Apply for Medicaid for Elderly or Disabled Adults

Apply for Medicaid for Elderly or Disabled Adults

Adults with disabilities can qualify for Medicaid based on their income and household status. The type of service or care that will be covered by Medicaid is called a Level of Care Determination which will occur after an individual has been determined financially eligible for Medicaid. 

Eligibility for Medicaid for elderly and disabled services

Adults with a physical or developmental disability can be eligible for Medicaid in Idaho if they meet the following criteria:

  • Live in Idaho
  • Be a U.S. citizen or eligible non-citizen
  • Have a disability diagnosis under the Social Security Act (or)
  • Be assessed to have functional impairments that qualify for the Developmental Disability Program 

If the individual needs home and community-based services or nursing home services, a Level of Care Determination must be completed.

If you are approved for the Medicaid, you may be required to pay a share of your medical costs. Based on our income, a share of cost will be determined. You will receive information about your share of cost in a notice from the department. 

How can I apply?

The application process for the Adult with Disabilities Program has two steps. 

Step 1:  Apply for Medicaid

Step 2:  Participate in a Level of Care Determination

1. Apply for Medicaid
Apply online
  • Apply: Online using idalink
  • Be prepared to provide this information with the application:
    • Verification of identity (e.g. driver's license)
    • Household income
    • Household resources
    • Current monthly expenses
    • If applicable, immigration status
Apply over the phone or in person
  • Be prepared to provide this information with the application:
    • Verification of identity (e.g. driver's license)
    • Household income
    • Household resources
    • Current monthly expenses
    • If applicable, immigration status
Apply by mail, email or fax
  • Then Apply by either:
    •  Email: MyBenefits@dhw.idaho.gov
    •  Fax: 1-866-434-8278 (toll free)
    •  Mail: Self Reliance Programs, PO Box 83720, Boise, ID 83720-0026
  • Be prepared to provide this information with the application:
    • Verification of identity (e.g driver's license)
    • Household income
    • Household resources
    • Current monthly expenses
    • If applicable, immigration status
2. Participate in a Level of care Determination

If an individual with disabilities is eligible for Medicaid and needs home and community-based services, a Level of Care Determination must be completed. The Level of Care Determination is the process the Idaho Medicaid program uses to determine if a person needs the kind of care provided in a nursing home or long-term care facility. 

If an individual with disabilities in not eligible for regular Medicaid due to their income but needs the kind of care provided in a nursing home or long-term care facility, a Level of Care Determination must be completed If the individual meets the level of care, a higher income limit can be used (see income limits on HCBS or Nursing Home page). 

  • You will receive two different notices/contacts from DHW:
    • One notice will let you know whether you are eligible for Medicaid.
    • You will be contacted by a DHW representative to schedule an appointment for the Level of Care Determination. 
  • You may need to provide additional information, but we will let you know if additional documentation is needed. 

REMINDER: There is a re-evaluation process each year for Medicaid. You will receive a notice in the mail with instructions on completing your re-evaluation.

File an Appeal

Your Rights to Appeal or Request a Fair Hearing
Appeals and Fair Hearings

This page explains how to file an appeal for an eligibility decision for public assistance programs. 

Go to Appeals and Fair Hearings