With health costs climbing across Idaho and inflation reshaping family budgets, the state’s Medicaid program has raised its income limits for 2025, expanding eligibility for working families, children, and low-income adults in urban and rural areas alike.
Medicaid remains a lifeline for roughly one in five Idahoans, providing doctor visits, hospital care, prescriptions, and preventive services at little or no cost. The 2025 adjustment, tied to the latest federal poverty guidelines, means some residents who narrowly missed qualifying last year may now be eligible.
Key Takeaways
- Individual income limit (138% FPL): ≈ $1,800 per month
- Family of four: Up to $3,698 per month may qualify
- Pregnant women: Eligible up to 185% FPL
- Children under 6: Covered up to 185% FPL; ages 6–18 up to 138% FPL
- Apply online: Idalink.idaho.gov or call 1-877-456-1233
What Medicaid Is and Who It Helps
Medicaid is a joint federal-state insurance program that helps people with limited income and resources afford care. It covers:
- Primary and preventive care
- Prescription medications
- Hospital and emergency services
- Mental health and substance-use treatment
- Dental and vision services for children
By covering these essentials, Idaho Medicaid prevents medical debt and improves public health outcomes across every county. Learn more at the Idaho Department of Health and Welfare’s Medicaid program page.
Idaho Medicaid Income Limits for 2025
Eligibility is based primarily on income relative to the Federal Poverty Level (FPL). The U.S. Department of Health and Human Services sets the FPL each year; for 2025, a single person’s poverty threshold is $15,650 annually. Idaho uses 138% of FPL as the cutoff for most adults.
Idaho Medicaid Income Limits (2025)
| Household Size | Monthly Income Limit (138% FPL) |
| 1 | $1,800 |
| 2 | $2,433 |
| 3 | $3,065 |
| 4 | $3,698 |
| 5 | $4,330 |
| 6 | $4,963 |
| 7 | $5,595 |
| 8 | $6,228 |
| Each extra person | + $632 |
(Source: U.S. Department of Health and Human Services FPL Guidelines, 2025)
Pregnant women and young children qualify under higher thresholds (up to 185% FPL). Always confirm your specific category with the Idaho DHW.
Eligibility Requirements Beyond Income
To receive Medicaid in Idaho, applicants must also meet:
- Residency: You must live in Idaho.
- Citizenship: You must be a U.S. citizen or legal immigrant (Green-card holder after five years).
- Category: You must fit an eligible group (child, pregnant woman, parent, elderly adult, or disabled person).
- Assets: Certain groups (seniors or disabled) face asset limits ($2,000 individual / $3,000 couple).
Medicaid Expansion in Idaho
Idaho voters approved Medicaid expansion in 2018, implemented in January 2020, under the Affordable Care Act.
The move opened coverage to working adults aged 19–64 with household income below 138% FPL, bridging the gap between traditional Medicaid and private insurance.
Since then, more than 93,000 expansion adults have enrolled, according to the Kaiser Family Foundation (May 2025 fact sheet). The change significantly reduced uninsured rates across Boise, Nampa, and eastern Idaho.
Idaho Medicaid Enrollment Snapshot (2025)
Idaho Medicaid & CHIP Enrollment (2025 or Most Recent)
| Category | Number of Idaho Residents | Source |
| Total Medicaid & CHIP enrollees | ≈ 355,000 | KFF “Medicaid in Idaho,” May 2025 |
| Adults in Medicaid Expansion (19–64) | ≈ 93,000 | KFF Fact Sheet (May 2025) |
(Cross-verified with CMS State Enrollment Reports and Idaho DHW monthly updates.)
Who’s Covered by Idaho Medicaid
The state’s 355,000 enrollees include children, pregnant women, seniors, people with disabilities, and low-income working adults. Children make up the largest share.
Idaho Medicaid Enrollment by Eligibility Group (2025 est.)
| Group | Estimated Number* | Percent of Total (~355k) | Notes |
| Children (<19) | ≈ 149,000 | 42% | KFF estimate: “2 in 5 are children.” |
| Adults in Expansion (19–64) | ≈ 93,000 | 26% | KFF Fact Sheet (May 2025). |
| Elderly & Disabled Adults | ≈ 113,000 | 32% | Derived from total minus known groups. |
| Total | ≈ 355,000 | 100% | Sources: KFF, CMS, Idaho DHW. |
*Estimates use point-in-time data; some values derived from public totals for clarity.
How to Apply for Medicaid in Idaho
Applying is free and can be done several ways:
- Online: Idalink.idaho.gov
- Phone: Call 1-877-456-1233
- In person: Visit a local DHW office
- Mail or fax: Request and submit a paper form to DHW
Documents you’ll need:
- Proof of identity (driver’s license or state ID)
- Social Security number
- Proof of income (recent pay stubs or tax forms)
- Proof of residency (utility bill or lease)
Most applications are processed within 45 days; urgent medical cases can receive expedited review.
FAQ: Idaho Medicaid 2025
What are the 2025 income limits for Idaho Medicaid?
For most adults, income must be below 138% of the Federal Poverty Level ($1,800 per month for a single adult or $3,698 for a family of four). Pregnant women and young children qualify up to 185% FPL.
Can my kids get Medicaid even if I don’t qualify in 2025?
Yes. Children in Idaho often qualify at higher income levels than adults, and U.S.-born children can receive coverage even if their parents are not citizens.
How long does Idaho Medicaid coverage last in 2025?
Coverage continues as long as you meet income and eligibility requirements. DHW sends a renewal notice annually via Idalink.
What does Idaho Medicaid cover for adults and children?
It includes doctor visits, prescriptions, lab tests, hospital care, emergency treatment, and mental health services. Dental and vision benefits are provided for children through CHIP.
What if my income rises above the limit in 2025?
Report changes promptly. You may transition to an Idaho Health Insurance Marketplace plan with premium tax credits. Never drop coverage until new insurance is active.
Can I appeal if I’m denied Medicaid in Idaho?
Yes. File an appeal within 90 days of denial through DHW. You can seek free assistance from Idaho Legal Aid Services.
Conclusion
Idaho Medicaid continues to anchor the state’s health safety net, covering over 355,000 residents and expanding access to care for those most at risk. With 2025 income limits adjusted for inflation, many families who previously missed eligibility can now enroll.
Check your status through healthandwelfare.idaho.gov or Idalink.idaho.gov, gather your documents, and apply today. Even if you think you’re slightly above the limit, deductions or family size adjustments could help you qualify.
