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Frequently Asked Questions

The State of Idaho is starting a new Behavioral Health Plan (IBHP) to advance mental health, substance use disorder and youth services. Magellan Healthcare, Inc. (Magellan) has been chosen to manage these services that have been, in the past, delivered by multiple commercial entities and state agencies. Starting July 1, 2024, Magellan will manage the entire system of care for Idaho, managing medically necessary mental health and substance use disorder services on behalf of the Department of Health and Welfare’s Division of Medicaid, Division of Behavioral Health (DBH), and Idaho Department of Juvenile Corrections. Magellan will oversee these services for Idahoans who qualify.

Who is Magellan Healthcare?

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.

What is an MCO?

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.

What is changing?

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.

When will the changes happen?

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

How will I know if this change will affect me?

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 late May 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.

What mental health and substance use disorder services will be covered through the Idaho Behavioral Health Plan (IBHP) (or by the managed care organization [MCO])?

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.

Will I be able to see the same providers after July 1, 2024?

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.

I contact Optum for help with outpatient, crisis, and/or Youth Empowerment (YES) services. Will that change?

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.

I contact BPA Health for help with substance use disorder services. Will that change?

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.

My provider or I work with Telligen or Medicaid for help with inpatient services. Will that change?

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.

I contact the Division of Behavioral Health (DBH) for help with services for my child or myself. Will that change?

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)
I contact Medicaid for help with psychiatric residential treatment facility (PRTF) services. Will that change?

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.

My child is currently in a psychiatric residential treatment facility (PRTF). Will they be able to stay there on/after July 1, 2024? Who will we work with when Magellan starts covering services?

Your child’s care will stay the same through this change. There should be no interruption in services.

You will get a letter from the IDHW in April. The letter will ask you to sign a document that will let Magellan see your child’s records before July 1, 2024.

If you sign the document and send it back to the IDHW: Magellan will send you a letter asking if we sit in on your child’s team meetings in May and June. 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 your child, you, and the team members 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 are not able to 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 and prepare for your next team meeting.

 

Who is eligible for services under the new Idaho Behavioral Health Plan (IBHP)?

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
I am a Tribal member; how do these changes affect me?

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.

How will the new program help me?

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.

How will I access services under the new program?

Magellan will send you a letter in late May 2024 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.

Will my benefits change?

Your benefits are not changing.

Who can I contact with more questions?

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.