misuse. You can watch videos, track symptoms and write about your thoughts in a journal. Click here to learn more and get started.