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Idaho Medicaid Qualifications

The Idaho Medicaid Plan matches the standard state plan required by the federal government. It has mandatory minimum health benefits for at-risk groups of the population. Idaho Medicaid also offers three benchmark benefit plans. The basic plan is for low-income children and adults with eligible children. The enhanced plan is for people with disabilities or other special health needs. The Medicare-Medicaid Coordinated plan is for people who are enrolled in both Medicare and Medicaid. According to the Kaiser Family Foundation, 19 percent of Idaho's population is enrolled in Medicaid.

  1. Eligible Groups

    • Medicaid was created to help certain groups of people who were found to be more in need of medical care and less likely to be able to afford it. The groups are children younger than age 19, the parents or guardians of these children, pregnant women, women who have breast or cervical cancer, senior citizens over age 65 and anyone who is blind or disabled.

    General Eligiblilty

    • If you belong to one of the eligible groups, you still must meet other eligibility criteria before receiving Medicaid in Idaho. You must be a U.S. citizen or a legal immigrant. You must reside in Idaho. You must also meet the financial resource limits and household income limits for the number of people in your household.

    Income Limits

    • For household Medicaid coverage with eligible children, a household of two people can earn no more than $2,247 a month in 2011, pregnant women can earn no more than $1,615 a month and an adult with an eligible child can earn no more than $251 a month. These numbers gradually increase with each additional person in the household until at eight members, the limits are $5,706; $4,102 and $645 a month, respectively. If the household grows any larger, the limits increase $577, $415 and $65 a month, respectively, for each additional person.

    Elderly and Disabled

    • The limits differ for the elderly and disabled. The first difference is that the household size can be no larger than two people. For a couple where one of them is disabled or over 65, the income limit is no more than $1,011 a month in 2011. For a couple where one of them is disabled and needing long-term care or over 65 and needing long-term care, the income limit is $4,044 a month. For a couple where one of them is disabled but working, the income limit is $6,071 a month.

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