Idaho Medicaid income limits for 2025 depend on your household size and program type. Most adults qualify with income up to 138% of poverty level.
Children and pregnant women may qualify at higher limits.
Page Contents
- 1 2025 Income Limits for Adults
- 2 Income Limits for Children
- 3 Pregnant Women Coverage
- 4 Seniors and Disabled Adults
- 5 What Income Counts?
- 6 How to Apply for Idaho Medicaid
- 7 How Long Does Approval Take?
- 8 Common Questions About Idaho Medicaid
- 8.1 What is the income limit for Idaho Medicaid in 2025?
- 8.2 Does Idaho Medicaid have an asset limit?
- 8.3 How do I know if my income qualifies?
- 8.4 What income counts for Medicaid eligibility?
- 8.5 Do pregnant women qualify for Idaho Medicaid?
- 8.6 What are income limits for children?
- 8.7 What are limits for seniors and disabled adults?
- 8.8 How do I apply for Idaho Medicaid?
- 8.9 What if I earn too much for Medicaid?
- 8.10 Does Idaho have a work requirement for Medicaid?
- 9 Federal Poverty Level Explained
- 10 Why These Limits Matter
- 11 Medicaid Expansion in Idaho
- 12 Special Programs and Waivers
- 13 What If You Don’t Qualify?
- 14 Take Action Today
- 15 About the Author
- 16 Sources and References
Quick Summary:
- ✓ Adults qualify for Idaho Medicaid expansion at 138% FPL
- ✓ Children ages 0-5 qualify at 147% FPL
- ✓ Pregnant women qualify at 138% FPL
- ✓ Seniors and disabled adults have different income limits
- ✓ CHIP covers children up to 190% FPL
- ✓ Most programs have no asset test
2025 Income Limits for Adults
Idaho expanded Medicaid in 2018. Adults under 65 now qualify.
You can earn up to 138% of poverty level. That means different amounts for different family sizes.
Adult Medicaid Income Chart 2025:
| Family Size | Yearly Income | Monthly Income |
|---|---|---|
| 1 person | $21,597 | $1,800 |
| 2 people | $29,187 | $2,433 |
| 3 people | $36,777 | $3,065 |
| 4 people | $44,367 | $3,697 |
| 5 people | $51,957 | $4,330 |
| 6 people | $59,547 | $4,962 |
| 7 people | $67,137 | $5,595 |
| 8 people | $74,727 | $6,228 |
Bigger Families:
Add $5,500 per year for each extra person. That’s about $458 per month.
Example: A family of 10 can earn up to $85,727 yearly and still qualify.
Income Limits for Children
Young children can qualify at higher income levels.
Children Ages 0-5
Children under 6 qualify at 147% of poverty level.
That’s about $23,006 yearly for one child in the household.
This helps more families get health coverage for babies and toddlers.
Children Ages 6-18
Children 6 to 18 qualify at 138% of poverty level.
Same limits as adults shown in the table above.
CHIP Program (Children’s Health Insurance)
Children can get CHIP up to 190% poverty level.
That’s $29,735 yearly for a family of one.
CHIP helps families who earn too much for Medicaid but still need help with healthcare costs.
You can check your exact Medicaid income limits 2025 by state to compare Idaho with other states.
Pregnant Women Coverage
Pregnant women qualify at 138% of poverty level in Idaho.
This covers prenatal care, delivery, and hospital costs.
Medicaid pays for doctor visits during pregnancy. It also covers ultrasounds and lab tests.
Important:
Coverage ends 60 days after birth.
Idaho has not extended postpartum coverage to 12 months yet. Many other states now offer 12 months of postpartum Medicaid.
Plan ahead for coverage after your baby is born.
Seniors and Disabled Adults
If you are 65 or older, blind, or disabled, different rules apply.
Idaho uses Social Security disability criteria to decide who qualifies as disabled.
Income Limits for Aged, Blind, and Disabled:
| Program Type | Single Person | Married Couple |
|---|---|---|
| Regular Medicaid (ABD) | $1,020/month | $1,470/month |
| Nursing Home Care | $2,921/month | $5,822/month |
| Home Services (HCBS Waiver) | $2,921/month | $5,822/month |
Asset Limits for Seniors:
- Single person: $2,000 in countable assets
- Married couple: $3,000 in countable assets
- Your home usually doesn’t count
- One car usually doesn’t count
- Life insurance under $1,500 doesn’t count
Long-term care Medicaid has higher income limits. This is for nursing homes and home care services.
You must also meet level-of-care requirements. A doctor must say you need nursing home care.
What Income Counts?
Idaho counts almost all income sources when checking eligibility.
Income That Counts:
- Wages from jobs
- Social Security retirement benefits
- SSI (Supplemental Security Income)
- Pension payments
- Unemployment benefits
- Child support received
- Alimony payments
- IRA or 401k withdrawals
- Stock dividends
- Rental income
- Interest from savings
Good News:
VA Aid and Attendance benefits above basic VA pension do NOT count as income in Idaho.
This helps veterans qualify more easily.
How to Apply for Idaho Medicaid
You can apply for Idaho Medicaid in three easy ways.
1. Apply Online
Visit the Idaho Health and Welfare website.
Create an account and fill out the application.
You can save your progress and come back later.
2. Apply by Phone
Call 1-877-456-1233
Hours: Monday through Friday, 8 AM to 5 PM Mountain Time
A specialist will help you apply over the phone.
3. Apply in Person
Visit your local Health and Welfare office.
Bring your documents with you.
A caseworker will help you fill out forms.
What You Need to Apply:
- Proof of identity (driver’s license or state ID)
- Social Security numbers for everyone applying
- Proof of income (recent pay stubs or tax returns)
- Proof you live in Idaho (utility bill or lease)
- Immigration documents if not born in the U.S.
How Long Does Approval Take?
Idaho usually decides within 45 days for most applications.
Disability applications can take up to 90 days.
You may get coverage faster in emergency situations.
If approved, coverage often starts the month you applied. Sometimes it starts the month you became eligible.
Common Questions About Idaho Medicaid
What is the income limit for Idaho Medicaid in 2025?
Adults under 65 can earn up to 138% of poverty level.
That’s $21,597 per year for one person.
A family of four can earn up to $44,367 per year.
Children ages 0-5 qualify at higher limits (147% FPL).
Does Idaho Medicaid have an asset limit?
No asset limit for most adults.
You can have savings and still qualify based on income alone.
Seniors and disabled adults do have asset limits:
Single person: $2,000
Married couple: $3,000
Your home and one car usually don’t count.
How do I know if my income qualifies?
Take the poverty level for your family size. Multiply by 1.38.
Example for one person:
Base poverty level: $15,060
Multiply: $15,060 × 1.38 = $21,597
You qualify if you earn less than $21,597 per year
Example for family of four:
Base poverty level: $31,200
Multiply: $31,200 × 1.38 = $43,056
You qualify if you earn less than $44,367 per year
What income counts for Medicaid eligibility?
Almost all income counts:
Income that counts:
Wages from your job
Social Security benefits
SSI payments
Pension money
Unemployment benefits
Child support you receive
Alimony payments
IRA withdrawals
Income that does NOT count:
VA Aid and Attendance benefits (above basic VA pension)
Holocaust restitution payments
Do pregnant women qualify for Idaho Medicaid?
Yes. Pregnant women qualify at 138% poverty level.
Medicaid covers prenatal care, delivery, and hospital costs.
Important: Coverage ends 60 days after birth.
Idaho has not extended postpartum coverage to 12 months like other states.
Plan for coverage after your baby arrives.
What are income limits for children?
Children have different limits based on age:
Ages 0-5:
Up to 147% poverty level
About $23,006 per year for single child
Ages 6-18:
Up to 138% poverty level
Same as adults
CHIP (Children’s Health Insurance):
Up to 190% poverty level
About $29,735 per year for one child
CHIP helps families who earn too much for Medicaid
What are limits for seniors and disabled adults?
Seniors (65+) and disabled adults have lower limits:
Regular Medicaid:
Single person: $1,020 per month
Married couple: $1,470 per month
Nursing home or home care:
Single person: $2,921 per month
Married couple: $5,822 per month
Plus asset limits:
Single: $2,000
Married: $3,000
How do I apply for Idaho Medicaid?
You have four ways to apply:
1. Online: Visit Idaho Health and Welfare website
2. By phone: Call 1-877-456-1233 Monday-Friday, 8 AM to 5 PM
3. In person: Visit your local Health and Welfare office
4. By mail: Mail application to: Self Reliance Programs PO Box 83720 Boise, ID 83720-0026
What to bring:
ID or driver’s license
Proof of income (pay stubs)
Proof you live in Idaho (utility bill)
Social Security numbers
What if I earn too much for Medicaid?
You may qualify for help through the health insurance marketplace.
Visit Your Health Idaho to shop for plans.
You might get tax credits to lower your monthly premium.
Spenddown option: If you have high medical bills, you might still qualify.
Medical expenses can be subtracted from your income.
This helps you meet the income limit.
Does Idaho have a work requirement for Medicaid?
No work requirement right now.
Idaho tried to add a work requirement in 2019. It was not approved.
New legislation passed the Idaho House in 2025. It has not become law yet.
Until approved, there is no work requirement in Idaho.
Federal Poverty Level Explained
The Federal Poverty Level (FPL) is set by the U.S. government each year.
It shows the minimum income a family needs to meet basic needs.
States use this number to set Medicaid limits.
2025 Federal Poverty Levels:
- 100% FPL for 1 person = $15,060 yearly
- 100% FPL for 2 people = $20,440 yearly
- 100% FPL for 3 people = $25,820 yearly
- 100% FPL for 4 people = $31,200 yearly
Idaho Medicaid uses percentages of FPL. For example, 138% FPL means you multiply the base amount by 1.38.
The HHS poverty guidelines are updated every January.
Why These Limits Matter
Income limits decide who gets help with healthcare costs.
If you qualify, Medicaid covers:
- Doctor visits and checkups
- Hospital stays and surgeries
- Prescription medications
- Lab tests and X-rays
- Mental health services
- Substance abuse treatment
- Emergency care
Many working families qualify for Idaho Medicaid. You don’t have to be unemployed.
Even if you work full-time, you might still qualify. It depends on family size and total income.
Single adults making $21,597 or less can qualify. A family of four making $44,367 or less can get coverage.
Medicaid Expansion in Idaho
Idaho voters approved Medicaid expansion in November 2018.
The program started in January 2020.
Before expansion, childless adults couldn’t get Medicaid. Now they can.
Medicaid expansion helps:
- Low-income workers without employer insurance
- Self-employed people who can’t afford private insurance
- Part-time workers
- People between jobs
- Adults without dependent children
Over 100,000 Idaho residents gained coverage through expansion.
Special Programs and Waivers
Idaho offers special Medicaid programs for specific needs.
Developmental Disabilities Waiver
Helps people with developmental disabilities live at home instead of institutions.
Covers personal care, respite care, and support services.
Aged and Disabled Waiver
Helps seniors and disabled adults avoid nursing homes.
Pays for home care services and modifications.
Children’s Waiver
Serves children with complex medical needs.
Covers nursing care and medical equipment at home.
What If You Don’t Qualify?
If your income is too high for Medicaid, you have options.
Affordable Care Act Marketplace
Visit Your Health Idaho to shop for private insurance.
You might qualify for tax credits to lower your premium.
Subsidies are available up to 400% of poverty level in many cases.
Employer Insurance
Check if your job offers health insurance.
Some employers pay part of the premium.
Community Health Centers
Idaho has community health centers that charge based on income.
You can get care even without insurance
Take Action Today
Don’t wait to apply for Medicaid.
Check your income against these limits. If you’re close, apply anyway.
Coverage can start the month you apply. The application is free.
Healthcare costs are expensive. One hospital visit can cost thousands of dollars.
Medicaid protects you from medical debt.
Apply now at the official Idaho Health and Welfare website.
About the Author
My name is Akash Biswas. I like to read hard government rules and make them easy to understand. Many people find Medicaid and Medicare confusing, and that is okay. I want to help.
I made this website so families can learn in simple words. I take big, hard information and break it into small, easy steps. I want every person to feel calm and sure when they read about Medicaid or Medicare.
My goal is to help you understand who can get help, how to apply, and what to do next. I hope this website makes your life easier and helps you get the care you need.
I study Medicaid and Medicare rules every day and work hard to share clear, correct, and easy information for all families.
Credentials:
- MSW in Social Work
- Former SNAP & Medicaid caseworker trainer
- Advocate for accessible benefits education
- Published writer on poverty, healthcare access, and food security
Akash personally writes and reviews most of the articles and calculators on CheckMedicaid.com, ensuring they are accurate, practical, and easy to understand.
Sources and References
This article uses information from:
- Idaho Department of Health and Welfare official eligibility guidelines
- U.S. Department of Health and Human Services 2025 Federal Poverty Guidelines
- Centers for Medicare & Medicaid Services
- Idaho state Medicaid program documentation
Last Updated: December 15, 2025
Disclaimer: This article provides general information only. Eligibility rules can change. Always verify with Idaho Health and Welfare or a qualified benefits specialist before making healthcare decisions.
