Medical Assistance In Kootenai County
Idaho law states that citizens should be responsible for paying for their own medical care. To the extent that is not possible, the
county and the state are required to offer some assistance.
What is the County Assistance Program?
County Assistance is a program created and controlled by state law designed to help Kootenai County residents in paying hospital
and medical bills in limited situations.
Am I eligible for assistance?
You must be a legal resident of the State of Idaho and Kootenai County.
You will be considered a resident of the State if:
a. You have actually lived in Idaho for a consecutive period of thirty (30) days; and
b. You do not live in the State on a temporary basis.
You will be considered a resident of Kootenai County if:
a. You have actually maintained a residence in Kootenai County for (30) days or longer
preceding the date of your application for assistance and
b. You do not live in Kootenai County on a temporary basis.
You must be "medically indigent". This means that your income and resources available to you are not sufficient to pay the
medical bills if payments were spread out over a period of 5 years.
Your income and resources include: All property, whether tangible or intangible, real (for example: land, house, building) or
personal, liquid or non-liquid, including, but not limited to, all forms of public assistance, crime victim's compensation,
worker's compensation, veteran's benefits, Medicaid, Medicare, and any other property from any sources for which you may be eligible
or in which you may have a vested interest.
Which medical services are covered?
To qualify for assistance, your medical services must be deemed as a "necessary medical service" under Idaho law. Your medical
records will be reviewed by utilizing a Medical Review process under Idaho Code 31.3503, 31-3508.
How do I apply for assistance?
Any person seeking assistance with payment of medical bills must do so by completing and filing an approved application form by
going to the Idaho Health and Welfare website. Once there you
need to click on the "Providers" tab. Under "State and County Medical Assistance" is where you will find the "Combined Application
for Assistance". You can also obtain a form at any hospital or at the Kootenai County Assistance Office at 451 Government Way,
Coeur d'Alene, ID 83814. Please use black or blue ink if filling out application in your own hand writing. Your signature
on the application must be notarized. Failure to have your signature notarized may result in your application being denied.
Your signature can be notarized at the Kootenai County Indigent Services office.
What do I do after I fill out my application?
After you have completed your application:
You must, without delay, bring your completed application to the County Assistance Office located at 451 Government Way,
Coeur d'Alene, ID 83814 the hours of 9:00-Noon and 1:00-5:00pm. (no applications will be accepted after 5:00 p.m.),
Monday - Friday. At that time a Claims Specialist will review your application to decide whether to conduct an interview immediately
or to schedule an interview for a later date. You should plan on staying for a 1-hour interview just in case. You may be scheduled
for a later interview after you've had a chance to gather some important financial documents and other information.
Please be advised that except in cases of an emergency room visit, it is important that your application be filed 10 days prior
to any medical services being provided to you. Otherwise, your application may be denied because it is untimely.
Please call our office to schedule an interview. If you have questions before you bring your completed application to the office
please call us at (208) 446-1880.
On a 10 day prior application, you must bring your completed application with you to the interview.
An interview will not be conducted unless you have the completed application with you.
You will not be allowed to use the interview time to complete your application.
What will the Claims Specialist do during the investigation?
The law requires that the Claims Specialist review your medical bills to ensure that the services, procedures and medicines are
covered for payment under the indigency statutes. The Claims Specialist will also ensure that your application is complete, was
filed timely, and then review all your available resources that could be used to pay for your medical bills.
When do I need to file my application?
If the medical service is not an emergency, you must file your application no later than ten (10) days prior to
If the medical service is an emergency, working with the hospital AND Health and Welfare, you must file your application within thirty-one (31) days beginning
with the first day of the provision of the medical service. If you will need additional treatment related to an original diagnosis
in accordance with a preapproved treatment plan, you must file your application ten (10) days prior to receiving the services.
A delayed application for necessary medical services may be filed up to one hundred eighty (180) days beginning with the first
day of the provision of necessary medical services provided that written documentation is included with the application or no later
than forty-five (45) days after an application has been filed showing that a bona fide application or claim has been filed for
Social Security Disability Insurance, Supplemental Security Income, third party insurance, Medicaid, Medicare, crime victim's
compensation, and/or worker's compensation.
Do I have to pay back the county for money spent on my behalf?
State law provides that if a county or the state provides any financial assistance to pay for medical services, the applicant
shall be obligated to reimburse the county and the State Catastrophic Health Care Cost Program for such reasonable portion as the
Board of County Commissioners may determine the applicant is able to repay over a reasonable period of time. Please click on this
link, Liens and Reimbursement for more information.
Is a Lien placed against my property?
YES. Idaho law provides that:
Upon application for financial assistance an automatic lien shall attach to all real and personal property of the applicant and on
insurance benefits to which the applicant may become entitled. The lien shall also attach to any additional resources to which it
may legally attach not covered above.
If my application is denied, can I appeal?
YES. You may appeal a denial of your application by filing a written Notice of Appeal with the Board of County Commissioners
(this can be filed in the office of County Assistance). Your Notice of Appeal must be filed within twenty-eight (28) days of the
date of the initial determination. If you do not file this appeal timely, the decision of the Board is final.
There is no cost to file an appeal.
Please be advised that the provider (doctor or hospital) has the legal right to file an
appeal on its own behalf if your application is denied and they may pursue the appeal, even if you choose not to.
If an appeal is timely filed, a hearing
will be scheduled before the Board of County Commissioners and you will receive a notice from this office giving you the time, date
and place of the hearing. You have the right to appear at the hearing and be heard by the Board regarding the denial of your
Violations and Penalties
It is a misdemeanor (crime) if an applicant or obligated person:
Willfully gives false or misleading information to a hospital, a county or an agent thereof, or to any individual in order to
obtain necessary medical services as or for a medically indigent person; or
obtains necessary medical services as a medically indigent person who fails to disclose insurance, worker's compensation, resources,
or other benefits available to him or her as payment or reimbursement of such expenses incurred.
You must cooperate in the application and investigation process!
Idaho law provides that:
Any applicant who fails to cooperate with a county or makes a material misstatement or material omission to a county in an
application pursuant to this chapter shall be ineligible for non-emergency assistance under this chapter for a period of two (2)
Any application or request which fails to meet the provisions of this section, and/or other provisions of this chapter [law] shall
Failure by the patient and/or obligated persons to complete the application process shall result in denial of the county assistance
If my application is approved, how soon will my doctor and hospital be paid?
State law requires payment within sixty (60) days of Board of Kootenai County Commissioners approval.