Medicaid appeals in Idaho: hearing deadline and keeping benefits

Medicaid (Idaho Medicaid (Medicaid for Adults, Children's Medicaid and CHIP)) denials in Idaho

Medicaid agency

Idaho Department of Health and Welfare (DHW)

Who holds the hearing

Idaho Office of Administrative Hearings (OAH)

Hearing deadline

30 days

The date on your notice about the eligibility decision

How to ask for a hearing

• Form: Complete the DHW Fair Hearing Request form and mail it
• Mail: Idaho Department of Health and Welfare, Self-Reliance Programs, P.O. Box 83720, Boise, ID 83720-0026
• Online: Email a written request to mybenefits@dhw.idaho.gov
• Fax: 1-866-434-8278 (toll-free)
• Phone: 1-877-456-1233 (toll-free); you may be asked to send a written request or the form

publicdocuments.dhw.idaho.gov · 1-877-456-1233

Mail address

Idaho Department of Health and Welfare, Self-Reliance Programs, P.O. Box 83720, Boise, ID 83720-0026

Keeping your benefits during the appeal

To keep getting benefits while your appeal is considered, you must tell DHW within 10 days of the date of the notice. If your appeal is denied, you must repay the benefits you got during that time.

When the hearing is held

DHW first contacts you to discuss your concerns and reviews your case. Most hearings are held by phone before an independent hearing officer.

Medicaid health plan (managed care) in Idaho

Appeal to the plan first

If you get Idaho Medicaid services through a managed care plan, appeal the plan's decision to the plan first, following the instructions in its notice. After the plan's appeal decision, you can ask DHW for a fair hearing. The federal managed care rules apply. For decisions DHW itself makes about your Medicaid services, you have 28 days from the date on the notice to appeal.

Law: 42 CFR 438.402, 438.408, 438.420

Write my appeal: free letters

Letter: Medicaid fair hearing request