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Idaho State Medicaid Waiver Program Application Guide

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  • Idaho State Medicaid Waiver Program Application Guide




    Waiver #1: TEFRA (Also known as Katie Beckett Program)


    Who Can Apply?

    Circumstances/Diagnosis: Any child under 19 who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.

    Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.

    What do I get?

    The way TEFRA waivers work is that they allow families with higher incomes to receive medicaid benefits for their child because eligibility is based on the child income. This means that you will be able to receive dental care, emergency and non-emergency transportation, inpatient and outpatient treatment, medical equipment, occupational therapy, pharmacy, physical therapy, vision.

    How do I apply?

    Contact the Idaho CareLine by calling 2-1-1, or toll-free (800) 926-2588 to request an application or visit your regional Department of Health and Welfare office.

    Waiver #2: Children’s Developmental Disability Services

    Who Can Apply?

    Circumstances/Diagnosis: Any child under 19 who is already on Medicaid and is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.

    Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.

    What do I get?

    Idaho has for some reason stored this information in a bunch of different documents on this page scroll down a little and you will be able to find listings and explanations of services.

    How do I apply?

    Fill out this application and send it to the contact information on the first page of the application.

    You can review this application guide for more information.

    What does the Goally Team Think?

    Idaho has a good waiver program just by virtue of not having a waitlist. In other states it can take many years to get services, but in Idaho it only takes as long as it takes to apply. The actual services Idaho is a little lackluster, other states are more expansive with their services, but they should cover the most important needs your child has. There are also several adult waiver programs that you case manager can help you transition to as your child gets older.

    Goally Waiver Scorecard

    Website clarity and ease of navigation: 2/5
    Access and requirements of qualification: 4/5
    Healthcare coverage: 2/5

    Other online resources for Idaho:

    Autism Navigator has online training courses for parents
    The ARC Idaho can help you with everything from advocacy to employment
    Idaho Parents Unlimited Inc. can help you with all things related to parent training.

    Telephone Resources


    Phone numbers for the regional Department of Health and Welfare office.
    Idaho Careline: 2-1-1
    Last edited by Nate; 07-08-2020, 11:35 PM.
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