UPDATE: In 2020, Medicaid requirements and application steps remain the same.
Learning how to qualify for Medicaid in Idaho is your crucial first step if you are interested in obtaining free or reduced-cost medical assistance from the Idaho Medicaid program. There are a number of Medicaid eligibility requirements for the Idaho Medicaid program and only those applicants who meet the Medicaid eligibility requirements may be accepted into the program.
Note that applicants who fall into different categories of income, living situations and disability may be subject to different criteria. To gain Idaho Medicaid benefits eligibility, you must meet all income-related and non-income related requirements that have been established by the state of Idaho.
So, if you are wondering, “What are the Medicaid application guidelines and how can I apply?” start by looking through the sections below:
- Income Requirements for Medicaid in Idaho
- What Are the Requirements for Medicaid in Idaho Which Are Not Income-related?
- Idaho Medicaid Eligibility Through Other Program Enrollment
Income Requirements for Medicaid in Idaho
For those asking, “Who is eligible for Medicaid in Idaho?” there is a simple answer: Residents with low incomes. The actual answer, however, is somewhat more complex. To obtain Medicaid benefits eligibility, defining the necessary income is essential.
The income required to meet Medicaid eligibility requirements is based on both the total income and the number of members in an applicant’s household. This is standard in every state within the nation that offers the Medicaid assistance program.
Regarding how to qualify for Medicaid based on income, your household income (based on your family’s size) must not exceed 138 percent of the Federal Poverty Level. For instance, if you are the only member of your household, you can earn a maximum annual income of $16,395 and still be eligible to receive Medicaid.
In the event that your household is composed of two individuals, you are allowed to earn $22,108 and still receive state medical assistance. As the number of members in your household increases, your maximum allowable income increases, according to the following chart:
- 3 members: $27,821
- 4 members: $33,534
- 5 members: $39,248
- 6 members: $44,961
- 7 members: $50,688
- 8 members: $56,429
- 9 members: $62,169
- 10 members: $67,910
- 11 members: $73,651
- 12 members: $79,392
If your household has more than 12 members, simply add $5,741 for each additional member of your household. The total will determine how much income you are allowed to earn and still receive benefits from the Idaho Medicaid program.
As long as your income is below the threshold, you may financial Medicaid eligibility requirements. Explore the different Medicaid qualifications by downloading our informative guide.
What Are the Requirements for Medicaid in Idaho Which Are Not Income-related?
Beyond the Idaho Medicaid eligibility requirements related to household income, the Medicaid program may also require prospective beneficiaries to meet various other qualifying criteria. Medicaid benefits eligibility can only be obtained by U.S. citizens or legal residents who are also Idaho state residents. Moreover, applicants must be considered in need of medical insurance assistance or health care, and (as mentioned above) they must be considered low-income or very low-income.
Beyond the income, residency/citizenship and medical necessity based Medicaid eligibility requirements, certain groups of individuals are automatically granted access to medical assistance benefits in Idaho. Applicants who are 65 years of age or older, for instance, can get medical assistance from Medicaid.
In addition to elderly people, Medicaid benefits eligibility is also granted automatically to residents of the state who are blind and those who have other disabilities. While learning how to qualify for Medicaid in ID, you may wonder what other groups are eligible to receive medical help. Each of the following groups of individuals can get Medicaid benefits.
If you are pregnant or you live in an intermediate care home or nursing facility, you can get Medicaid. If you are younger than 21 years of age, you also qualify. If you have been in the United States for a limited duration of time as a refugee, you can receive medical assistance, as well.
In addition, participants of Breast and Cervical Cancer Treatment Programs are eligible for benefits through the Medicaid program. Parents or caretakers of children younger than 21 can also be accepted as beneficiaries of Medicaid if the child’s parent is:
- Not living with the child
So long as you can provide proof of your income and your other eligibility qualifications when you apply for medical assistance benefits, you will be accepted into the program. Download our helpful guide to learn about the different eligibility qualifications for Medicaid.
Idaho Medicaid Eligibility Through Other Program Enrollment
Multiple methods are available for how to qualify for Medicaid coverage in Idaho. However, there is another way to determine who is eligible for Medicaid in Idaho. Applicants that are already members of certain other accepted state programs such as SSI and TANF, where they may also receive medical assistance from Medicaid.
In the event you receive benefits from any of these other programs within the state, you can apply for Medicaid assistance as well. You will get the medical help required to maintain your health and the health of every member of your household. Simply review the Medicaid eligibility requirements provided above concerning income, residency, citizenship and other factors in order to verify your qualifications before submitting an application.
If your application is deemed to be non-eligible, you may appeal the decision. In most cases, you will have 90 days from the action. Once your appeal request is received, the Idaho Department of Health Care Services will make a ruling regarding your application within 45 days of its receipt. If your application is approved after the IDHW’s reconsideration, you and your household will begin to receive medical assistance benefits through the Medicaid program.