Medicaid Office

Idaho Medicaid Income Limits

Updated August 2026

Idaho expanded Medicaid through Proposition 2, which voters passed in November 2018. Expansion took effect January 1, 2020. The expansion category — adults ages 19–64 — added a significant new group to Idaho Medicaid eligibility. Before Proposition 2, Idaho was one of the last states without adult expansion. Figures below reflect the Idaho Department of Health and Welfare's official income limits, effective January 2026.

138% FPL

Adults 19–64 (expansion)

138% FPL

Children (Medicaid)

190% FPL

Children (CHIP)

No asset test

For MAGI groups

Idaho Medicaid income limits by coverage group (2026)

Adults 19–64 (expansion)

FPL %
138% FPL
Monthly limit (household of 1)
$1,836/mo
Monthly limit (household of 4)
$3,795/mo

Children under 19 — Medicaid

FPL %
Up to 138% FPL
Monthly limit (household of 1)
$1,836/mo
Monthly limit (household of 4)
$3,795/mo

Children under 19 — CHIP

FPL %
138%–190% FPL
Monthly limit (household of 1)
N/A (household of 2 min. $3,427/mo)
Monthly limit (household of 4)
$5,225/mo

Pregnant women

FPL %
138% FPL (household includes unborn child)
Monthly limit (household of 1)
N/A (household of 2 min. $2,489/mo)
Monthly limit (household of 4)
$3,795/mo

Parents and caretaker relatives

FPL %
Same as expansion adults
Monthly limit (household of 1)
$1,836/mo
Monthly limit (household of 4)
$3,795/mo

Aged, Blind, and Disabled (AABD)

FPL %
SSI-linked
Monthly limit (household of 1)
$1,047/mo
Monthly limit (household of 4)
—

No asset test for MAGI-based Idaho Medicaid

Idaho Medicaid for adults under the expansion, children, and pregnant women uses MAGI-based rules with no asset test. Savings, vehicles, and home equity are not counted. This is standard for all ACA expansion states.

Idaho Medicaid for elderly and disabled individuals requiring long-term care uses separate income and asset rules. Per DHW's 2026 program income limits, Long-Term Facility Care and Home and Community Based Services (HCBS) both use a $3,002/month individual income limit with a $2,000 individual resource limit. The Aid to the Aged, Blind, and Disabled (AABD) program uses a $1,047/month individual income limit ($1,511/month for a couple), also with a $2,000 individual resource limit. The state enforces a 60-month look-back period for asset transfers before a long-term care application.

Idaho operates a Medicaid estate recovery program. The state may seek reimbursement from the estate of a member who received long-term care services at age 55 or older. Consult an Idaho-licensed elder law attorney before making asset transfers if a family member may need long-term care Medicaid.

Idaho does have a separate CHIP program for children above the Medicaid limit

Idaho covers children through Medicaid up to 138% FPL — the same MAGI standard used for expansion adults. Children whose family income falls between 138% and 190% FPL qualify for Idaho's Children's Health Insurance Plan (CHIP), a separate, state-administered program with its own monthly premiums (partially offset by the Children's Wellness Benefit for members current on checkups and immunizations). Children above 190% FPL who are not eligible for other programs may be able to access coverage through the federal health insurance marketplace at healthcare.gov.

Medicare Savings Programs (QMB) in Idaho

Idaho's Proposition 2 expansion covers adults ages 19–64 — it doesn't reach the Idahoans who need Medicaid help the most with Medicare costs. For residents 65 and older, or younger Idahoans who qualify for Medicare through disability, the program that matters is the Qualified Medicare Beneficiary (QMB) benefit and its two related tiers, SLMB and QI, run by Idaho Medicaid separately from Prop 2 expansion coverage.

QMB

Situation
Individual
Monthly income limit
$1,350/mo

QMB

Situation
Married couple
Monthly income limit
$1,824/mo

SLMB

Situation
Individual
Monthly income limit
$1,616/mo

SLMB

Situation
Married couple
Monthly income limit
$2,184/mo

QI

Situation
Individual
Monthly income limit
$1,816/mo

QI

Situation
Married couple
Monthly income limit
$2,455/mo

QMB pays the Part A premium for anyone who owes one, the full Part B premium ($202.90/month in 2026), and every Medicare deductible, coinsurance, and copayment. SLMB and QI cover the Part B premium only, but they open eligibility to Idahoans with somewhat higher income than QMB allows — SLMB up to $1,616/month individually, QI up to $1,816/month.

QI comes with a catch the other two don't have: Congress caps its funding each year, so it's awarded first-come, first-served, and enrollees have to reapply annually rather than staying enrolled automatically. QMB carries no such cap.

No provider can bill a QMB enrollee for Medicare cost-sharing — that protection is federal law, not a state policy Idaho could waive. QMB, SLMB, and QI enrollees also get Extra Help automatically, which limits Part D prescription costs to no more than $12.65 per covered drug in 2026. Apply through Idaho Medicaid at the Department of Health and Welfare, healthandwelfare.idaho.gov — not through Medicare.

Idaho Medicaid

Visit the official Idaho Medicaid website

Income Limits in Nearby States

Montana Nevada New Mexico Oregon Utah

Related guides

Income Limits

Current income cutoffs by state and household size, tied to the Federal Poverty Level.

Read more →

Spend-Down

How to qualify by deducting medical bills from income that's above the limit.

Read more →

QMB Program

What the QMB program covers, what a QMB card proves, and how to apply.

Read more →