Medicaid, Low-Income Subsidy and Special Needs Plans

Idaho Medicaid

Idaho Medicaid is part of a joint federal and state program that helps pay medical costs for certain groups of people with limited income and resources. Individual states have their own unique qualifications for Medicaid eligibility.  If you qualify for Idaho Medicaid, you automatically qualify for Extra Help (described below).

Another Idaho Medicaid resource is the booklet titled “Idaho Health Plan coverage“.  You can apply for Idaho Medicaid through the Social Security Administration.  This is their contact information:



Low-Income Subsidy

This program, also called Extra Helpis designed to help pay for your Medicare prescription drug costs and potentially part/all of your prescription drug plan premium.  CMS publishes these limits annually.  For 2014, these are:

Marital Status                               Income                             Assets

Single                                      $17,505                        $13,440*

Married                                   $23,595                        $26,860*

     *   there are rules that exclude some assets like your primary home.

If your annual income/assets are equal to or lower than these limits, apply for ‘Extra Help’.  Your monthly premium for your MAPD or PDP plan could be lower.   You can apply anytime during the year that you meet the qualification requirements.   If you qualify, we can help you find the lowest cost MAPD or stand alone PDP plan that best meets your needs and budget. Call us.

Call the Social Security Administration and apply for ‘Extra Help‘.  They may take your application over the phone or may direct you to the “Application for Help with Medicare Prescription Drug Plan Costs”(form number: SSA-1020).  


Special Needs Plans

Medicare Special Needs Plans (SNP) is a unique Medicare Advantage Plan (like an HMO or PPO) that limits membership to people with specific diseases or characteristics.  You can join a SNP if one is offered in your area, you have Medicare Parts A and Part B, and have a chronic condition, live in an institution (like a nursing home), or you require nursing home care at your home.  Learn more about SNP’s.  Learn more about a SNP plans in Idaho.


This page was last modified on Aug 25, 2014 @ 10:58 AM