Spina Bifida Benefits in Idaho: How to Apply & Get Help

To get federal disability benefits in Idaho, you must meet Social Security Administration (SSA) rules. For Social Security Disability Insurance (SSDI), you need a qualifying disability and enough work credits (usually 40, with 20 earned in the last 10 years). SSDI is for people who have worked and paid Social Security taxes. For Supplemental Security Income (SSI), you must have limited income and resources, and be disabled, blind, or age 65 or older. Both programs require a medical condition that stops you from working for at least 12 months or is expected to result in death. Spina Bifida is considered a qualifying disability if it meets SSA’s criteria for physical impairments.

• SSDI: Based on work history and taxes paid.
• SSI: Based on financial need.
• Both programs require a medical review.
• Benefits may include cash payments and health coverage (Medicare for SSDI, Medicaid for SSI).

SSA Disability Qualifying Rules [accessed 2025-11-05]

Idaho does not have its own state disability program, but residents with Spina Bifida can access federal benefits and state Medicaid programs. To get Medicaid services for developmental disabilities, you must first qualify financially for Medicaid. Then, you need to meet the level of care criteria for developmental disabilities, which includes having a chronic condition that appeared before age 22 and causes significant functional limitations. Spina Bifida may qualify if it causes intellectual disability, mobility issues, or other major life activity limitations. Idaho also offers Medicaid waivers for home and community-based services, which can help with personal care, therapy, and other supports.

• Medicaid eligibility is based on income and assets.
• Developmental disability services require a separate application and assessment.
• Waivers may have waiting lists.
• Idaho Disability Determinations Service (DDS) reviews medical evidence for Social Security claims.

Idaho Medicaid Developmental Disabilities Programs [accessed 2025-11-05]

• Check if you meet federal SSI/SSDI rules.
• Apply for Social Security benefits online, by phone, or at a local office.
• If you need Medicaid, apply through Idaho Health and Welfare.
• For developmental disability services, complete a Medicaid application first, then apply for the DD program.
• Gather medical records and work history.
• Contact Idaho Disability Determinations Service for help with medical review.

• Step 1: Review eligibility for SSI or SSDI. Use the SSA’s online tools to check if your condition and work history qualify.
• Step 2: Apply for Social Security benefits. You can apply online at SSA.gov, call 1-800-772-1213, or visit a local Social Security office. You will need to provide personal information, medical records, and work history.
• Step 3: If you need Medicaid, apply through Idaho Health and Welfare’s online portal or by phone. You must meet income and asset limits.
• Step 4: For developmental disability services, complete a Medicaid application and be found financially eligible. Then, apply for the DD program and complete an assessment to determine eligibility for services.
• Step 5: Gather all required documents, including medical records, proof of income, and identification.
• Step 6: Submit your applications and wait for a decision. The Idaho Disability Determinations Service (DDS) will review your medical evidence.
• Step 7: If approved, you will receive benefits and information about next steps. If denied, you can appeal.
• Step 8: Report any changes in income, work, or health to avoid overpayments.

SSA Disability Application [accessed 2025-11-05] Idaho Medicaid Application [accessed 2025-11-05]

• Social Security Disability Insurance (SSDI): Monthly payments based on work history. Average SSDI payment in Idaho is $1,334.02. Includes Medicare after 24 months.
• Supplemental Security Income (SSI): Monthly payments for people with low income and limited resources. Average SSI payment in Idaho is $612.03. Includes Medicaid.
• Medicare: Health coverage for SSDI recipients after 24 months of disability.
• Medicaid: Health coverage for SSI recipients and others who meet income limits.

SSA Disability Programs [accessed 2025-11-05]

• Medicaid Developmental Disabilities Programs: Idaho offers Medicaid waivers for home and community-based services for people with developmental disabilities, including Spina Bifida if it meets criteria. Services may include personal care, therapy, and support coordination.
• Medicaid Waivers (HCBS): These waivers help people live in their homes instead of institutions. There may be waiting lists.
• Idaho Disability Determinations Service (DDS): Reviews medical evidence for Social Security claims and helps with the application process.
• Other State Services: Idaho Health and Welfare provides case management, therapy, and support services for people with disabilities.

Idaho Medicaid Waivers [accessed 2025-11-05] Idaho DDS [accessed 2025-11-05]

ABLE accounts let people with disabilities save money without losing SSI or Medicaid benefits. In Idaho, you can open an ABLE account through the state’s ABLE program. Funds can be used for disability-related expenses like housing, education, and transportation. Contributions are limited each year, and there are tax benefits.

Idaho ABLE Program [accessed 2025-11-05]

• SSI: Income limits change each year. In 2025, the federal SSI payment is $943/month for an individual, but Idaho may have different rules. Countable income includes wages, Social Security, and other sources.
• SSDI: There is no income limit, but you cannot earn more than the Substantial Gainful Activity (SGA) limit. In 2025, SGA is $1,509/month for non-blind individuals.
• Medicaid: Income and asset limits apply. Limits vary by program and household size.

SSA SGA Limits 2025 [accessed 2025-11-05]

If your income, work, or health changes, you must report it to Social Security or Medicaid. Not reporting changes can lead to overpayments and penalties. Report changes online, by phone, or in person. Keep records of all reports and decisions.

SSA Reporting Changes [accessed 2025-11-05]

• Idaho Disability Determinations Service
  Phone: 208-334-3230

  Website

  Reviews medical evidence for Social Security claims.
• Idaho Department of Health and Welfare
  Phone: 208-334-3100

  Website

  Handles Medicaid and developmental disability services.

• What federal benefits can I get for Spina Bifida in Idaho?

  You may qualify for Social Security Disability Insurance (SSDI) if you have a work history, or Supplemental Security Income (SSI) if you have limited income. Both programs provide monthly payments and health coverage. Spina Bifida is considered a qualifying disability if it meets SSA criteria.

• Does Idaho have a state disability program for Spina Bifida?

  Idaho does not have its own state disability program, but residents can access federal benefits and state Medicaid programs. Medicaid waivers may help with home and community-based services for people with developmental disabilities.

• How do I apply for Medicaid in Idaho with Spina Bifida?

  Apply for Medicaid through Idaho Health and Welfare. You must meet income and asset limits. If you need developmental disability services, complete a Medicaid application first, then apply for the DD program and complete an assessment.

• What is the average SSI and SSDI payment in Idaho?

  The average SSDI payment in Idaho is $1,334.02 per month. The average SSI payment is $612.03. Payment amounts depend on your income, work history, and other factors.

• Can I work while getting disability benefits in Idaho?

  Yes, but there are limits. For SSDI, you cannot earn more than the Substantial Gainful Activity (SGA) limit, which is $1,509/month in 2025. SSI has income limits. Work incentives may help you keep benefits while working.

• What is a Medicaid waiver in Idaho?