Magellan Healthcare is a mental health services company that has been in the field of mental health and substance use disorder treatment for over 50 years. Magellan offers an array of clinically led, evidence-based solutions to state agencies, employers, health plans and federal agencies.

A managed care organization (MCO) helps you manage your health. Idaho’s new MCO for mental health is Magellan Healthcare, Inc. Magellan will help you get the services you need by managing care and providing access to mental healthcare and substance use disorder services through a network of providers.

Idaho awarded the Idaho Behavioral Health Plan (IBHP) contract to Magellan. On July 1, 2024, Magellan will begin managing mental health and substance use disorder services and care for both Medicaid members and those who don’t have Medicaid coverage In the past, the IBHP was only for Medicaid members. Those who didn’t have Medicaid coverage received care from Children’s Mental Health and Adult Mental Health within the Division of Behavioral Health.

The changes will go into effect on July 1, 2024.

This change will affect all eligible Medicaid members and those who don’t have Medicaid coverage, including those who receive services through:

• Optum
• BPA Health
• Telligen/Medicaid
• The Division of Behavioral Health (DBH)
• Psychiatric residential treatment facilities (PRTF)

Magellan will send you a welcome letter in June 2024 that will explain what to do, where you can find information on how to access services, and any next steps you should take to transition your care. If you receive services through the Idaho Division of Behavioral Health (DBH), you will work with Magellan starting July 1, 2024.

Starting July 1, 2024, Magellan (the MCO) will manage mental health, substance use disorder and crisis services currently provided by the Idaho Division of Behavioral Health (DBH), the Idaho Division of Medicaid, Optum, Telligen and BPA Health, including:

• Intensive care coordination (ICC)
• Assertive community treatment (ACT)
• Youth Empowerment Services (YES)
• Wraparound services
• Coordinated specialty care for early serious mental illness (ESMI)
• Home with adult residential treatment (HART)
• Parenting with Love and Limits (PLL)
• Outpatient services
• Inpatient services
• Psychiatric residential treatment facility (PRTF)
• Behavioral health services, including children’s mental health services, for those who do not have Medicaid coverage
• Substance use disorder (SUD) services

You can learn more about the services that are covered in the IBHP by clicking this link. Stay tuned to this website for a complete list of program services in the Member Handbook when it is posted.

You will be able to see the same providers you are seeing now for at least 90 days after July 1, 2024. We are working hard to add current Medicaid and Department of Behavioral Health providers to the Magellan network. We hope to have them all in the Magellan network before the 90 days runs out so that you can continue to see them.

Starting on July 1, 2024, Magellan will manage all services you get through Optum. Starting on July 1, 2024, you will contact Magellan for help with and access to outpatient and crisis services and those you get through the YES system of care. YES services will be provided to Medicaid members and those who do not have Medicaid coverage who qualify.

Starting on July 1, 2024, Magellan will manage all services you get through BPA Health. Starting on July 1, 2024, you will contact Magellan for help with substance use disorder and other services you currently get from BPA Health.

Starting on July 1, 2024, Magellan will manage all services you get through Telligen. Starting on July 1, 2024, you will contact Magellan for help with and access to inpatient services.

Starting on July 1, 2024, Magellan will manage certain services you get through the DBH. Starting on July 1, 2024, you will contact Magellan for help with and access to the following services:

• Assertive community treatment (ACT)
• Children’s mental health and Youth Empowerment Services (YES)
• Wraparound
• Managed specialty care for early serious mental illness (ESMI)
• Home with adult residential treatment (HART)
• Mental health courts
• Parenting with Love and Limits (PLL)

Starting on July 1, 2024, Magellan will manage psychiatric residential treatment services you get through Medicaid. Starting on July 1, 2024, you will contact Magellan for help with and access to psychiatric residential treatment services.

A Magellan care coordinator will work closely with you, your child, and your child’s providers to ensure a smooth transition to the new Idaho Behavioral Health Plan (IBHP). Magellan will honor all existing authorizations for your child’s care. If your child’s facility is in Magellan’s network and the stay is authorized, your child will be able to continue getting care there on/after July 1, 2024. If the facility is not in Magellan’s network, Magellan will work closely with the facility to enroll them. If, for some reason, the facility does not join our network, your child will be able to stay there for at least 90 days after July 1, 2024. Magellan will waive cost-share requirements for people not on Medicaid from July 1, 2024, to June 30, 2025.

You will get a letter from the Idaho Department of Health and Welfare (IDHW) soon. The letter will explain how Magellan will work with you prior to the new IBHP service start on July 1, 2024. It will ask you to let Magellan see your child’s records and work with you, your child and the facility before July 1, 2024, to learn more about your child’s treatment.

If you sign the document and send it back to the IDHW: Magellan will send you a letter asking if we may sit in on your child’s treatment team meetings, with you, your child, and their residential treatment provider in May and June 2024. If you let us do this, you and your child will meet your Magellan care coordinator before July 1, 2024. This will help us get to know you and your child before the transition date. This will also help us make sure your child continues to get the services and supports outlined in their care plan.

If you do not sign the document and send it back to the IDHW: Your child’s new care coordinator will contact you as soon as possible after July 1, 2024, to talk about your child’s care so they continue to get care.

Medicaid-eligible adults, children and youth in Idaho can get IBHP services if they meet certain program or benefit eligibility requirements.

Services for these conditions are also available to those who do not have Medicaid coverage but meet certain program or benefit eligibility requirements.

• Anxiety, depression and other mental concerns
• Serious mental illness (SMI)
• Severe and persistent mental illness (SPMI)
• Serious emotional disturbance (SED)
• Substance use disorder (SUD)
• Co-occurring disorders, such as SMI and SUD

Your benefits are not changing. Under the new Idaho Behavioral Health Plan (IBHP), you will still be able to access services through your current Tribal Health clinic, Urban Indian Health clinic, or Indian Health Service clinic. You may also access care through non-Indian Health Services Tribal and Urban (IHS I/T/U) providers.

Through the new Idaho Behavioral Health Plan (IBHP), Idahoans will have expanded access to mental health and substance use disorder services, including crisis services, that are coordinated and streamlined.

Magellan will send you a letter in June that welcomes you to the plan and explains what to do, where you can find details on how to access services, and any next steps you should take.

Your benefits are not changing.

Until July 1, 2024, if you have questions about your coverage, contact Optum or the Division of Behavioral Health.

To find out if you are eligible for Medicaid, contact the Division of Self-Reliance at 1-877-456-1233 (TTY 711).

For general referrals, contact the Idaho CareLine at 2-1-1.

For questions about the future Idaho Behavioral Health Plan or other questions, email IBHP@dhw.idaho.gov to connect with the Idaho Behavioral Health Plan Governance Bureau.