How to get Medicaid or low-cost care in Idaho

Idaho Medicaid expansion in plain words

Medicaid is a program that pays for health care for people with low incomes. In Idaho the Department of Health and Welfare runs it. According to KFF, a health policy research group, Idaho began covering more low-income adults on January 1, 2020.

The state calls this part of the program Medicaid Expansion. It covers adults ages 19 through 64 who live in Idaho and have an income up to 138 percent of the federal poverty level. That level is a dollar amount the government sets each year to measure poverty. You must be a citizen or have a qualifying immigration status. You also must not be disabled, pregnant, or eligible for Medicare or another Medicaid program, because those people are covered under other rules.

Our guide on who qualifies for Medicaid explains the other groups.

Applying through Idalink

Idalink is Idaho's online portal for health care, food help and other programs. Besides applying there, you can manage your coverage and update your contact information.

Other choices are a phone interview at 877-456-1233, a visit to a field office, or a paper form. You can send the paper form by email to MyBenefits@dhw.idaho.gov or by fax to 1-866-434-8278. You can also mail it to Self Reliance Programs, PO Box 83720, Boise, ID 83720-0026.

Before you apply, gather proof of who you are, your household income, your monthly bills and your immigration status if it applies. After the state decides, you will get a written notice in the mail. The state may also ask you to confirm household details by mail, so answer quickly. More tips are in our guide to how to apply for Medicaid.

The Idaho work rule starts in 2027

The state says the work rule for Medicaid Expansion starts on January 1, 2027. Adults in the expansion group must report work or community activity to qualify and to stay covered. The state starts reviewing coverage periods that end on or after that date.

The rule asks for at least 80 hours a month of work, community service, approved job training or school. Earning at least $580 a month also meets the rule. Applicants must meet the rule for three months before they can be approved, the state says. Members must verify their activity twice a year when they renew.

The state lists many people who do not have to meet the rule. They include pregnant people, people who were pregnant in the past 12 months, and the main caregiver of a child 13 or younger. Caregivers of a person with a disability are on the list. So are people with a serious health condition and people in drug or alcohol treatment. American Indians and Alaska Natives are excused, and so are veterans with a 100 percent disability rating. People who must follow SNAP or TANF work rules are excused as well.

The state is mailing letters to affected households and plans virtual town halls. It warns that the rules may change if the federal government issues new guidance. Until then, it is smart to save a record of each month's work, volunteer or school hours, because you will need it at renewal. To get alerts by email, text or mail, sign up in your Idalink account. Our Medicaid work requirement guide explains the national rule.

Your Health Idaho if you earn too much for Medicaid

Idaho runs its own marketplace, called Your Health Idaho. A marketplace is a website where you compare private health plans, and a tax credit can lower the monthly price if your income qualifies. Your Health Idaho says open enrollment for 2027 coverage runs from October 15 to December 15, 2026, and you can call 855-944-3246 for help.

Certified agents and brokers offer free help, and you can book an appointment on the website or use its live chat. If you lost a job, our guide on what to do after losing insurance explains the special sign-up window.

Health centers and clinics in Idaho

Federally funded community health centers serve everyone and charge by income and family size. To find one, enter your zip code in the free Find a Health Center tool from the Health Resources and Services Administration.

At the center, ask about the sliding fee, which is a price scale based on what you earn. Ask which proof of income you need and how soon you can get a first visit. Idaho has wide open areas, so also ask whether the center offers visits by video. Our guide to sliding-scale clinics can help you compare. You can apply for Medicaid at any time of year, unlike a marketplace plan, which helps if your income drops.

Checking an Idaho doctor

The Idaho Board of Medicine is part of the Division of Occupational and Professional Licenses. It has a tool called Search for a License or Registration, which you can use to confirm that a physician is licensed in Idaho. You can also call the division at 208-334-3233.

Flat-fee doctors and emergencies

Some Idaho doctors charge a flat monthly fee for primary care and do not bill insurance for those visits, which is called direct primary care. Our directory lists cash-pay doctors you can search.

In an emergency, call 911 or go to the nearest emergency room. Federal law says a hospital with an emergency room must examine you whether or not you have coverage. If a bill comes later, our guide to hospital financial assistance shows how to ask for help.