Utah Medicaid provides free or low-cost health coverage to low-income residents. Eligibility depends on your age, income, household size, and health needs.
Most adults qualify at 138% of the federal poverty level. Children and pregnant women can earn more and still get coverage.
Quick Facts:
- Adults ages 19–64 qualify with income up to 138% FPL (~$1,800/month)
- Children qualify at 138–144% FPL; CHIP covers kids up to 205% FPL
- Pregnant women qualify at 144% FPL with 12 months postpartum coverage
- Seniors and disabled applicants face asset limits ($2,000 single/$3,000 couple)
- Apply online at jobs.utah.gov/mycase or call 1-866-435-7414
Page Contents
- 1 What Is Utah Medicaid?
- 2 Who Qualifies for Utah Medicaid?
- 3 2026 Income Limits by Program
- 4 Asset Limits for 2026
- 5 Spousal Protections Rules
- 6 Medicaid Look-Back Period
- 7 How Utah Treats Your Home
- 8 Long-Term Care Program Options
- 9 Where You Live Matters (Managed Care)
- 10 Major 2026 Policy Updates
- 11 Spend-Down Program (Medically Needy)
- 12 How to Apply for Utah Medicaid
- 13 Quick Reference: 2026 Limits at a Glance
- 14 Frequently Asked Questions
What Is Utah Medicaid?
Utah Medicaid is a state and federal health insurance program. It helps low-income people get medical care. The Utah Department of Health & Human Services (DHHS) runs the program.
The Department of Workforce Services (DWS) checks if you qualify.
You can get Medicaid if you have a low income. You must also be a Utah resident and U.S. citizen (or qualified immigrant).
Utah expanded Medicaid in 2020. This means more adults can now get coverage.
Key Points About Utah Medicaid:
- Covers doctor visits, hospital stays, prescriptions, and dental
- No monthly premiums for most enrollees
- Some programs require small co-pays
- Coverage starts the month you apply (in some cases)
Who Qualifies for Utah Medicaid?
You must meet basic rules to get Medicaid. These rules change based on your age and health status. Here are the main groups that qualify:
Adults Ages 19–64 (Medicaid Expansion)
This group covers low-income adults without children. You qualify if your income is at or below 138% of the Federal Poverty Level (FPL).
For one person, this equals about $21,597 per year or $1,800 per month. There is no asset test for this group. You only need to prove your income is low enough.
Children (Ages 0–18)
Kids get Medicaid at slightly higher income levels. Children under age 6 qualify at 144% FPL. Kids ages 6–18 qualify at 138% FPL.
If your income is too high for Medicaid, your child may get CHIP coverage. CHIP covers kids up to 205% FPL.
Pregnant Women
Pregnant women qualify at 144% FPL. This equals about $1,875 per month for one person. Coverage includes prenatal care, delivery, and postpartum care. You keep coverage for 12 months after birth.
Seniors and Disabled Individuals (ABD)
People age 65+, blind, or disabled have different rules. They must meet strict income and asset limits. Assets include bank accounts, stocks, and retirement funds.
The asset limit is $2,000 for one person or $3,000 for a couple. Income limits vary by program.
Learn more about specific income thresholds in our guide to Utah Medicaid income limits in 2026.
2026 Income Limits by Program
Income limits change each year. They are tied to the Federal Poverty Level. The FPL usually updates in January. Utah applies new limits in the spring.
MAGI-Based Programs (Most Applicants)
MAGI stands for Modified Adjusted Gross Income. It is how Utah measures income for most applicants. This includes adults, children, and pregnant women.
| Group | Income Limit (% FPL) | Monthly Income (1 Person) |
|---|---|---|
| Adults 19–64 | 138% | ~$1,800 |
| Pregnant Women | 144% | ~$1,875 |
| Children 0-5 | 144% | ~$1,875 |
| Children 6-18 | 138% | ~$1,800 |
| CHIP (Children) | 205% | ~$2,670 |
Note: Add $442 per month for each additional family member.
Long-Term Care Programs (Seniors/Disabled)
These programs help with nursing home care or home-based services. They have different income rules.
| Program | Monthly Income Limit (Single) | Monthly Income Limit (Couple) |
|---|---|---|
| Aging Waiver | $1,305 | $1,763 (combined) |
| New Choices Waiver | $2,982 | $2,982 per spouse |
| Nursing Home Medicaid | No strict limit* | No strict limit* |
Nursing home residents pay most income toward care. They keep only $45/month for personal needs.
Compare these limits to other states in our Medicaid income limits by state in 2026 guide.
Asset Limits for 2026
Assets are things you own. They include cash, bank accounts, and investments. Some programs check your assets. Others do not.
Who Faces Asset Tests?
You DO NOT need an asset test if you are:
- An adult under 65 (expansion group)
- A pregnant woman
- A child (any age)
- A parent/caretaker relative
You DO need an asset test if you are:
- Age 65 or older
- Blind or disabled
- Applying for long-term care
Countable vs. Non-Countable Assets
Countable assets (they count toward limits):
- Checking and savings accounts
- Stocks and bonds
- Retirement accounts you can access
- Certificates of deposit
Non-countable assets (they do not count):
- Your primary home (if you plan to return)
- One vehicle
- Household goods and personal items
- Irrevocable funeral trusts
- Life insurance worth $1,500 or less
2026 Asset Limits Table
| Situation | Asset Limit |
|---|---|
| Single applicant (Nursing Home/Aging Waiver) | $2,000 |
| Married couple (both applying) | $4,000 |
| Community Spouse (non-applicant) | Up to $162,660 |
The Community Spouse Resource Allowance (CSRA) protects the healthy spouse. They can keep up to half the couple’s assets. The maximum is $162,660 in 2026. The minimum is $32,532.
Spousal Protections Rules
Married couples have special protections. These rules prevent the healthy spouse from becoming poor.
Income Protection
Only the applicant’s income counts toward the limit. The non-applicant spouse keeps their own income. If their income is low, they may get money from the applicant. This is called the Minimum Monthly Maintenance Needs Allowance (MMMNA).
The 2026 MMMNA is $2,644 per month. This ensures the healthy spouse has enough to live on.
Asset Protection
The healthy spouse can keep assets up to the CSRA limit. This happens even if the applicant has too many assets. The couple must “spend down” assets to the limit before Medicaid starts.
Medicaid Look-Back Period
Utah checks your past financial records. This is called the look-back period. It applies to nursing home and waiver programs.
The 5-Year Rule
Utah looks back 60 months (5 years) from your application date. They check for gifts or sales below market value. If you gave away assets to qualify, you face a penalty. This penalty delays your coverage.
Important: The look-back does NOT apply to regular Medicaid. It only applies to long-term care programs.
Gift Tax vs. Medicaid Rules
Federal gift tax rules allow gifts up to $19,000 per person in 2026. But Medicaid does not care about gift tax rules. Any gift during the look-back period can hurt your eligibility.
How Utah Treats Your Home
Your home is usually safe. Medicaid does not count it as an asset right away.
Home Exemption Rules
Your home is exempt if:
- Your spouse lives there
- Your child under 21 lives there
- Your blind or disabled child lives there
- You plan to return home
The home equity limit is $730,000 in 2026. If your home is worth more, you may not qualify.
Estate Recovery
After you die, Medicaid may claim your estate. This is called estate recovery. They can recover costs from your home sale. There are exceptions for minor children and disabled heirs.
Long-Term Care Program Options
Utah offers three ways to get long-term care through Medicaid:
1. Nursing Home Medicaid
This covers care in a skilled nursing facility. It is an entitlement program. If you qualify, you get a spot. You must need a Nursing Facility Level of Care (NFLOC). This means you need help with daily tasks.
2. HCBS Waivers
These programs help you stay at home. They are not entitlements. There may be waiting lists. Utah offers several waivers:
- Aging Waiver (age 65+)
- New Choices Waiver (transition from nursing home to home)
- Acquired Brain Injury Waiver
- Autism Waiver
- Medically Complex Children’s Waiver
3. Regular Medicaid ABD
This covers basic health needs for aged, blind, or disabled individuals. It may include some home care services.
Medical Eligibility
You must prove you need help with daily activities. This includes:
- Bathing and dressing
- Eating and toileting
- Moving around
- Managing medications
- Cooking and cleaning
A nurse will assess your needs. Diagnosis alone is not enough.
Check provider payment rates in our Medicaid Fee Schedule 2026 resource.
Where You Live Matters (Managed Care)
Utah uses different health plans based on your county.
Utah Medicaid Integrated Care (UMIC)
If you live in these counties, you join UMIC:
- Davis
- Salt Lake
- Utah
- Washington
- Weber
UMIC combines physical and mental health services.
Accountable Care Organizations (ACO)
If you live in these counties, you join an ACO:
- Box Elder
- Cache
- Iron
- Morgan
- Rich
- Summit
- Tooele
- Wasatch
ACOs focus on coordinated care between doctors.
Major 2026 Policy Updates
Medicaid rules change often. Here are key updates for 2026:
Work Requirements (Pending)
A federal law may require work for expansion adults. Utah wants to start this in July 2026. It is not active yet. If it starts, you must work 80 hours per month. Exemptions include:
- Seniors 65+
- Disabled individuals
- Pregnant women
- Caregivers of young children
Federal Funding Changes
The federal government reduced extra funding for expansion states. This starts in 2026. Utah may face higher costs.
Income Limit Increases
FPL adjustments raised limits by about 3%. This helps more people qualify.
Long-Term Care Income Cap
The income cap rose from $2,901 to $2,982 per month. This applies to nursing home and waiver programs.
Dental Benefits for Seniors
Adults 65+ now get dental coverage through a special waiver.
Spend-Down Program (Medically Needy)
Some people earn too much but have high medical bills. Utah offers a spend-down program. You can “spend down” your excess income on medical costs. Once you reach the limit, you qualify for Medicaid for the rest of the month.
This helps seniors who need nursing home care but exceed income limits.
How to Apply for Utah Medicaid
You have four ways to apply:
Online (Fastest):
Visit jobs.utah.gov/mycase
By Phone:
Call 1-866-435-7414
In Person:
Find a DWS office near you
By Mail:
Send forms to:
DWS
P.O. Box 45200
Salt Lake City, UT 84145-0200
What You Need to Apply
- Social Security numbers for all applicants
- Proof of Utah residency
- Proof of income (pay stubs, tax returns)
- Proof of citizenship or immigration status
- Medical records (for disability or long-term care)
Processing Time
Most applications take 45 to 90 days. Disability applications may take longer. You can check status online through myCase.
Estimate your eligibility with our Utah Medicaid eligibility calculator.
Quick Reference: 2026 Limits at a Glance
| Program | Income Limit | Asset Limit | Asset Test? |
|---|---|---|---|
| Adult Expansion | $1,800/mo | None | No |
| Pregnant Women | $1,875/mo | None | No |
| Children 0-5 | $1,875/mo | None | No |
| CHIP | $2,670/mo | None | No |
| Aging Waiver | $1,305/mo | $2,000 | Yes |
| New Choices Waiver | $2,982/mo | $2,000 | Yes |
| Nursing Home | Income to care | $2,000 | Yes |
| ABD Medicaid | Varies | $2,000 | Yes |
Frequently Asked Questions
What is the income limit for Utah Medicaid in 2026?
Adults qualify at 138% FPL (~$1,800/month). Pregnant women and young children qualify at 144% FPL (~$1,875/month). CHIP covers kids up to 205% FPL (~$2,670/month).
Does Utah Medicaid check your bank account?
Only for seniors, blind, or disabled applicants. The asset limit is $2,000 for one person. Regular Medicaid for adults and children has no asset test.
How long does Utah Medicaid approval take?
Most applications process in 45 to 90 days. Long-term care applications may take longer if they need medical assessments.
Can I get Medicaid if I own a house in Utah?
Yes, your primary home is usually exempt. The equity limit is $730,000. Your spouse or minor child can live there without affecting eligibility.
What is the 5-year look-back period?
Utah checks 60 months of financial records for nursing home and waiver applicants. Gifts or asset transfers during this time may cause penalties.
Does Utah Medicaid cover dental for adults?
Yes, adults 65 and older get dental benefits through a special waiver. Some other adult groups may have limited dental coverage.
Last Updated: February, 2026
Sources: Utah Department of Health & Human Services, MedicaidPlanningAssistance.org, HealthInsurance.org, Centers for Medicare & Medicaid Services
