Does Idaho Have Medicaid? Income Limits, Applying, and Appeals

To qualify for Idaho Medicaid, most adults under 65 need household income at or below 138% of the federal poverty level, which is roughly $21,597 a year for a single person under the 2025 poverty guidelines.¹ Children, pregnant women, and people who are elderly or disabled fall under different rules, and some of those categories allow higher incomes or add asset limits. You also need to be an Idaho resident and either a U.S. citizen or a qualifying legal immigrant.²

Income Limits by Category

Idaho uses Modified Adjusted Gross Income (MAGI), based on what you report on your tax return, to decide most Medicaid cases. The limits break down by who you are and who else is in your household:

Adults under 65: income up to 138% of the FPL. Idaho added this group after voters approved Medicaid expansion in 2018, with coverage taking effect in 2020.¹
Pregnant women: income up to 138% of the FPL.¹
Children ages 0–5: family income up to approximately 147% of the FPL.
Children ages 6–18: family income up to approximately 138% of the FPL.³
CHIP: children under 19 whose family income is too high for Medicaid but within 185% of the FPL.³

Translating those percentages into dollars: the 2025 federal poverty level is $15,650 for one person and $32,150 for a family of four. At 138% FPL, a single adult qualifies with annual income up to about $21,597, and a family of four qualifies with income up to about $44,367. The poverty guidelines update every year, so the exact dollar cutoffs move with them.

If You’re 65 or Older, Blind, or Disabled

Idaho runs a separate Medicaid track for people who are 65 or older, blind, or living with a disability. This track isn’t based only on income. It also sets asset limits: $2,000 for an individual and $3,000 for a couple.⁴ Not everything you own counts. The home you live in and certain personal belongings are typically excluded.⁵ Qualifying individuals may also receive a small monthly cash payment through the Aid to the Aged, Blind, and Disabled (AABD) program.⁶

How to Apply

Before you start, pull together proof of identity (driver’s license, state ID, or passport), proof of your Idaho address (a utility bill or lease), and income documentation such as recent pay stubs or tax returns. You’ll also need information about everyone in your household and any existing health coverage.

Idaho accepts applications four ways:

Online through the Idalink portal at idalink.idaho.gov, Idaho’s self-service system for Medicaid, food assistance, cash assistance, and child care benefits.²
By mail or fax to the Self Reliance Programs office.
By phone through the Department of Health and Welfare customer service line.
In person at a local DHW office.

One point of confusion worth flagging: Your Health Idaho (yourhealthidaho.org) is the state’s marketplace for private insurance plans, not a Medicaid application portal. For Medicaid, use Idalink or one of the other methods above.

What Happens After You Apply

Federal rules give states 45 calendar days to process most Medicaid applications, and up to 90 days if the application is based on a disability.⁷ During that window, Idaho may mail you a request to verify household details. Respond quickly, because any delay on your end stretches the timeline.

You’ll get a written eligibility notice in the mail once a decision is made.² An approval notice tells you which coverage group you’re in and when benefits start. A denial explains the reason and your appeal rights.

Keeping Your Coverage

Medicaid isn’t a one-time enrollment. Idaho requires periodic recertification, and the Department of Health and Welfare will mail you the forms when it’s time. If you still meet the rules and complete the paperwork, your coverage continues without interruption.⁸ Missed renewals are one of the most common reasons people lose Medicaid, and it usually happens because the paperwork got set aside rather than because the person actually became ineligible. Treat any recertification notice from DHW as urgent.

If You’re Denied or Your Benefits Are Cut

If Idaho denies your application or reduces your benefits, you can request a “fair hearing,” which is an appeal reviewed by an independent hearing officer. You have 30 days from the date on your decision notice to file.⁹

Before any formal hearing, the department will contact you to talk through your concerns and recheck how your eligibility and benefits were calculated. That informal review sometimes settles things. If it doesn’t, your case goes to the Office of Administrative Hearings, where most hearings happen by phone. You can represent yourself or bring an attorney, relative, or friend to speak for you.⁹

To file, you can submit a Fair Hearing Request form by mail, send a written request by email or fax, or call to start the process. For Self-Reliance Programs appeals:

Mail: P.O. Box 83720, Boise, ID 83720-0026
Email: mybenefits@dhw.idaho.gov
Phone: 866-434-8278 or 877-456-1233 (both toll-free)

A detail that trips people up: if you want your current benefits to continue while the appeal is pending, you have to tell the department within 10 days of the date on your notice. Wait longer and your benefits may stop until the appeal is decided. And if you keep benefits during the appeal and lose, you’ll owe back the benefits you received during that period.⁹

1
Idaho Department of Health and Welfare. About Medicaid for Adults
2
Idaho Department of Health and Welfare. Apply for Medicaid
3
Medicaid.gov. Medicaid, Children’s Health Insurance Program, and Basic Health Program Eligibility Levels
4
Idaho Department of Health and Welfare. Medicaid Program Income Limits
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Idaho Department of Health and Welfare. About Medicaid for Elderly or Adults with Disabilities
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Idaho Department of Health and Welfare. About AABD Cash Assistance
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eCFR. 42 CFR 435.912 – Timely Determination and Redetermination of Eligibility
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Idaho Department of Health and Welfare. Manage My Adult Medicaid
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Idaho Department of Health and Welfare. Appeals and Fair Hearings