Idaho Medicaid Income Limits (2026)

Idaho Medicaid covers approximately 412,000 Idahoans as of early 2026, representing roughly 22% of the state's population. Idaho adopted the Affordable Care Act's Medicaid expansion on January 1, 2020, following a decisive 2018 ballot initiative (Proposition 2) that passed with 60.6% of the vote. The expansion added coverage for adults ages 19-64 with income at or below 138% of the Federal Poverty Level, a population previously excluded from Idaho Medicaid unless they were pregnant, disabled, elderly, or parents of dependent children meeting a much lower income test. The Idaho Department of Health and Welfare (DHW) administers Idaho Medicaid through its Division of Medicaid. For 2026, the adult Idaho Medicaid income threshold is $22,032 per year for a single individual and $45,540 per year for a household of four, both set at 138% of the 2026 Federal Poverty Level as published by the U.S. Department of Health and Human Services at aspe.hhs.gov.

Idaho Medicaid eligibility divides into MAGI (Modified Adjusted Gross Income) categories and asset-tested categories. The three main MAGI groups are adults ages 19-64 qualifying at 138% FPL, children qualifying for Medicaid or Idaho CHIP, and pregnant women qualifying at 138% FPL per Idaho DHW's published 2026 income limits. These MAGI groups have no asset or resource test. Asset-tested categories cover aged adults 65 and older, blind individuals, and people with disabilities under SSI-related rules, as well as long-term care and Home and Community-Based Services (HCBS) populations. Idaho also operates specialty programs including the Katie Beckett program for children with disabilities (income limit $3,002/month), Medicaid for Workers with Disabilities (MWD), and the Youth Empowerment Services (YES) program for youth transitioning out of foster care. The income limits table below reflects the 2026 thresholds for the three largest populations: adults, children (Medicaid and CHIP combined), and pregnant women.

Idaho Medicaid services cover doctor visits, hospital care, prescription drugs, mental health and substance use disorder treatment, dental care, vision, home health, and long-term care. Idaho Medicaid uses a managed care model for most populations through coordinated care organizations. The state participates in the federal Continuous Eligibility mandate that has required 12-month continuous enrollment for children since January 2024, meaning covered children cannot lose Medicaid mid-year due to income fluctuations. Idaho's CHIP program covers children under age 19 in households with income between the Medicaid limit and 190% FPL, with low-cost premiums on a sliding scale. Understanding which Idaho Medicaid income threshold applies to your household is the starting point for determining coverage. The table below shows 2026 income limits by household size, drawn from the Idaho Department of Health and Welfare's official Medicaid Program Income Limits page at healthandwelfare.idaho.gov.

Idaho Medicaid (Idaho Department of Health and Welfare) income limits by household size (2026)

Idaho Medicaid income limits 2026 by household size. Adult column = ACA expansion threshold (138% FPL). Children column = Idaho CHIP limit (190% FPL). Pregnancy column = Idaho pregnancy Medicaid limit (138% FPL per DHW 2026 published guidelines). Figures are from the Idaho Department of Health and Welfare Medicaid Program Income Limits page, effective January 2026.

Idaho Medicaid (Idaho Department of Health and Welfare) eligibility requirements (non-income)

Idaho Medicaid eligibility depends on income, categorical group, Idaho residency, and citizenship or immigration status. Income is the primary gate for the three MAGI categories (adults, children, pregnant women); the asset test applies only to aged, blind, disabled (ABD), long-term care, and HCBS populations. Below are the non-income criteria that apply across Idaho Medicaid populations.

• Idaho residency: The applicant must reside in Idaho with intent to remain. Individuals who are temporarily in Idaho, in transit, or who have established residency in another state do not qualify. Residency is established through a physical Idaho address with supporting documentation such as a lease, utility bill, postmarked mail, or a letter from a shelter or social service agency.
• Citizenship and immigration status: U.S. citizens and nationals qualify. Lawful permanent residents (green card holders) who arrived before August 22, 1996, qualify immediately for most categories. Those who arrived after August 22, 1996, must satisfy a 5-year waiting period before most full-benefit Medicaid categories are available to them. Refugees, asylees, and certain other humanitarian immigration statuses may qualify sooner or immediately. Undocumented individuals do not qualify for full Idaho Medicaid, but may receive emergency Medicaid coverage for acute life-threatening conditions.
• Social Security Number: All applicants for whom coverage is sought must provide a Social Security Number (SSN) or proof that an SSN application has been filed. Applicants may apply on behalf of household members who have an SSN even if the applicant themselves does not have one. This requirement does not prevent emergency Medicaid coverage.
• Age and category: Adults ages 19-64 qualify under the ACA expansion group at 138% FPL without needing a dependent child, disability, or pregnancy (the expansion removed the prior categorical requirement). Children birth through age 18 qualify for Idaho Medicaid at or below 138% FPL, and for Idaho CHIP up to 190% FPL. Children ages 19-20 may qualify in certain categories. Pregnant women qualify under pregnancy Medicaid at 138% FPL per Idaho DHW's 2026 published income limits, with postpartum coverage extending 12 months after delivery under the federal continuous postpartum coverage rule. Adults 65 and older qualify under aged Medicaid subject to asset-test rules.
• Asset test (ABD and long-term care only): MAGI categories (adults, children, pregnant women) have no asset test since the ACA. Aged, blind, and disabled (ABD) and long-term care categories apply the SSI-linked resource limit: $2,000 for an individual and $2,000 each for a couple. For long-term care (nursing home Medicaid), Idaho enforces the 60-month lookback period for asset transfers. Community spouse resource allowances apply to protect a portion of assets for the at-home spouse when one spouse enters a nursing facility.
• Other health coverage: Having employer-sponsored or private health insurance does not automatically disqualify an applicant from Idaho Medicaid. Idaho Medicaid is the payer of last resort; other insurance pays first. Medicare enrollees may qualify for Idaho Medicaid as dual-eligibles, or for Medicare Savings Programs (QMB, SLMB, or QI) administered through DHW. Work requirements for ACA expansion adults are under federal development and expected to begin in January 2027 under reconciliation legislation passed in 2025; Idaho DHW will publish implementation details as they become available.
• Continuous eligibility for children: Under the federal Medicaid Continuous Eligibility mandate effective January 2024, children enrolled in Idaho Medicaid or Idaho CHIP cannot be disenrolled before completing 12 months of coverage due to income fluctuations. This means a child enrolled in early 2026 will remain covered through at least early 2027 unless the family moves out of Idaho or another disqualifying event occurs.

What income counts for Idaho Medicaid (Idaho Department of Health and Welfare)

Idaho Medicaid uses Modified Adjusted Gross Income (MAGI) rules to calculate income for adults, children, and pregnancy categories. MAGI is generally equal to the adjusted gross income (AGI) from a federal tax return with a few additions. Idaho does not apply a state-specific disregard on top of the federal calculation for the standard adult expansion group, so the published thresholds ($22,032 per year for a single adult in 2026) reflect the full 138% FPL limit without an additional disregard buffer. Knowing what counts and what is excluded is critical, because including non-countable income in your calculation may incorrectly suggest you are over the limit.

Income sources included

• Wages, salaries, and tips from employment (W-2 income) for all household members. This includes overtime pay, bonuses, commissions, and any other earned compensation from an employer, regardless of whether the employment is full-time, part-time, or seasonal.
• Net self-employment earnings, calculated as gross revenue minus ordinary and necessary business expenses. Self-employment income is reported on IRS Schedule C, Schedule F (for farming), or Schedule SE. Gig-economy earnings, freelance income, and income from a sole proprietorship all count as self-employment income for MAGI purposes.
• Unemployment compensation, including regular Idaho state unemployment benefits and any federal supplemental unemployment benefits received during the year. All unemployment payments are counted in full as MAGI income.
• Social Security retirement and survivor benefits (the taxable portion included in adjusted gross income). Social Security Disability Insurance (SSDI) benefits are also counted. Important distinction: Supplemental Security Income (SSI) is NOT counted even though SSDI is counted.
• Interest and dividend income, including taxable interest from savings accounts, certificates of deposit, bonds, and similar instruments, as well as dividends from stocks, mutual funds, and exchange-traded funds. Capital gain distributions from mutual funds are also included.
• Capital gains from the sale of assets, including stocks, real estate, and other investments. Both short-term and long-term capital gains are included in MAGI. Note that the gain (not the gross sale proceeds) is what counts; a $200,000 home sale that yields a $20,000 capital gain adds $20,000 to MAGI, not $200,000.
• Pension, retirement account, and annuity distributions. Traditional IRA and 401(k) distributions are counted in full as MAGI income. Roth IRA qualified distributions (from accounts held more than 5 years and taken after age 59.5) are excluded. Pension payments from employer-sponsored retirement plans are counted.
• Net rental income from property owned by household members, calculated as gross rents received minus allowable rental expenses (mortgage interest, property taxes, depreciation, maintenance). Rental income is reported on IRS Schedule E. Short-term rental income from platforms such as Airbnb or VRBO is also counted.

Income sources excluded

• Supplemental Security Income (SSI): SSI payments are excluded from MAGI income. SSI recipients in Idaho are automatically linked to Idaho Medicaid without a separate income eligibility determination. Do not confuse SSI with SSDI: SSDI is counted, SSI is not.
• Child support received: Payments received from a noncustodial parent as child support are not counted as income for the MAGI household, regardless of the amount. Child support paid out by a household member is also not deducted from MAGI income.
• Veterans' benefits: VA disability compensation, GI Bill educational stipends, VA pension payments, and other veterans' benefit payments are not counted as MAGI income. Idaho has a large veteran population, and many Idaho veterans who might otherwise assume they are over-income may qualify for Idaho Medicaid when VA benefits are properly excluded.
• Workers' compensation: Payments received for a work-related injury or illness, including both lost-wages payments and medical expense reimbursements from workers' compensation, are excluded from MAGI income.
• Gifts and inheritances: One-time transfers such as monetary gifts from family members, bequests from an estate, and life insurance death benefit proceeds are not counted as MAGI income. However, if inherited assets generate ongoing income (such as dividends from inherited stock), that ongoing income does count.
• SNAP, TANF, and other federal need-based assistance: Food and nutrition benefits (SNAP), Temporary Assistance for Needy Families (TANF) cash assistance, Low Income Home Energy Assistance Program (LIHEAP) payments, and most other federal need-based benefit payments are not counted as MAGI income.

How to apply for Idaho Medicaid (Idaho Department of Health and Welfare) in Idaho

Idaho Medicaid applications are processed through the Idaho Department of Health and Welfare (DHW), Self Reliance Division. The primary application channel is idalink.idaho.gov, Idaho's online self-service portal where applicants can apply for Medicaid, food assistance (SNAP), cash assistance (TANF), and child care assistance all in one application. The same online application covers both Idaho Medicaid and Idaho CHIP, so there is no need to file separate applications for each program. Applicants can also apply by phone at 1-877-456-1233, by fax or mail using a paper form, or in person at a local DHW office.

1. 1. Gather your documents before starting: photo ID for the head of household, Social Security Numbers or cards for every household member applying for coverage, proof of Idaho residency (lease, utility bill, or postmarked mail), proof of U.S. citizenship or qualifying immigration status (birth certificate, U.S. passport, or permanent resident card), and income documentation for the past 30 days (pay stubs, award letters for Social Security or pension, or a signed statement if income is zero).
2. 2. Create an account at idalink.idaho.gov, or call DHW at 1-877-456-1233 Monday through Friday, 8 a.m. to 5 p.m. Mountain Time. The online application can be completed in approximately 20 minutes and is available 24 hours a day. Translation assistance is available by phone.
3. 3. Complete the online application: list all household members who need coverage, report all income sources for the past 30 days, and identify the Idaho programs you are applying for. The idalink system will automatically evaluate your eligibility for Medicaid, CHIP, SNAP, and other programs based on the information provided.
4. 4. Upload or submit supporting documents through the idalink document upload feature. Accepted formats include PDF, JPG, and common image formats. If you prefer to submit documents by fax, fax to 1-866-434-8278. By mail, send to: Self Reliance Programs, PO Box 83720, Boise, ID 83720-0026. DHW may also verify some income and citizenship information electronically.
5. 5. Respond promptly to any request for additional information from DHW. The agency will send a notice requesting any missing documentation; failure to respond within the specified timeframe is one of the most common reasons Idaho Medicaid applications are denied. Respond as quickly as possible to avoid delays.
6. 6. Await your eligibility determination. DHW has up to 45 days to process and decide standard Idaho Medicaid applications. Pregnancy applications receive expedited processing and are typically decided within 15 days. If approved, you will receive a notice of approval, your Medicaid card, and information about managed care enrollment. If denied, the notice will include the reason and instructions for appealing.

Official portal: idalink.idaho.gov

Documents needed

• Photo ID for the head of household (Idaho driver's license, state ID card, U.S. passport, tribal ID, or other government-issued photo ID)
• Social Security Number or proof of pending SSN application for every household member who is applying for coverage
• Proof of Idaho residency: a current lease or rental agreement, a recent utility bill, a piece of postmarked mail addressed to the applicant at an Idaho address, or a letter from a shelter or social service organization
• Proof of U.S. citizenship or qualifying immigration status (birth certificate, U.S. passport, Certificate of Naturalization, Certificate of Citizenship, or Permanent Resident Card / Form I-551)
• Income verification for the past 30 days: pay stubs for employed household members; award letters for Social Security, SSDI, or pension income; Schedule C or profit and loss statement for self-employed applicants; or a signed zero-income statement if the household has no current income
• For pregnant women: a provider verification of pregnancy (clinic note, a letter from a licensed health care provider, or a Medicaid-approved pregnancy verification form from a licensed Idaho health provider)

Processing timeline: Standard Idaho Medicaid applications are decided within 45 days of the application date per DHW policy. Pregnancy Medicaid applications receive expedited processing and are typically decided within 15 days under federal rules. Applications for aged, blind, or disabled (ABD) categories may take 60-90 days because they require a medical disability determination. If DHW requests additional information, applicants should respond promptly because the clock may pause pending the response.

Common reasons applications get denied

• Household MAGI income exceeds the 138% FPL threshold for the applicant's category (the most common single reason for denial). Review all income sources carefully using the includes and excludes list to confirm whether your income is correctly calculated before submitting.
• Failure to provide requested documentation within DHW's specified response window. DHW sends a notice requesting additional proof; if the household does not respond in time, the application is denied without prejudice and a new application must be filed.
• Failure to establish Idaho residency: the applicant cannot document a current Idaho address, or DHW finds evidence that the applicant is residing in another state.
• Immigration status does not meet eligibility requirements: undocumented applicants and some visa holders do not meet the citizenship or qualifying immigration status requirement for full Idaho Medicaid. Emergency Medicaid remains available for acute conditions regardless of immigration status.
• Duplicate enrollment in another state's Medicaid: if DHW determines the applicant is already enrolled in another state's Medicaid program, the Idaho application will be held until the applicant disenrolls from the other state. A person may only be enrolled in one state's Medicaid program at a time.

If your child's family income is above the Idaho Medicaid limit: Idaho CHIP

Idaho Medicaid covers children under age 19 in households with income at or below 138% of the Federal Poverty Level ($45,540 per year for a family of four in 2026). Children in households with income above 138% FPL and at or below 190% FPL qualify for Idaho CHIP (Children's Health Insurance Program). The 190% FPL CHIP threshold equals $62,700 per year for a family of four in 2026. Idaho CHIP covers doctor visits, hospital care, dental, vision, hearing, immunizations, mental health services, and prescription drugs. There may be a small monthly premium on a sliding scale based on income. Children current on well-child checkups and immunizations may receive a $10 reduction in their monthly CHIP premium. The same idalink.idaho.gov application covers both Medicaid and CHIP; DHW automatically evaluates children for both programs when you apply.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older with limited income: Idaho Medicare Savings Programs

Idaho runs three Medicare Savings Programs (MSPs) for low-income Idaho residents who are already enrolled in Medicare. These programs are administered through the Idaho Department of Health and Welfare (DHW) and help Medicare beneficiaries pay for Medicare premiums, deductibles, and cost-sharing. For 2026, Idaho MSP monthly income limits are: Qualified Medicare Beneficiary (QMB) at $1,350 per month for individuals and $1,824 per month for couples (QMB covers Part A and Part B premiums, deductibles, and copays); Specified Low-Income Medicare Beneficiary (SLMB) at $1,616 per month for individuals and $2,184 per month for couples (SLMB pays the Part B premium only); and Qualifying Individual (QI) at $1,816 per month for individuals and $2,455 per month for couples (QI also pays the Part B premium). Approximately 12 million Americans nationwide are dual-eligible for both Medicare and Medicaid. Idaho residents can apply for MSPs through the same idalink.idaho.gov portal or by calling DHW at 1-877-456-1233.

Read the Medicare eligibility guide

Frequently Asked Questions