Promoting and protecting the health and safety of all Idahoans

Idaho's Medicaid for Workers with Disabilities

The Medicaid for Workers with Disabilities (MWD) program is health insurance for people who work and who have a disability. Keep reading for more information about the program, how much you might pay for your health insurance, and how to apply.

Can I sign up for the program?
The Medicaid for Workers with Disabilities program is open to people who:

  • Have a disability (by Social Security Administration definition),
  • Are between 16 and 64 years old,
  • Have a job or are self-employed,
  • Are a resident of Idaho, and
  • Meet certain income and resource limits (see tables below)
How much money can I make and qualify for this program? 
Refer to the income guidelines listed here for income and resource limits for the program for single and married people. If your income and resources are less than the amounts listed, you may be eligible.

How much will I pay for my health care?
This program has health care premiums. Premiums are what you pay once each month for your health care. The chart listed here is based on whether you are single or married and tells you how much you might pay for your monthly health care premium, if found eligible.

How much you pay for your monthly premium depends on your income.  If your earned income is more than the maximum amount listed, you may still qualify. You could potentially have up to half of your remaining earned income deducted after certain disregards are applied to your eligibility determination.

If I receive Social Security Disability Insurance (or other Social Security benefits), how will this program affect those benefits?

This program is intended to help you work while earning more money and keeping your health insurance at the same time. However, the income guidelines for the MWD program are higher than the income limits for Social Security Disability Insurance (SSDI). You may earn more money by working and still be eligible for the MWD program because the income limits are higher. Keep in mind that your Social Security benefits benefits may be affected (reduced or ended) as a result of any increase in your income. If you are on SSDI or SSI, and have questions about how working will impact your Social Security benefits, contact a Community Work Incentives Counselor (CWIC). These counselors can help you to make a decision if you are concerned about Social Security benefits. You can call DisAbility Rights Idaho to connect with a CWIC. Their number is 1(866) 262-3462.

If I am a worker with a disability, but do not currently receive any federal benefits like SSDI or SSI, but I meet all the other criteria, am I still eligible for Medicaid for Workers with Disabilities? 

It depends. If you are eligible for SSDI, or other disability benefits, then you must make sure you’ve applied for those benefits first. You will be asked whether you have exhausted applying for these other programs when you apply for Medicaid for Workers with Disabilities. 

Otherwise, if you don’t qualify for those federal benefit programs (either because you make too much money or you haven’t worked long enough), then you must meet Social Security Disability standards. Our local Disability Determination office will assess whether you qualify. You can go online to to see how they assess applicants.

You will be asked to fill out a separate form to verify your disability at the same time you are filling out your Medicaid for Workers with Disability program application. You may have to go to a doctor, submit your medical history, and sign medical release of information forms once you begin the process to verify your disability.

What health care coverage will I receive?
If you qualify for this program, you will get the same health care coverage provided under the Medicaid Enhanced Plan. You can read more about this plan by viewing the Idaho Health Plan Coverage Booklet.

What if I need additional help in my home over and above what the program allows?
In addition to the Medicaid for Workers with Disabilities program, you may be eligible for additional assistance in your home if you request services under the Aged & Disabled Waiver or the Developmental Disabilities Waiver.  To be eligible, you would need to meet the level of care necessary to qualify for one of these waiver programs. Once you are determined to meet the level of care for the waiver, no additional financial eligibility is required to receive these services as long as you still qualify for the Medicaid for Workers with Disabilities program.

I think meet all the requirements and I’m ready to apply. What do I do next?
The next step is to fill out Health and Welfare’s Application for Assistance (printable version). This application is also available in the lobby of all Health and Welfare offices. At the top of your application write, “MEDICAID FOR WORKERS WITH DISABILITIES.”

If you have questions on how to fill out the application, ask to speak to a Self Reliance Specialist at Health and Welfare. They can help answer questions about the application itself. Once you have filled out the application, take it to the nearest Health and Welfare office, fax it to 1(866) 434-8278, or mail it to P.O. Box 83720, Boise, ID 83720-0026.

Once you have applied, you should receive a notice in the mail letting you know whether you’ve been approved or denied based on income or resources or disability. All of these letters include your rights to an appeal.