Utah Medicaid Income Limits 2026: Eligibility Chart by Household Size

Written & Reviewed by Akash Biswas, MSW | Former Medicaid Caseworker Trainer | Verified against Medicaid.gov and Utah Medicaid official guidelines | Last Updated: May 2026

Quick Summary

• Most adults in Utah qualify if they earn at or below 138% of the Federal Poverty Level (FPL)
• Children and pregnant women qualify at up to 144% FPL
• CHIP covers children up to about 200% FPL
• No asset test for most working-age adults and families
• Seniors and people with disabilities follow different income and asset rules
• 👉 Use our free Medicaid Eligibility Calculator in 2026 to check your income in minutes

What Is Medicaid?

Medicaid is a free or low-cost health insurance program. The federal government and your state share the cost.

It covers millions of low-income people across the U.S. In Utah, the program is managed by the Utah Department of Health and Human Services, with eligibility handled by the Department of Workforce Services (DWS).

Who Qualifies for Medicaid in Utah in 2026?

Utah expanded Medicaid in 2019 under the Affordable Care Act. This means most low-income adults can now qualify — not just parents or people with disabilities.

You may qualify if you fall into one of these groups:

To qualify for any Utah Medicaid program, you must also:

• Be a Utah resident
• Be a U.S. citizen or have qualifying immigration status
• Have or apply for a Social Security number
• Meet the income rules for your specific program

To learn how Utah’s rules compare to other states, see our full guide on Medicaid Income Limits by State in 2026.

Utah Medicaid Income Limits 2026

Income is measured using Modified Adjusted Gross Income (MAGI) for most programs. This includes wages, self-employment, Social Security, and other income. Child support received and SSI payments do not count.

There is no asset test for MAGI-based programs. That means savings and property do not disqualify you.

ACA Medicaid Expansion — Adults Ages 19–64 (138% FPL)

Each additional person adds approximately $632/month to the limit.

Source: Calculated from 2026 HHS Federal Poverty Guidelines at 138% FPL

Medicaid for Children Ages 0–18 (144% FPL)

Each additional person adds approximately $682/month.

The unborn child counts as a household member when calculating family size.

Medicaid for Pregnant Women (144% FPL)

Pregnant women qualify under the same 144% FPL threshold as children. Your unborn baby is counted as a family member.

Postpartum coverage continues for 12 months after delivery. Presumptive eligibility allows prenatal care to start right away while your application is reviewed.

CHIP — Children’s Health Insurance Program (~200% FPL)

Children who earn too much for Medicaid may still qualify for Utah CHIP. CHIP covers uninsured children under age 19.

Source: chip.utah.gov — Effective March 2026

Utah CHIP is managed through three health plans: Molina Healthcare, SelectHealth, and Healthy U.

Long-Term Care Medicaid for Seniors (Ages 65+)

Seniors applying for nursing home or home-based care follow different rules. These programs use “countable income” — not MAGI. Asset limits also apply.

For nursing home care, most monthly income goes toward the cost of care. A $45/month Personal Needs Allowance is kept by the resident.

Spousal Protections in 2026

When only one spouse needs long-term care, the other spouse is protected:

• Minimum monthly income kept: $2,644/month
• Maximum monthly income kept: $4,066.50/month
• Assets the at-home spouse may keep: Up to $162,660
• Home equity exemption: Up to $752,000

Utah has a 60-month (5-year) look-back rule. Asset transfers made for less than fair market value within 5 years of applying may cause a penalty period.

Medically Needy / Spenddown Program

If your income is too high for regular Medicaid, you may still qualify through Utah’s Spenddown Program. You subtract qualifying medical bills from your income until you reach the limit below.

• Income limit (single): $1,330/month
• Income limit (couple): $1,803/month
• Asset limit: $2,000 (single) | $3,000 (couple)

Effective: March 1, 2026 – February 28, 2027

2026 Federal Poverty Level (FPL) Reference Table

All Medicaid income limits are based on the 2026 HHS Federal Poverty Guidelines.

Each additional person above 8 adds $5,680/year ($473/month).

Source: HHS ASPE 2026 Poverty Guidelines

For a full breakdown by coverage group, visit our guide on Utah Medicaid Eligibility in 2026.

What Does Utah Medicaid Cover?

Utah Medicaid covers a wide range of health services. Most enrollees receive care through a managed care plan.

Here is what is typically covered:

• Doctor visits and preventive care
• Hospital stays (inpatient and outpatient)
• Prescription drugs (through Utah’s preferred drug list)
• Mental health and substance use treatment
• Prenatal and postpartum care
• Vision and dental (limited for adults)
• Lab tests and X-rays
• Home- and community-based services (for qualifying seniors and people with disabilities)
• Long-term care (nursing facility and waiver programs)

Note on GLP-1 medications (e.g., Ozempic): As of January 2026, these require a Type 2 diabetes diagnosis (ICD-10 code) to be covered under Utah Medicaid managed care plans.

How to Apply for Medicaid in Utah

Applying is free. Here are your options:

Step 1 — Gather your documents. You will need proof of income, residency, ID, and Social Security number.

Step 2 — Choose how to apply.

Step 3 — Submit your application. You can apply any time — there is no open enrollment period for Medicaid.

Step 4 — Wait for a decision. Most applications are processed within 45 days. Disability-related cases may take up to 90 days.

Step 5 — Receive your Medicaid card. Once approved, you will get your card in the mail. Coverage usually begins on the first of the month you applied.

What Happens After You Apply?

After submitting your application, here is what to expect.

Processing Timeline

• Standard applications: Up to 45 days
• Disability-related applications: Up to 90 days
• Pregnancy applications: Faster review — presumptive eligibility may start immediately

Retroactive Coverage

Utah may cover medical bills from up to 3 months before your application date. Ask about this when you apply.

Annual Renewal

You must renew your Medicaid every year. Utah will mail you a renewal notice. Make sure your address is up to date with DWS.

2026 Policy Changes to Know

The One Big Beautiful Bill Act (OBBBA), signed in July 2025, will bring several changes:

• Work requirements of 80 hours/month will be required for expansion adults by January 1, 2027
• Some non-citizen enrollees may lose eligibility starting fall 2026
• CHIP continues through June 2028

Exemptions from work requirements include pregnant and postpartum individuals, caregivers of dependent children, people in substance use disorder treatment, and recently incarcerated individuals.

Utah also proposed a separate state-level work requirement waiver in 2025. As of April 2026, it has not been approved by CMS. Current Medicaid rules remain in effect.

To understand how reimbursement rates may affect your providers, see our guide on the Medicaid Fee Schedule in 2026.

Frequently Asked Questions (FAQ)

Sources & Disclaimer

Sources:

• Medicaid.gov — Official Medicaid Information
• Healthcare.gov — Medicaid & CHIP Overview
• Utah Medicaid — medicaid.utah.gov
• Utah CHIP — chip.utah.gov
• HHS ASPE 2026 Federal Poverty Guidelines
• Utah Department of Workforce Services — jobs.utah.gov/mycase

Disclaimer: CheckMedicaid.com is not affiliated with any government agency. This content is for educational purposes only. For official eligibility determinations, contact the Utah Department of Workforce Services at 1-866-435-7414 or visit medicaid.utah.gov.

Last Updated: April 2026

Utah Medicaid Income Limits 2025 (Monthly Income)

🏠 Household Size: 1 Person

• Adults (19–64) / Expansion Adults (138% FPL): $1,800
• Pregnant Women (139% FPL): $1,813
• Children (0–5): $1,813
• Children (6–18): $1,732
• Parents & Caregivers: $1,800
• Aged, Blind & Disabled (ABD – SSI level): $967
• Long-Term Care / Nursing Home (300% SSI): $2,901
• Children with Special Health Care Needs: $1,813

🏠 Household Size: 2 People

• Adults / Expansion Adults: $2,432
• Pregnant Women: $2,451
• Children (0–5): $2,451
• Children (6–18): $2,340
• Parents & Caregivers: $2,432
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $2,451

🏠 Household Size: 3 People

• Adults / Expansion Adults: $3,065
• Pregnant Women: $3,088
• Children (0–5): $3,088
• Children (6–18): $2,948
• Parents & Caregivers: $3,065
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $3,088

🏠 Household Size: 4 People

• Adults / Expansion Adults: $3,698
• Pregnant Women: $3,726
• Children (0–5): $3,726
• Children (6–18): $3,557
• Parents & Caregivers: $3,698
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $3,726

🏠 Household Size: 5 People

• Adults / Expansion Adults: $4,330
• Pregnant Women: $4,363
• Children (0–5): $4,363
• Children (6–18): $4,165
• Parents & Caregivers: $4,330
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $4,363

🏠 Household Size: 6 People

• Adults / Expansion Adults: $4,963
• Pregnant Women: $5,001
• Children (0–5): $5,001
• Children (6–18): $4,773
• Parents & Caregivers: $4,963
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $5,001

🏠 Household Size: 7 People

• Adults / Expansion Adults: $5,595
• Pregnant Women: $5,638
• Children (0–5): $5,638
• Children (6–18): $5,381
• Parents & Caregivers: $5,595
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $5,638

🏠 Household Size: 8 People

• Adults / Expansion Adults: $6,228
• Pregnant Women: $6,276
• Children (0–5): $6,276
• Children (6–18): $5,990
• Parents & Caregivers: $6,228
• ABD (SSI level): $1,450
• Long-Term Care / Nursing Home: $2,901
• Children with Special Health Care Needs: $6,276

✅ Quick Tips for Readers

• Amounts are monthly gross income limits
• Children have higher limits than adults
• Long-term care uses a fixed SSI-based limit
• ABD limits are much lower than expansion Medicaid