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Long-Term Care Provider Enrollment and General Information | Idaho Department of Health and Welfare

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The Bureau of Long Term Care (BLTC) works with multiple healthcare providers that help participants maintain independence in their home through authorized services. Periodic quality assurance reviews make sure that participants receive safe and quality care and services.

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Welcome to Youth Empowerment Services (YES)!
Youth Empowerment Services (YES) is Idaho's children's mental health system of care that helps families access services and supports for their children under 18 with serious emotional disturbance (SED). The YES system of care also creates meaningful partnerships between families, youth, providers, and public agencies to address the youth's specific needs and help them function better at home, in school, and in the community. If your child is aged 18-21, and is eligible for Medicaid, similar services are available through EPSDT.

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Youth Empowerment Services - YOUTH EMPOWERMENT SERVICES

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Welcome to Youth Empowerment Services (YES)! Youth Empowerment Services (YES) is Idaho's children's mental health system of care that helps families access services and supports for their children under 18 with serious emotional disturbance (SED).

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| Tool/Manual

I Want to Know About...

What is the Social Security Administration (SSA)?

The Social Security Administration (SSA) provides Americans financial protection and support throughout life's journey. SSA administers retirement, disability, survivor, and family benefits and enrolls individuals in Medicare. They also provide Social Security numbers, which are unique identifiers needed for individuals to work, handle financial transactions, and establish eligibility for certain government services.

What is Supplemental Security Income (SSI)?

SSA provides Supplemental Security Income (SSI) monthly payments to people with disabilities and older adults who have little or no income and resources. In most states, but not all, receiving SSI qualifies someone for Medicaid. Adults and children might be eligible for SSI if they have:

1. Little or no income, and

2. Little or no resources, and

3. A disability, blindness, or are age 65 or older.

Can I work if I receive SSI?

Yes! One of SSA's highest priorities is to help disabled people take advantage of employment opportunities and achieve greater financial independence. Work incentives and employment supports help people with disabilities and blind SSI recipients go to work by minimizing the risk of losing their SSI or Medicaid benefits.

What is Social Security Disability Insurance (SSDI)?

SSA provides Social Security Disability Insurance (SSDI) monthly payments to people who have developed a disability or who are blind and who are "insured" by workers' contributions to the Social Security trust fund. These contributions are based on someone's earnings (or those of your spouse or parents) as required by the Federal Insurance Contributions Act (FICA).

Many people work while receiving benefits. Timothy Elliott is a disabled Veteran of the U.S. Navy who did not return to work for 10 years after his disability for fear of losing his benefits. With support and tools, he has successfully balanced working and receiving benefits for 20 years. Read Timothy's full story on the LEAD Center website.

Can I work if I receive SSDI?

Yes! After you start receiving SSDI, you may want to try working again. Work incentives can help you keep your cash benefits and Medicare while you test your ability to work. SSA has a publication, Working While Disabled: How We Can Help, that explains a beneficiary's rights and responsibilities when they receive SSDI.

I have an overpayment, what do I do?

If you received a letter in the mail that says you were overpaid Social Security benefits and need to pay SSA back, you can request a waiver at any time. You can ask SSA to waive repayment if you can't afford it and feel the error wasn't your fault, or if you believe the overpayment is unfair for another reason. If you think that you were not overpaid or if the amount of the overpayment is not correct, you may appeal by filing a request for reconsideration. The appeal request must be filed within 60 days of receiving the notice.

If SSA is currently withholding some or all of your cash payment and if you are unable to meet necessary living expenses, you can request that SSA readjust your current rate of withholding by submitting a Request for Change in Overpayment Recovery Rate.

Can I work and keep my medical benefits?

Many people believe that they will automatically lose their Medicare or Medicaid as soon as they obtain employment. Working, however, does not necessarily mean losing access to federal or state health care benefits because there are protections in place, called Medicare and Medicaid Employment Supports, that help working beneficiaries keep their benefits.

Can I have an Achieving a Better Life Experience (ABLE) account and keep Medicaid?

An Achieving A Better Life Experience (ABLE) account allows you to save amounts above the SSI resource limit and keep means-tested benefits such as SSI, Supplemental Nutrition Assistance Program (SNAP), and Medicaid. The SSI resource limit is $2,000 for an individual. In 2024, the ABLE account annual contribution limit is $18,000, but employed account owners can contribute more. Savings in the account up to $100,000 are not counted by the SSI program. Savings in the account exceeding $100,000 count toward the resource limit for SSI. A beneficiary's Medicaid continues with any amount of savings in the account up to the state ABLE account limit.

Kenley is a teenager with Down syndrome who is excited to make her own employment and financial decisions as she gets older. Kenley and her mother, Jennifer Casselman, often use digital tools to understand the interplay of Kenley's benefits, her ABLE account, and employment. Read Kenley's full story on the LEAD Center website.

Who can I contact if I have additional questions about working while receiving SSI or SSDI?

SSA has work incentives, including the Ticket to Work program, which may make it possible for people receiving SSI and/or SSDI to work and still receive monthly payments. You can visit ChooseWork.SSA.gov to learn more about Ticket to Work and other work incentives. You may also call the Ticket to Work Help Line if you have questions about work, benefits, or SSA work incentives: 1-866-968-7842, Monday through Friday between 8 a.m. and 8 p.m. ET.

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Financial Toolkit: Frequently Asked Questions " LEAD Center

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I Want to Know About... What is the Social Security Administration (SSA)? The Social Security Administration (SSA) provides Americans financial protection and support throughout life's journey. SSA administers retirement, disability, survivor, and family benefits and enrolls individuals in Medicare. They also provide Social Security numbers, which are unique identifiers needed for individuals to work, handle [...]

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ssi Benefits for Children with Disabilities

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Katie Beckett - Idaho Medicaid Buckets of Financial Services  (1)

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Parent Resources Childrens Mental Health

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Family Directed Support Services | Idaho Department of Health and Welfare

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Children Special Health Programs and Genetic Services

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Have more questions, or need resources? Reach out to a Parent Education Coordinator?

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Have more questions, or need resources? Reach out to a Parent Education Coordinator?

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In this edition we discuss the Family Glitch and whether you've been affected, the dangers of sitting, important tax information, it's not too late to sign up for vision insurance, the teen mental health crisis, Read more...

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Your Health Idaho " Idaho's Official Health Insurance Marketplace

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Idaho's health insurance marketplace where Idahoans find the right coverage for their needs. The only place to save on monthly premiums with a tax credit.

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Welcome to the Idaho Department of Insurance

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Idaho Department of Insurance serves and protects Idahoans by equitably, effectively and efficiently administering the Idaho Insurance and Fire Code.

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Coverage of Treatments for Autism Spectrum Disorder

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Coverage of Treatments for Autism Spectrum Disorder

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US Department of Health and Human Services

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Assistant Secretary for Public Affairs (ASPA)

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Regulations and guidance about the current health care law.

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Medicaid School-Based Service Providers | Idaho Department of Health and Welfare

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School-based services are health-related and rehabilitative services provided to children with disabilities who receive services under the Individuals with Disabilities Education Act (IDEA). These services are provided by school districts and charter schools and are considered medically necessary fo…

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Program mission

To enable children with special healthcare needs to have improved health outcomes and an enhanced quality of life through care coordination assistance to ensure access to care and financial support for continuity of care to achieve health goals.

Who is eligible for CSHP?

Program eligibility and limitations may depend on:

Age of child, must be under the age of 18

Diagnosis of a qualifying medical condition

Residency status, child must be a legal resident of Idaho (per rule, only child must be legal)

Family income and size to determine financial eligibility

Uninsured children

Insured children with cystic fibrosis or PKU

Child's parent/guardian is required to apply for Medicaid before applying for CSHP services

What services are provided?

To ensure access to care, CSHP offers:

Financial assistance for pre-approved services

Care coordination support by a care coordinator

Referrals

Prior authorization of CSHP services are required.

Any CSHP-funded services provided must be approved in advance

You, your healthcare provider, or the billing contact can reach out to CSHP staff at 208-334-5962 or IdahoMCH@dhw.idaho.gov to obtain prior authorization

Failure to obtain prior authorization may result in denied claims and your family may be responsible for the cost of the services provided

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Program mission To enable children with special healthcare needs to have improved health outcomes and an enhanced quality of life through care coordination assistance to ensure access to care and financial support for continuity of care to achieve health goals. Who is eligible for CSHP?

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If you are eligible for Children's Medicaid or CHIP, you can qualify for services under EPSDT. There are not different income limits for this program. Children enrolled in Medicaid are eligible for medically necessary screenings, diagnosis, and treatment for physical conditions or mental illnesses. If Idaho Medicaid doesn't usually cover a service under basic plans, but it is listed in the federal Medicaid law, then it is coverable under EPSDT. Companies who provide these services to children enrolled in Idaho Medicaid must use EPSDT as a guide.

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Early Periodic Screening, Diagnostic and Treatment (EPSDT)

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If you are eligible for Children's Medicaid or CHIP, you can qualify for services under EPSDT. There are not different income limits for this program. Children enrolled in Medicaid are eligible for medically necessary screenings, diagnosis, and treatment for physical conditions or mental illnesses.

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Welcome to Youth Empowerment Services (YES)!
Youth Empowerment Services (YES) is Idaho's children's mental health system of care that helps families access services and supports for their children under 18 with serious emotional disturbance (SED). The YES system of care also creates meaningful partnerships between families, youth, providers, and public agencies to address the youth's specific needs and help them function better at home, in school, and in the community. If your child is aged 18-21, and is eligible for Medicaid, similar services are available through EPSDT.

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Youth Empowerment Services - YOUTH EMPOWERMENT SERVICES

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Welcome to Youth Empowerment Services (YES)! Youth Empowerment Services (YES) is Idaho's children's mental health system of care that helps families access services and supports for their children under 18 with serious emotional disturbance (SED).

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There are different paths to receiving mental health care through YES. All of these paths depend on whether the child or youth is enrolled in Medicaid or has been identified as having serious emotional disturbance (SED). Children with SED are eligible for Medicaid at a higher income level. Read the information below to determine how to get help.

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There are different paths to receiving mental health care through YES. All of these paths depend on whether the child or youth is enrolled in Medicaid or has been identified as having serious emotional disturbance (SED). Children with SED are eligible for Medicaid at a higher income level.

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Idaho Medicaid for Children                     Eligibility and How to Apply

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Idaho Medicaid for Children                     Eligibility and How to Apply

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Temporary Assistance for Families in Idaho (TAFI)

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Services can be delivered under a traditional pathway by a Developmental Disabilities Agency (DDA) /Independent Provider or under a Family Directed services option where the parent acts in the role of the employer. A case manager is available to assist you to develop your child's plan of services and navigate children's services.

Developmental disability

A developmental disability (DD) is a chronic disability of a person which appears before 22 years of age and:

Is attributable to an impairment, such as an intellectual disability, cerebral palsy, epilepsy, autism, or other condition found to be closely related to or similar to one of these impairments that requires similar treatment or services, or is attributable to dyslexia.

Results in substantial functional limitations in three or more of the following areas of major life activity; self care, receptive and expressive language, learning, mobility, self direction, capacity for independent living, or economic self sufficiency.

Reflects the needs for a combination and sequence of special, interdisciplinary or generic care, treatment or other services which are of life-long or extended duration and individually planned and coordinated.

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Services can be delivered under a traditional pathway by a Developmental Disabilities Agency (DDA) /Independent Provider or under a Family Directed services option where the parent acts in the role of the employer. A case manager is available to assist you to develop your child's plan of services and navigate children's services.

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Children's Health Insurance Program (CHIP)

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Children's Health Insurance Program (CHIP)

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Children's Health Insurance Program (CHIP)

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The Children's Health Insurance Program (CHIP) is a low-cost health coverage program for children under age 19 whose family income is too high to qualify for Medicaid. There may be a small monthly premium ($10 or $15, depending on income) for each child enrolled in CHIP.

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To be eligible for SSI benefits, a child must be either blind or disabled.

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How to Apply for Children's Developmental Disability Services

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How to Apply for Children's Developmental Disability Services

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To determine eligibility, please apply for both Medicaid and the Katie Beckett program at the same time. In order to be eligible for the Katie Beckett program, your child must meet the following criteria:

Live in Idaho

Be a child under the age of 19

Be a U.S. citizen or eligible non-citizen

Have a disability diagnosis under the Social Security Act

Be assessed to have functional impairments that qualify for the Katie Beckett program

Your household income must be less than the program income limits for your household size (see the specific income limits by selecting a Medicaid Program in the menu)

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To determine eligibility, please apply for both Medicaid and the Katie Beckett program at the same time. In order to be eligible for the Katie Beckett program, your child must meet the following criteria: Live in Idaho Be a child under the age of 19 Be a U.S.

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In April, ACL observes National Financial Capability Month, which was created to raise awareness of the importance of financial literacy - and the need for financial education - for all Americans.

Understanding how to manage money is crucial to financial independence for everyone. For many people with disabilities, increased ability to manage personal finances also can increase their independence and help them to participate fully in their communities.

For example, everyone should have the knowledge and skills to save and invest money. They also need to understand how tax rules affect them.

Many people with disabilities have additional things they need to know about. For example, people who receive government-funded benefits, such as Social Security and Medicaid, need to understand how saving money can affect those benefits. People with disabilities also need to know about programs and options that can help them save money; in fact, they may be eligible for an ABLE account, which is a tax-advantaged savings plan for people with disabilities.

David Jones, director of the Office of Intellectual and Developmental Disabilities within ACL's Administration on Disabilities, recently asked Jody Ellis, director of the ABLE National Resource Center, 10 questions about ABLE accounts.

As millions of people meet the April 15 federal tax deadline today, we're sharing Jody's answers to help people with disabilities and their families learn about this important savings option.

What is an ABLE account?

Jody: An ABLE account is a tax-free savings and investment account owned by a person with a disability. Eligible individuals can establish and contribute to an ABLE account, which does not adversely affect their eligibility for federally-funded, means-tested benefits like Medicaid. An ABLE account balance, up to $100,000, does not count as an asset for Supplemental Security Income (SSI). It may be used at any time to help cover the extra expenses related to living a life with a disability.

Who can open an ABLE account and who can contribute to it?

Jody: To be eligible for an account, a person must have a qualifying disability with the disability onset prior to age 26 (this age is increasing in 2026 - see below). Eligible individuals must meet the "severity of disability requirement" in one of two ways: (1) receiving SSI or Social Security Disability Insurance (SSDI); or (2) not receiving these benefits but possessing a disability certification signed by a licensed physician. As for contributions, the owner of the ABLE account can contribute, and contributions can come from friends and family, special needs or pooled trusts, or a 529 college savings account rollover.

How can the funds in an ABLE account be used?

Jody: ABLE funds may be used to pay for qualified disability expenses. These are expenses that enhance the health, independence, or quality of life for a person with a disability. They fall into broad categories such as education, housing, transportation, employment training and support, assistive technology, health, prevention and wellness, financial management and administrative services, legal fees, and other disability-related expenses that the ABLE account owner might have as a result of having a disability. For all expenses, it is important to save the receipts in your records as they may come in handy if the IRS or Social Security Administration ask questions.

What are the current contribution limits to an ABLE Account?
Jody: Currently, up to $18,000 may be directly deposited into an ABLE account each year. However, if the account holder is employed, they may be able to contribute more than $18,000. For example, an employed ABLE account holder who does not contribute to a retirement account can contribute an additional $14,580 from their earnings beyond the annual $18,000 limit. This amount is higher for residents of Alaska ($18,210) and Hawaii ($16,770).
What data can you share about the ABLE program?

Jody: As of 2024, 46 states and the District of Columbia offer ABLE accounts. At the end of December 2023, there were 162,969 active ABLE account holders with a combined asset total of more than $1.7 billion. The average balance for an ABLE account holder is $10,683. We have found that many people have used their ABLE savings to purchase an accessible home or vehicle.

How can people learn more about how ABLE is administered in their states? Could a person open an ABLE account from another state?

Jody: A good place to start is to find out what is offered within one's state of residence to see if there are specific advantages for those who select their state's ABLE plan. For example, some plans offer lower fees or a tax deduction - or they may have a favorable Medicaid payback policy for people who select their own state's ABLE plan. There are many state plans that allow out-of-state residents to enroll. To access more information, you can visit the Choose the program that's right for you page. You can also search state plans by using the state comparison tool.

How does saving in an ABLE account impact government benefits for people with disabilities?

Jody: ABLE savings will not affect Free Application for Federal Student Aid (FAFSA), Housing and Urban and Development (HUD) housing programs, Supplemental Nutrition Assistance Program (SNAP), or Medicaid, including Medicaid Waiver and Self-Direction Services. ABLE savings up to $100,000 do not affect eligibility for SSI. SSDI beneficiaries may save up to the ABLE plan limit based on state guidelines that currently range from $235,000 to $596,925. To learn more about ABLE and government benefits, we developed the Understanding ABLE and Public Benefits Decision guide.

Where can people learn more about how others are using ABLE accounts?

Jody: The ABLE National Resource Center (NRC) developed an initiative called the Ambassador Program that puts a spotlight on ABLE account owners and their family members to share their lived experiences about ABLE accounts with others. Currently, there are 29 ABLE ambassadors. These stories are shared on the ABLE NRC website on the Meet Our ABLE Ambassadors page.

What recent changes has Congress made that will impact ABLE in the future?

Jody: Congress recently passed the ABLE Age Adjustment Act (S. 331/H.R. 1219), which expands the eligibility requirements to open an ABLE account to include those with an onset of disability that began prior to turning age 46. This change will become effective in 2026. There are an estimated 8 million Americans eligible for ABLE accounts under the current eligibility requirements, which require onset of disability by age 26. With increased onset age, it is estimated that an additional six million people will be eligible, including 1.2 million more veterans. In total, we estimate 14 million people will be eligible for an ABLE account by January 1, 2026.
Jody: You can get more informed about ABLE by navigating the ABLE NRC webpage. To get periodic updates, you can to receive our quarterly newsletter. In addition, ABLE-related questions may be submitted via email at info@ablenrc.org. We are also active on social media and you can follow us at @ablenrc on , , , and to learn more about the positive impact an ABLE account can make in someone's life.
How can people learn more or continue to stay informed about ABLE?

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A Conversation About ABLE Accounts With Jody Ellis, Director, ABLE National Resource Center

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In April, ACL observes National Financial Capability Month, which was created to raise awareness of the importance of financial literacy - and the need for financial education - for all Americans. Understanding how to manage money is crucial to financial independence for everyone.