Medicaid is a program that helps low-income people pay for health care. It is run by the state and federal governments.
In Utah, it covers doctor visits, hospital stays, and prescriptions. It is vital for residents who cannot afford care. Many rely on it for check-ups and emergencies.
Utah expanded Medicaid in 2019. It started with limits but went full in 2020. This lets more adults get coverage. Adults without kids can qualify based on income. This change helped thousands.
This article covers eligibility for 2026. It includes updates on rules. We use 2025 values where 2026 data is not final.
The article will update after official releases from the Utah Department of Health and Human Services.
Accurate info on income and assets is key. Utah made changes to the expansion to cover more people. Always check official sites.
Quick Eligibility Overview
Many groups qualify for Utah Medicaid in 2026. Adults aged 19 to 64 under expansion can get it if their income is low. No need for kids.
Children from low-income families qualify. Limits are higher for young kids.
Pregnant women get coverage. It includes care after birth for 12 months.
Seniors 65 and older qualify for long-term care. Disabled people do too.
Income limits vary. Expansion adults can earn up to 138% of poverty level. Children up to 144% for ages 1 to 5. Pregnant women up to 144%.
General Medicaid has no asset test for most.
Long-term care does. It has stricter rules but higher income caps.
To apply, go online or to offices. Bring ID, pay stubs, and residency proof. Send all papers to avoid delays. Check status online.
Long-Term Care Medicaid Income and Asset Limits in Utah
Long-term care Medicaid helps people who need daily help. This includes bathing or eating. It pays for nursing homes or home services. Home services are called HCBS waivers.
It differs from regular Medicaid. Regular covers basic care with simple income rules. Long-term care has no strict income limit for nursing homes. But you pay most income toward care. Waivers have caps.
Special rules protect spouses. The at-home spouse keeps some assets and income.
Spend-down lets you use medical bills to lower income. This helps qualify.
Asset limits are $2,000 for a single person. Home equity limit is $713,000. Exempt items include personal things. Long-term care rules stand apart from expansion.
What Counts as Income for Utah Medicaid?
Income includes money you get each month. This counts Social Security like SSI or SSDI. Pensions from old jobs count. Veteran benefits are income. IRA or 401k payouts count. Rental money from property is included.
For standard Medicaid, use tax rules. Some things like gifts do not count. For long-term care, most income counts. You report all.
Long-term care has stricter checks. But it allows Miller Trusts for extra income. Income from assets must be reported. For children and pregnant women, some aid does not count.
What If Your Income Is Too High?
Income limits for 2026 depend on your group. Expansion adults can earn up to 138% of poverty level. If income is over, you may still qualify. For long-term care, use a Miller Trust.
This is a Qualified Income Trust. Put extra income in the trust. It lowers your counted income. The trust pays for care. Money left goes to the state after death. Miller Trusts help with income only.
Not assets. If over limit, you may get denied at first. Use spend-down to fix it. Pay bills to lower income.
Utah Medicaid Asset Rules
Assets are things you own. Countable assets include cash. Bank accounts count. Real estate besides your home counts if not used. Stocks and bonds are countable.
Exempt assets do not count. Your primary home is exempt up to $713,000 equity. One vehicle is exempt. Personal belongings like clothes do not count.
Utah looks back 5 years for transfers. If you give away assets to qualify, you get a penalty. This delays coverage. The penalty is based on transfer value. Get help from experts to plan transfers.
Spousal Protections Under Utah Medicaid
Rules protect married couples. When one needs long-term care, the other stays safe.
The Community Spouse Resource Allowance lets the at-home spouse keep assets. Up to $162,660 in 2026.
The Monthly Maintenance Needs Allowance helps with costs. It can be $2,642 to $4,066 per month.
These ensure the spouse at home has money. Both get support.
Why Long-Term Care Medicaid Is Different
Long-term care has higher income limits. But it tests assets strictly. It uses tools like Miller Trusts for income over caps.
Nursing home and HCBS rules differ from regular Medicaid.
Utah Medicaid Overview
Utah Medicaid provides free or low-cost health insurance. It is for low-income people and families. Expansion started in 2019. It covers adults without kids up to 138% of poverty level.
It covers hospital visits and doctor appointments. Mental health care is included. Prescriptions and substance use treatments too.
Children get dental and vision care. Utah tailors it with traditional services. Expansion for adults. Long-term care for seniors and disabled.
Eligibility bases on income and assets. Also categories like pregnant or elderly. Apply online at mycase.utah.gov.
Or in-person at offices. Call 1-866-435-7414 for help.
Who Qualifies for Utah Medicaid in 2026?
Adults aged 19 to 64 qualify under expansion. This includes those without kids if income is low.
Children qualify if family income is below limits. Higher for younger kids.
Pregnant women get coverage. It lasts 12 months after birth.
Seniors 65 and older qualify for long-term care. Disabled adults do too. People needing nursing home or home care qualify. Some do not. Childless adults over income do not. Always apply to check.
Income Rules Depend on Your Category
Rules vary by group. Adults under expansion have limits at 138% poverty level.
Children and pregnant women have higher thresholds. Up to 144% for young children.
Seniors and disabled have different rules for long-term care. Caps like $2,982 for some waivers.
They must meet income and asset limits. Home equity has exemptions.
Eligibility varies by category. Long-term care differs from expansion.
Utah Medicaid Income Limits (2025 Table – 2026 Update Pending)
Here are limits based on 2025. We will update for 2026 official numbers.
| Category | Household Size | Monthly Income Limit (2025) |
| Adult (Expansion) | 1 | $1,732 |
| Adult (Expansion) | 2 | $2,342 |
| Adult (Expansion) | 3 | $2,952 |
| Children | 1 | $1,810 (ages 1-5, 144% FPL) |
| Parents/Caretakers | 2 | $2,342 |
| Pregnant Women | 2 | $3,376 (144% FPL) |
| Seniors / Disabled (LTC) | 1 | $2,901 (New Choices Waiver) |
Note: These are 2025 values. We will update this article once the official 2026 numbers are released by Utah Medicaid.
Asset Testing Overview
Utah does not test assets for most adults. Children and pregnant women skip it.
Seniors and disabled get tested for long-term care.
Exempt assets are primary home and one car. Personal belongings too.
Countable are cash and stocks. Real estate besides home.
Transfers in 5 years can cause penalties. Follow rules to avoid delays.
Medicaid Eligibility for Seniors and Long-Term Care in Utah (2026)
It helps seniors and disabled with daily tasks. Like dressing or eating.
Options are nursing homes or assisted living. Or home care via HCBS.
Rules differ from general. Spend down assets with medical costs.
Spousal allowance lets at-home spouse keep assets.
Miller Trusts help with high income. Put excess in trust.
Working While on Medicaid
Yes, you can work and get Utah Medicaid.
Expansion covers if income is below limits.
Part-time or gig workers qualify based on pay.
Children get it no matter parents’ work.
How to Apply for Medicaid in Utah (Step-by-Step)
1. Check if you qualify at mycase.utah.gov.
2. Gather ID, income proof, assets, and Utah address.
3. Apply online at mycase.utah.gov.
4. Or visit a local office for help.
5. Submit all. Include everything.
6. Follow up if they ask for more.
7. Get decision by mail or online.
What Happens After You Apply?
They review your info. May ask for extra papers.
You get notice of yes or no.
If yes, benefits start. If no, appeal or fix.
Standard approval usually takes 45 days.
Disability or long-term care up to 90 days.
Missing papers delay it. Complete forms fully.
Common Reasons Utah Medicaid Applications Are Denied
Some reasons why Medicaid applications are denied in Utah are:
- Income over limit for group.
- Assets too high for long-term care.
- Wrong or missing papers.
- Not a Utah resident.
Medicaid vs CHIP in Utah (2026)
Medicaid covers low-income groups. Adults, kids, pregnant, seniors. Services like hospital and mental health.
CHIP covers kids over Medicaid limits. Up to 200% poverty.
Both by Utah Medicaid. CHIP has low premiums.
Apply same way. State picks the right one.
Frequently Asked Questions
Who is eligible for Medicaid in Utah in 2026?
In Utah, adults aged 19 to 64 can qualify under Medicaid expansion if their income is low. Children from low-income families, pregnant women, seniors 65 and older, and people with disabilities are also eligible based on income and asset rules. Always check your specific situation, as categories like long-term care have extra requirements.
What are the 2026 income limits for Medicaid in Utah?
For adults under expansion, the limit is 138% of the federal poverty level, about $1,835 per month for one person. Seniors and disabled people in long-term care waivers like New Choices have a cap around $2,982 per month. Limits update yearly and vary by household size and program.
How do I apply for Medicaid in Utah?
You can apply online at mycase.utah.gov, which is quick and easy. Or visit a local Department of Workforce Services office for in-person help. Gather your ID, income proof, and residency documents before starting to speed things up.
How long does it take to process a Medicaid application?
Standard applications usually take about 45 days to process. Cases for disability or long-term care can take up to 90 days due to extra reviews. Submit all required papers right away to avoid delays.
What are the asset limits for long-term care Medicaid in Utah?
For a single person, the asset limit is $2,000 in countable items like cash and stocks. Married couples with both applying have a $4,000 limit, while one applicant allows the healthy spouse up to $162,660. Homes and cars are often exempt if they meet rules.
What if I have more income than the Medicaid limit?
If your income is over the cap for long-term care, you can use a Miller Trust to qualify. This trust holds extra income and uses it for care costs, lowering what counts toward eligibility. It only works for income, not assets, and the state may claim leftovers later.
Can I keep my home if I apply for Medicaid?
Yes, your primary home is usually exempt from asset limits. The home equity limit is $752,000, so as long as your share is under that, it does not count. If a spouse or dependent child lives there, it stays protected even if you move to care.
Is there Medicaid for pregnant women in Utah?
Yes, pregnant women can qualify up to 144% of the poverty level, about $2,599 per month for a household of two. Coverage includes prenatal care and lasts 12 months after birth. No asset test applies for this group.
Final Takeaway
Utah Medicaid eligibility bases on income, assets, and category. Adults use expansion. Children and pregnant have higher caps. Seniors and disabled use long-term care rules.
We used 2025 limits here. 2026 updates come soon. Check for changes.
Apply online at mycase.utah.gov. Or visit offices. Get help if needed. Coverage helps many. Do not wait if you think you qualify.
