Medicaid has different programs available that provide health coverage for:
- Children under age 19
- Parents or other related adults with children under age 19
- Pregnant women
- Women diagnosed with breast or cervical cancer or pre-cancer
- People aged 65 or older
- People who are blind or disabled (using Social Security criteria)
APPLY FOR MEDICAID
You can apply for Medicaid with just your name, address, and signature on our Application for Assistance. This gets you started, but we still need you to provide the rest of the information on the application before we can determine if you’re eligible.
If your family's income is too high to qualify for Medicaid, we will determine if your children quailify for Idaho's State Children's Health Insurance Program (SCHIP). SCHIP is a health coverage program for children under age 19 whose family income is too high to qualify for Medicaid. There may be a small monthly cost for SCHIP coverage ($10.00 or $15.00, depending on income) for each child who receives SCHIP.
ELIGIBILITY REQUIREMENTS
In order to receive Medicaid, certain eligibility requirements must be met in areas such as, citizenship/immigration status, income, resources, work requirements, and other areas based on your household's circumstances.
MEDICAID AND SCHIP COVERAGE
Medicaid and SCHIP will pay for a number of services, such as prescriptions and dental care. While it is possible to have Medicaid and private health insurance, children who have private health insurance cannot qualify for SCHIP.
BENEFIT PLANS
The Idaho Medicaid State Plan is made up of the Standard State Plan which includes mandatory minimum benefits and three Benchmark benefit plans that are aligned with health needs and include an emphasis on prevention and wellness. Click on the plan titles below to see the benefits for each or click on the comparison sheet to quickly view the differences between the plans.
This booklet has information about each of Medicaid’s benefit plans, the importance of using your Healthy Connections doctor, when to use the emergency room, and keeping your child’s well-child checks and immunizations up-to-date. It also has links to connect you with more specific program information, important phone numbers, and office locations.
Standard – Provides the mandatory minimum benefits.
Basic - For low-income children and adults with eligible dependent children.
Enhanced - participants with disabilities or special health needs.
Medicare/Medicaid Coordinated - For participants who are eligible and enrolled for both Medicare and Medicaid.