Idaho Medicaid Eligibility Requirements

This page provides general guidelines for the Idaho Medicaid eligibility requirements. This is an assistance program that provides medical coverage for low-income people of all ages. The department that handles the Medicaid program is Idaho Department of Health and Welfare. If you have questions or issues about the Medicaid application or the eligibility requirements, contact the Idaho Medicaid office.


Idaho Medicaid Overview

The Medicaid program is a federal and state funded program that serves needy individuals and families who meet financial and other eligibility requirements and certain other individuals who lack adequate resources to pay for medical care.


Idaho Medicaid Eligibility Requirements - Non Income

Regular Medicaid requires U.S. citizenship or legal immigration status, while Emergency Medicaid does not.


Documents Needed For Idaho Medicaid Application

  • If a U.S. citizen, proof of Citizenship and Identity
  • Social Security Number or proof that you applied for one
  • Resident Alien Card or other forms that show you live in Idaho (If not a citizen)
  • Proof of Income
  • Complete a Health Questionnaire
  • Most recent bank statements
  • Value of vehicles
  • Current value in stock/bonds, certificate of deposits, life insurance, trusts

Idaho Medicaid Benefits

Regular Medicaid: Depending on the plan chosen (Standard, Basic, Enhanced, and Medicare-Medicaid Coordinated), services include primary care, hospital services, lab/x-ray, physician services, midwife, nursing home coverage (over age 21), family planning, home health, emergency, medical transportation, preventive health, nutrition, prescription drugs, dental, vision, mental health, therapies, durable medical equipment and supplies, prosthetics/orthotics, school based services, nursing facility services, intermediate care facilities for developmentally challenged persons, psychosocial rehabilitation, private duty nursing, home & community-based waiver services.

Emergency Medicaid: Emergencies, deliveries but not prenatal or post-partum care, kidney dialysis, treatment for breast and cervical cancer.


Idaho Medicaid & CHIP Eligibility Levels

Below is the modified adjusted gross income (MAGI) eligibility levels for Idaho Medicaid and Children's Health Insurance Program (CHIP).

Eligibility Levels - By Percentage Of Federal Poverty Level (FPL)

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
No
Age 0-1: 142%
Age 1-5: 142%
Age 6-18: 133%
 185% Medicaid: 133%
CHIP: N/A		 24% N/A

Eligibility Levels - Individual By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
No
Age 0-1: $1,381
Age 1-5: $1,381
Age 6-18: $1,293
 $1,799 Medicaid: N/A
CHIP: N/A		 $233 N/A

Eligibility Levels - Family Of Two By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
No
Age 0-1: $1,861
Age 1-5: $1,861
Age 6-18: $1,743
 $2,425 Medicaid: $1,743
CHIP: N/A		 $3158 N/A

Eligibility Levels - Family Of Three By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
No
Age 0-1: $2,342
Age 1-5: $2,342
Age 6-18: $2,193
 $3,051 Medicaid: $2,193
CHIP: N/A		 $3968 N/A

Eligibility Levels - Family Of Four By Monthly Income

Medicaid Expansion Medicaid Children Separate CHIP Pregnant Women Parents Other Adults
No
Age 0-1: $2,822
Age 1-5: $2,822
Age 6-18: $2,643
 $3,677 Medicaid: $2,643
CHIP: N/A		 $477 N/A

Medicaid Eligibility

State Medicaid Office

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