Nursing Homes in Idaho
Nursing homes provide a wide range of both medical and nonmedical services to seniors who need constant attention but may not qualify for hospitalization. This includes seniors who’re recovering from surgery or a short-term injury or those who are stable but have a long-term condition, such as cancer. Typically, seniors or their loved ones will choose nursing home care when they require assistance but can’t be cared for at home.
According to Genworth’s 2021 Cost of Care Survey, nursing home care in Idaho averages $8,517 to $9,125 per month, depending on whether an individual chooses a semiprivate or a private room. Nearly 17% of the state’s population is seniors aged 65 and older, many of whom require long-term care. Of these senior residents, approximately 3,600 reside in 80 nursing homes.
This guide covers ways to help seniors with limited incomes pay for nursing home care and provides information on other benefit programs. The guide describes Medicaid and Medicare and offers details on the application process.
Popular Cities in Idaho
Cost of Idaho Nursing Homes
The average cost of nursing homes in Idaho is $228 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Idaho?
In Idaho, seniors can get help to pay for nursing home care through the state's Medicaid program. Coverage is available in Medicaid-approved facilities for seniors who meet specific eligibility requirements. As of December 2022, more than 449,000 individuals have been enrolled in Idaho Medicaid.
Nursing home care covers nonmedical assistance, including grooming, bathing, transportation and meals. It also includes medical assistance, such as skilled nursing, occupational, speech and physical therapy and wound care. While Medicaid covers most medical services directly, the Aged and Disabled Medicaid Waiver program covers home and community-based services.
Eligibility for Medicaid in Idaho
Seniors applying for Idaho Medicaid must meet the income and asset limits set by the state. These limits are subject to change every year. In 2023, a single applicant must have an income that totals no more than $2,752 per month with assets totaling $2,000 or less. In a two-person household, both spouses should have a total income of no more than $5,504 per month with assets of no more than $3,000.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $2,752 per month | $2,000 |
| Two-Person Household | $5,504 per month | $3,000 |
To qualify for Idaho Medicaid, seniors must also meet additional requirements:
- U.S. citizen or a legal immigrant
- Resident of Idaho
- Require nursing home care
- At least 65 years of age or older
Applying for Medicaid in Idaho
Seniors can apply for Medicaid in Idaho in several different ways. Applications are taken online through the state Medicaid website, Idalink, or seniors may apply for benefits over the phone by calling (877) 456-1233, or fax the application to (866) 434-8278. Those who prefer to apply in person can make an appointment and visit their closest field office. It’s possible to download an application and submit it signed through the mail at:
Self Reliance Programs
P.O. Box 83720
Boise, ID 83720-0026
What Information You Will Need
Applicants must provide supporting documentation when applying for state Medicaid. Some of this information includes:
- Driver’s license or other forms of photo identification
- Social Security numbers for all applicants
- Proof of U.S. citizenship or legal alien status
- Copies of financial information, including all income, Social Security awards letters and retirement accounts
- Copies of health and life insurance policies
- Proof of assets
- List of current expenses
Additional Medicaid Support & Resources in Idaho
Applying for Medicaid can be a confusing process for seniors who are unsure of which services they need and how much coverage is required to pay for long-term services. The following resources can provide guidance throughout the application process.
| Contact | Service | |
|---|---|---|
| Benefits.gov | (877) 456-1233 | Benefits.gov is a federal-run website that provides a list of public benefit programs in each state. The site includes Medicaid, with contact numbers, application information and details on what agency manages the program. There’s also a list of qualifications and a checklist on whether you may be eligible to apply. |
| Idaho Department of Health and Welfare | (877) 456-1233 | The Idaho Department of Health and Welfare helps seniors apply for and understand state Medicaid. It provides information on eligibility and offers details on the different waiver programs that can help lower your long-term care cost liability. |
| Health Insurance Marketplace | (866) 682-3017 | Aside from private insurance, the Health Insurance Marketplace can help you determine if you’re eligible for state and federal financial benefit programs, including Medicaid. |
Can You Use Medicare to Pay for Nursing Home Care in Idaho?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Idaho
Seniors who are eligible for Medicare may have questions and concerns about coverage. The following resources help older adults navigate the application process and determine which Medicare plans best suit their needs.
| Contact | Service | |
|---|---|---|
| Idaho Senior Health Insurance Benefits Advisors (SHIBA) | (208) 334-4250 | SHIBA serves as a consumer guide to state Medicare in Idaho. Seniors can receive information on benefits and services by contacting the program directly or by searching the website for educational information. The website also has information on Medicare fraud and filing complaints about services and coverage. |
| Idaho Department of Health and Welfare | (877) 456-1233 | The Idaho Department of Health and Welfare works to improve the life of seniors in the state. It offers advice and assistance with insurance, including answering questions about Medicare and the application process. Other services include administering state programs such as SNAP benefits and licensing care facilities. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is the main place to go for questions and information about the federal Medicare program. Seniors can get information on additional health and drug plans and can locate providers and health care communities that accept Medicare as payment. |
Other Financial Assistance Options for Nursing Home Care in Idaho
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Idaho
| Licensing Requirements | Nursing homes in Idaho are licensed and regulated by the Idaho Department of Health and Welfare, Division of Licensing and Certification. New communities must apply for their license within three months of opening day, and all renewals must be submitted within 30 days of expiration. |
| Staffing Requirements | Staff members must include a director of nursing services, a supervision nurse and a charge nurse. Facilities with at least 90 residents must always have an RN on duty, and all other facilities must have at least two staff members available. |
| Staff Training Requirements | Nursing homes in Idaho have no staff training requirements; however, all licensed nurses must meet the minimum training requirements to maintain their licensing. |
| Admission Restrictions | Nursing homes must have admissions policies set in writing to provide to residents. All facilities have been approved to house a specific number of residents based on the size of the facility and the number of staff members. |
| Care Planning Requirements | All residents must have an individualized written care plan that is based on their needs. Regular reviews must be provided to ensure the care plan is updated to accommodate an individual’s changing needs. |
| Dietary and Nutritional Services Requirements | The dietary and nutritional needs of each resident must be met, and all special diets must be provided. Menus should be prepared at least one week in advance and should be kept on file for at least 30 days. |
| Specialized Rehabilitative Services | On-site physical and occupational therapy services must be provided in nursing homes in Idaho. Other types of rehabilitation services can be offered off-site, but nursing homes must arrange for transportation to and from these sites. |
| Medication and Pharmaceutical Services | Nursing homes work directly with a licensed pharmacist to provide medications to seniors. All medications must be dispensed by a licensed nurse, and prescriptions must be stored properly with the patient's name and dispensing information. |
| Activities Requirements | Activities must be planned and provided by an experienced activities director to meet the needs of all residents of nursing homes. Nursing homes can’t require residents to fund these activities. |
| Infection Control Requirements | Communities must plan for residents who contract a communicable disease. All facilities must have at least one isolation room to prevent the spread among other residents. |
| Medicaid Coverage | Facilities that adhere to the Idaho Medicare requirements may accept Medicare as payment for some services. Eligible seniors must meet annual income and asset limits. |
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