Idaho Medicaid and CHIP for a Grandchild Living with a Grandparent

You Do Not Need Custody to Get a Child Covered

One of the most common fears grandparents have is that they need legal guardianship or a custody order before they can get health insurance for a grandchild. In Idaho, informal relative caregivers can apply for Medicaid or CHIP on behalf of a child who lives with them. You need to verify identity, Idaho residence, and income — not a court order.

How Idaho Determines Eligibility

Child Medicaid and CHIP in Idaho use Modified Adjusted Gross Income (MAGI) rules. Children in households at or below 138% of the Federal Poverty Level qualify for standard Medicaid. CHIP extends coverage to higher income levels.

The key question is who counts in the child's MAGI household. If a grandparent claims the child as a tax dependent, Medicaid and CHIP use non-filer household rules rather than automatically including the grandparent's tax household. For a child under 19, those rules include any parent and siblings under 19 who live with the child; the grandparent is not included solely because of the tax claim.

There is no asset test for children's Medicaid under MAGI rules. Your savings, your home, your car — none of that is counted.

Twelve Months of Continuous Eligibility

Once a child is approved for Idaho Medicaid or CHIP, coverage stays active for a full 12 months regardless of mid-year changes in household income. If you get a raise, pick up more hours, or have another family member move in, the child's coverage continues until the 12-month redetermination.

This is a significant protection. The child remains covered during the 12-month period even if income changes make the child temporarily ineligible. Keep your contact information current and follow any IDHW request or Medicaid reporting instructions.

What Medicaid Covers

Idaho Medicaid for children includes:

• Doctor visits and preventive care
• Hospital stays and emergency services
• Prescription medications
• Dental care through the Idaho Smiles program (administered by MCNA Dental)
• Mental health and substance use services through the Idaho Behavioral Health Plan (Magellan Health)
• Vision and hearing services

The Katie Beckett Pathway for Children with Disabilities

If the child has a severe chronic medical condition or developmental disability — autism, cerebral palsy, or other conditions causing substantial functional limitations — the Katie Beckett Program provides an alternative route to Medicaid even when family income is above standard Medicaid guidelines. Eligibility still depends on the program's income and resource limits, the child's disability criteria, and a Level of Care assessment; a premium may be based on family income.

For some eligibility paths, the child must meet SSI disability criteria and the level of care normally provided in a medical institution. The assessment uses information from the child's doctor and other health care providers. This is not a quick application, but for families who would otherwise be over income for standard Medicaid, it can be the path to coverage.

How to Apply

Apply through idalink.idaho.gov. The same application covers TAFI, SNAP, Medicaid, and child care assistance. You can also apply by phone at 1-877-456-1233, by email to [email protected], or at any IDHW field office.

IDHW says Medicaid application processing may take up to 45 days. If more information is needed, the department will let you know; respond to the request by its deadline.

Connecting Health Coverage to Other Benefits

Being approved for Medicaid automatically satisfies WIC income requirements if the child is under five. It also counts as a qualifying event for other support services.

If you are also applying for TAFI and SNAP, do it all on one idalink application. The income counting rules differ across programs, and one approval can streamline the others.

The Idaho Kinship Financial Help Guide walks through exactly how Medicaid interacts with TAFI, SNAP, and child care assistance — including which income counts where and what documentation you need for each.

Frequently Asked Questions

Can I apply for Medicaid for my grandchild if the parents are still alive?

Yes. The parent does not need to be deceased. As long as the child lives with you and you can verify residence and the family relationship, you can apply.

Does the child's Medicaid affect my own Medicare or health insurance?

No. The child's Medicaid coverage is entirely separate from your own benefits.

What if the child already has insurance through a parent's employer?

Medicaid can serve as secondary coverage, filling gaps in the primary plan. Report existing coverage on the application.

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