Idaho Medicaid Eligibility and Enrollment
- Are you eligible for Medicaid in Idaho? Find out how Idaho Medicaid works, who is eligible to sign up and how it differs from Medicaid in other states.
Idaho Medicaid is a joint federal and state government partnership that provides healthcare services for people who are aged, blind, pregnant, disabled or under 18.
Most of the participants who may qualify for Idaho Medicaid are:
- Under age 19, or 65 and older
- Pregnant, blind or disabled
- The parent or caretaker relative responsible for a child under the age of 18
- Aged 19 through 64 with household income below 133% of the federal poverty level
- Women diagnosed with breast or cervical cancer and with income under 200% of the federal poverty level
Idaho Medicaid provides low-cost healthcare coverage to an estimated 357,000 eligible state residents mainly on the basis of financial and medical need.
What Benefits Does Idaho Medicaid Cover?
The basic plan for Idaho Medicaid is designed to provide health and wellness benefits for eligible adults who do not have special needs. This program covers routine medical treatments, annual physicals, counseling and mental health services, preventative care and emergency services.
The Idaho Medicaid Enhanced Plan is for people with disabilities and includes all the benefits of a basic plan. Participants under this plan need a referral from a doctor to be eligible.
Pregnant women in Idaho are eligible for Medicaid if they meet the guidelines for income and asset limits. The pregnancy coverage ensures women receive quality and timely prenatal and postpartum care for up to 60 days after delivery.
Who Is Eligible for Medicaid in Idaho?
Residents are eligible for Idaho Medicaid coverage if they meet all the federal guidelines, including income and asset limits. An enrollee must be a U.S. citizen and permanent resident in need of medically necessary treatment, and whose income is characterized as substantially low.
Beneficiaries must also be pregnant, blind, disabled or be a caretaker for a child 18 years of age or younger.
To qualify for Medicaid in Idaho, participants must earn less than the modified annual gross income (MAGI), which in 2021 is set to 133% of the federal poverty level.
In Idaho, this equates to earning:
- $12,800 annually for individual adults
- $26,500 annually for a family of four
Maximum qualifying incomes in Idaho are $16,971 for individuals and $34,846 for a family of four.
Children in Idaho are eligible for several Medicaid programs. These include programs designed for:
- Individuals with incomes under 190% of the federal poverty level
- Individuals with disabilities
- Individuals who have behavioral health needs
Children who live in a household with income over 138% of the federal poverty level may be eligible for the Children’s Health Insurance Program (CHIP) if their family earns less than $32,760 annually for a family of two, or $49,788 a year for a family of four. Pregnant women are eligible to sign up for Medicaid with an income of 133% of MAGI, though adult caretakers for children must earn less than 22% of MAGI to financially qualify for Medicaid for themselves.
How Do I Enroll in Medicaid in Idaho?
Residents eligible for Medicaid in Idaho can enroll in several ways. Applications are available through the Idaho Medicaid web portal. Once on the website, you will be asked to select your service — Medicaid for adults or Medicaid for children — and proceed with answering the prompts.
If you need help with your application, or if you have questions, contact the Idaho Medicaid offices at (877) 456-1233.
Contact Information for Idaho Medicaid
Find a local Idaho Department of Health and Welfare office online or email questions to the agency at Questions@dhw.idaho.gov.