By Ruth Brown, Idaho Reports
This summer, insurance coverage for some disabled Idahoans will automatically shift after the state dropped Blue Cross of Idaho as its contracted provider for dual-enrollee recipients.
A dual-enrollee is a person enrolled in both Medicaid and Medicare. Dual-enrollees often have low income and complex healthcare needs. Recently, the state changed contracts for dual enrollment plans from Blue Cross of Idaho to United Healthcare, though the Blue Cross contract ended in June, and the United Healthcare contract didn’t begin until January 2026, causing concern about a gap in coverage.
But now, United Healthcare will start dual coverage in June.
In Idaho, about 26,000 people are enrolled in both Medicare and Medicaid. The federally funded Medicare acts as their primary insurance. Medicaid covers services that Medicare doesn’t, such as in-home care and behavioral health. It also covers Medicare premiums and offers expanded benefits for over-the-counter medical supplies and devices such as canes, disposable gloves, and adult diapers.
A letter from the Idaho Department of Health and Welfare to stakeholders, providers and enrollees, dated Feb. 5, stated “Effective June 1, 2025, dual members in (34 counties) are required to enroll in IMPlus with Molina Healthcare of Idaho or United Health Care, unless they choose to enroll in Molina’s Medicare Medicaid Coordinated Plan.”
In the remaining 10 counties, those people are unaffected by the transition from Blue Cross of Idaho to UnitedHealthcare as managed care is not available for dually eligible enrollees, according to IDHW spokesman AJ McWhorter. Idaho Medicaid pays through a fee-for-service model in those counties.
Dual enrollees on Medicaid or who are Molina members currently enrolled with Blue Cross of Idaho will be automatically enrolled in United’s IMPlus plan unless they choose to receive their benefits through Molina, according to the letter.
“Molina is the only health plan that will offer Medicaid-Medicare from June 1, 2025, to December 31, 2025. Coverage for the MMCP with United will be available starting on January 1,” the letter states.
The department also has a website for frequently asked questions, and said they will provide more information via U.S. mail in March.
Ruth Brown | Producer
Ruth Brown grew up in South Dakota and her first job out of college was covering the South Dakota Legislature. She’s since moved on to Idaho lawmakers. Brown spent 10 years working in print journalism, including newspapers such as the Idaho Statesman and Idaho Press, where she’s covered everything from the correctional system to health care issues. She joined Idaho Reports in 2021 and looks forward to telling stories about how state policy can impact the lives of regular Idahoans.