Idaho Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Idaho.
7.6 million Medicaid long-term care recipients nationwide
Idaho Department of Health and Welfare
Processing Time
Up to 90 days; waiting lists may exist for A&D Waiver despite no enrollment caps
Idaho Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Idaho, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Idaho follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$3,002/month
Married Couple (One Applying)
$5,984/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$162,660 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Idaho Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $10,494/month average (semi-private), $11,072/month (private) (the average monthly nursing home cost in Idaho).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Idaho
Nursing Home Care
Medicaid pays 100% of nursing home costs in Idaho once eligibility is established. The average monthly cost is $10,494/month average (semi-private), $11,072/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Aged and Disabled (A&D) Waiver - Assisted Living Services: A&D Waiver participants can reside in residential assisted living facilities and receive waiver services including personal care assistance and care coordination. However, the program does not pay for room and board costs in assisted living facilities. Participants must cover housing costs from their income or other resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Idaho offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Aged and Disabled (A&D) Waiver
Statewide program for Idahoans age 65+ or disabled adults age 18-64 at risk of nursing home admission. Services include adult day health care, skilled nursing, specialized medical equipment, personal emergency response systems, personal care assistance, and respite care. Participants can reside at home, with loved ones, in certified family homes (adult foster care), or residential assisted living facilities. No enrollment caps or waiting lists currently.
Program Details →Idaho Medicaid Plus (IMPlus)
For dual-eligible individuals (Medicare and Medicaid) age 21+ enrolled in Medicare Parts A, B, and D. Provides hospitalization, medical care, nursing home care (following Medicare payment), personal care services, and long-term HCBS services via the A&D Waiver. Available in 33 counties including Ada, Bannock, Boise, Bonner, Bonneville, Canyon, Kootenai, and Twin Falls.
Program Details →How to Apply for Medicaid in Idaho
Idaho Medicaid applications typically take Up to 90 days; waiting lists may exist for A&D Waiver despite no enrollment caps. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Idaho through:
- Online through Your Health Idaho portal
- Call 1-877-456-1233 for application assistance
- Email MyBenefits@dhw.idaho.gov
- In-person at local Health and Welfare office
- Eligibility lookups: 1-866-686-4272
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Idaho from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Idaho-Specific Programs and Resources
Medicare Medicaid Coordinated Plan (MMCP)
For dual-eligible individuals providing coordinated Medicare and Medicaid benefits through managed care. UnitedHealthcare Community Plan of Idaho began offering MMCP benefits January 1, 2026. Alternative to IMPlus program.
Learn MoreIdaho Home Choice (Money Follows the Person)
Federal program helping institutionalized Medicaid-eligible persons transition from nursing facilities back home or into the community with transitional supports and services.
Learn MoreNeed Help with Idaho Medicaid?
Contact Idaho Department of Health and Welfare for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-877-456-1233Application Helpline
1-877-456-1233