Utah Medicaid Income Limits 2026: Eligibility & Asset Rules

There is no single Utah Medicaid income limit. Utah runs two different income tests, and which one measures you depends on your age and on why you need coverage. If you are under 65 and not enrolled in Medicare, Utah covers you through the ACA expansion at an effective 138% of the federal poverty level, about $22,025 a year for one person, with no asset test at all.1,2,3,4 If you are 65 or older, blind, or disabled, or you need nursing-home care, a stricter test applies: countable assets are capped at $2,000 for a single nursing-home or waiver applicant, and there is no single income cap. For nursing-facility Medicaid, Utah's rule is that monthly income must generally be less than the private cost of nursing-home care, with a spend-down available. The $2,982/month figure often quoted for Utah, 300% of the Supplemental Security Income (SSI) Federal Benefit Rate, is the limit for particular waivers, not for Utah long-term care as a whole.5,6

Who runs Utah Medicaid, and the two agencies you'll deal with

Utah Medicaid is administered by the Utah Department of Health and Human Services (DHHS), but eligibility for long-term-care Medicaid is determined by Department of Workforce Services (DWS) eligibility workers. That split matters: you apply through DWS, DHHS runs the medical program, and for long-term care both touch your case. Utah sets its own rules within the federal Medicaid frame, and the rules below are Utah's.5

Which Utah Medicaid income limit applies to you: MAGI or the aged-and-disabled test

Utah measures applicants against one of two income tests, and they are not close.

• The MAGI test. MAGI stands for Modified Adjusted Gross Income. It governs adults under 65 who are not enrolled in Medicare, parents and caretaker relatives, pregnant women, and children. Federal law bars Utah from applying any asset or resource test to these groups.4
• The SSI-related aged, blind, and disabled (ABD) test. This is the track for applicants who are 65 or older, blind, or disabled, and the one behind nursing-home and waiver Medicaid. It carries the $2,000 asset limit for a single nursing-home or waiver applicant, and its income standard depends on which program you are applying for, as the long-term-care section below sets out. Federal law expressly excepts this track from the no-asset-test rule.5,4

The two tests also count different people. On the MAGI track, household size generally follows federal income-tax filing relationships (the tax household), so who is counted, and whose income is counted, can differ from the aged, blind, and disabled track for the very same family. Generally, not always: for someone who does not expect to file and will not be claimed as a dependent, non-filer rules are used instead, and you do not have to file a return to apply.7

Utah Medicaid income limits for the MAGI groups in 2026

Utah has adopted the ACA Medicaid expansion, so it runs the full set of MAGI groups, including the adult group.1 Utah states these limits as percentages of the federal poverty level (FPL), because the dollar amount moves with household size.

Utah's Medicaid agency states the adult expansion limit as annual income up to 138% of the FPL, while the CMS national eligibility table lists Utah's expansion level at 133%. Both are right. The regulation writes the group's standard as 133% of FPL, then requires a 5-percentage-point MAGI disregard, which lifts the effective ceiling to 138%. Read that disregard narrowly, though: it applies when testing income against the highest MAGI standard available for a family size, not group by group, so do not assume 5 points get added to whichever standard you are checking.1,2 For one person in 2026, 138% of FPL is about $22,025 a year, against the $15,960/year federal poverty guideline for a household of one in the 48 contiguous states and DC. HHS publishes only annual figures, so the roughly $1,835/month version is our arithmetic.3

The CMS figures date from December 1, 2023, and the 36% is CMS's conversion of a dollar standard Utah sets by household size.1 Check Utah's current income tables before acting on a percentage.

Parents and caretaker relatives: Utah's standard of about 36%

Parents and other caretaker relatives are a federally mandatory Medicaid group, but unlike the children's and adult groups, their standard is not pegged to the poverty level. Where children are mandatory down to 133% of FPL and the adult group runs to an effective 138%, this group is covered at a standard the state sets between a federal floor and a federal ceiling. The floor is the state's AFDC income standard as it stood on May 1, 1988, converted to a MAGI equivalent, and it sits well below the poverty line.8,9 Utah sets its standard in dollars by household size, and CMS puts it at about 36% of FPL. Applied to the 2026 guideline of $21,640/year for two, that is roughly $7,790 a year, but treat it as a ballpark: Utah's own dollar table for your household size is the number that decides.1,3

For an older Utahn raising a grandchild, this group is worth asking about, though "caretaker relative" is a term federal rules define, so confirm you fit it when you apply.8 The 36% standard is also where Utah's expansion changes the answer: a caretaker who is under 65, not pregnant, and not enrolled in Medicare, and whose income runs over 36%, can qualify through the adult group at 138% of FPL instead. One condition rides with that: a state may not cover a parent or caretaker relative living with a dependent child under 19 through the adult group unless that child is on Medicaid or CHIP or otherwise has minimum essential coverage. Get the grandchild enrolled first.2,1 The low standard bites hardest on the caretaker the adult group excludes anyway: one who is 65 or older, or enrolled in Medicare. The caretaker group itself still uses MAGI rules and no asset test; above 36%, the aged, blind, and disabled track, asset test and all, comes next.4,1

Turning 65 closes the adult pathway

The new adult group is written for people under 65 who are not entitled to or enrolled in Medicare, at an effective ceiling of 138% of FPL, and, being a MAGI group, it applies no asset test.2,4 On the 65th birthday that pathway closes, and the same person is assessed on the SSI-related aged, blind, and disabled track instead. Two things change at once. The income yardstick changes from an effective 138% of FPL to the aged, blind, and disabled rules, which Utah sets program by program (one of its coverage groups, 100% FPL Aged and Disabled, is pegged to the poverty line itself), and a resource test appears where none could legally apply before ($2,000 for a single applicant on Utah's nursing-home and waiver programs). Ask DWS for the current dollar figure at your household size.5,4

The arithmetic is unforgiving: someone covered at 130% of poverty with modest savings can be above the 100% FPL group's line and, if they need nursing-home or waiver care, over the $2,000 resource limit the day they turn 65, without a dollar of their income changing.5 The same door closes early for anyone under 65 who reaches Medicare through disability, because the adult group excludes Medicare enrollees.2 If that transition is coming, read the long-term-care and spend-down sections below before coverage lapses.

Children, pregnancy, and CHIP

Utah covers children under 19 through Medicaid at 139% of FPL for ages 0–5 and 133% for ages 6–18 (CMS's figures as of December 2023), and above those levels through a separate CHIP program to 200% of FPL. Pregnant women are covered to 139% of FPL.1 Coverage of children under 19 is federally mandatory down to a floor of 133% of FPL, which a state may exceed.9 None of these groups face an asset test.4

The asset limit: $2,000 for a single applicant

A single nursing-home or waiver applicant is limited to $2,000 in countable assets under Utah Medicaid policy. For a married couple, the institutionalized spouse is allowed $2,000 while the at-home spouse is governed by the separate, far larger spousal allowance covered below.5

"Countable" is doing real work in those sentences. Utah's Program Summary gives examples of what it does not count for normal living: the home the family lives in (subject to the equity limit below), furniture, and most personal items. It is an illustration, not a closed list, and Utah adds that each program has its own rules about counting assets, so ask DWS about anything not named. Utah also excludes one vehicle per household, regardless of value, if it is used for transportation. A pre-need funeral contract that cannot be revoked or sold is excluded, and the part of it representing burial funds reduces the $1,500 maximum burial fund exclusion rather than sitting outside it. So the $2,000 test falls on what is left after those exclusions, not on the roof over someone's head.5

How the Utah Medicaid income limit works for long-term care: it depends on the program

There is no single 300%-of-SSI income cap across Utah long-term care. The income test differs program by program.5

• Nursing-facility Medicaid. Generally, a person's monthly income must be less than the private cost for nursing home care, and spenddown is allowed, treated as a contribution to care and paid to the nursing home.5
• The Aging, Brain Injury, Utah Community Supports, Technology Dependent Children, and Medically Complex Children waivers. These follow the nursing-home income rules, but the client keeps 100% of poverty for personal needs, $1,330/month in 2026. Spenddown is allowed on each.5
• The Physical Disabilities Waiver. This one does use an income limit of 300% of the SSI rate, $2,982/month for 2026 (300% of the $994 SSI Federal Benefit Rate). Someone over it must spend down to the medically needy limit for disabled people.5,6
• The New Choices Waiver and the Community Transitions Waiver. New Choices has its own age test: 65 or older, or 18 to 64 and meeting SSA disability criteria. Community Transitions serves people of all ages with intellectual disabilities who meet an aged, blind, or disabled category. Applicants for either waiver must then fit one of six coverage groups: SSI recipients; SSI protected-group individuals; 100% FPL Aged and Disabled (not spenddown clients); Medicaid Work Incentive; the Special Income Group (income not over 300% of the SSI rate, $2,982/month for 2026); or the Spenddown Waiver Group. The 300% figure is one route in, not the standard.5

Each of Utah's long-term care and waiver programs carries its own financial and level-of-care criteria; ask DWS which program you are being measured against.10,5

Once someone qualifies, Utah runs a post-eligibility calculation, often called patient liability: the resident's income, minus allowed deductions, goes toward the cost of care and Medicaid pays the balance. Qualifying does not mean the care is free.5,4

Over your program's income limit? The spend-down path

Someone who meets every condition except the income limit may be able to use Utah's Medically Needy program, usually called spenddown: they agree to spend monthly income down to the Medicaid standard, paying the excess to the state or to a medical provider. For nursing-facility Medicaid that amount is treated as a contribution to care and paid to the nursing home. Not all Medicaid programs allow spenddown.5

Long-term care: what a nursing-home resident keeps

When Utah Medicaid pays for nursing-facility care, most of the resident's monthly income goes toward the cost of care through the patient-liability calculation above. What they keep is the Personal Needs Allowance (PNA), money reserved for clothing, a haircut, a phone. Utah sets it at $45/month for a long-term stay, above the federal floor of $30 (an SSI recipient gets the $30 SSI payment plus a $15 state supplement). On the waivers that follow nursing-home income rules (Aging, Brain Injury, Utah Community Supports, Technology Dependent Children, and Medically Complex Children), the figure is far larger: 100% of poverty, $1,330/month in 2026. The Physical Disabilities and Community Transitions waivers use their own allowance, set by whether income is under or over 300% of the SSI rate.5,4

It is not the only money protected: incurred medical costs and insurance premiums come off too, a spouse or dependent at home can have income shifted to them, and federal rules permit a home-maintenance allowance for up to six months where a physician certifies the resident is likely to return home. Ask for each by name.4 (For the national picture, see our explainer on the Medicaid personal needs allowance.)

The five-year look-back

Utah reviews asset transfers made in the 60 months before a long-term-care application.11,12 Giving away money or property for less than fair market value during that window, gifting a grandchild a down payment, or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though the applicant is otherwise eligible. The penalty length is the total uncompensated value of what was given away, not its gross value, divided by the average monthly private-pay cost of nursing-facility care in Utah at the time of application. Utah updates that divisor periodically, so confirm the current figure with Utah Medicaid.11

There are real exceptions (transfers between spouses, to a blind or disabled child, certain caregiver-child home transfers), but anything inside the five-year window deserves an elder-law attorney's review before you move anything.11,12 For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other stays in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Utah applies the federal framework for 2026:5,12

Income from the institutionalized spouse can be diverted to bring the at-home spouse up to that allowance before patient liability is calculated.5 Do not read $162,660 as a hard ceiling on assets. Utah's Medicaid Policy Manual caps only the spousal-share route, so a hearing or a court order may lawfully set more. What narrows that route in practice is the mandatory income-first rule, under which the state must first treat all of the institutionalized spouse's available income as made available to the community spouse.5

The home is exempt from the equity test entirely while a spouse, a child under 21, or a blind or permanently and totally disabled child lawfully lives in it, whatever it is worth, so where the at-home spouse still lives there, the $752,000 line does not apply. Where nobody in that list lives there, equity above it bars long-term-care coverage, though the same statute preserves a reverse mortgage or home equity loan to bring equity below the line and requires a hardship waiver process.12

After death: estate recovery

Utah's Office of Recovery Services reaches further than long-term care: Utah says it recovers all Medicaid funds spent on a recipient who received medical assistance after age 55. For that age group, federal law requires recovery for nursing-facility and home and community-based services and related hospital and drug costs, and lets a state go further, as Utah does.10,13 Federal law bars recovery while a surviving spouse is living, and while there is a surviving child under 21 or blind or permanently and totally disabled, and requires every state to waive recovery for undue hardship. Read the surviving-spouse rule carefully: it is a deferral, not a permanent exemption. Recovery may be made after that spouse dies.13,10 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Utah

You apply through the Department of Workforce Services, whose eligibility workers decide your case: online, by mail, by fax, or in person at any DWS office. Two routes matter most.5

Nursing-home Medicaid also requires a nursing-facility level of care on top of the financial rules.10 Apply even if the income looks high: the program-specific tests and spenddown may still get you in.

Learn More

Find personalized help planning a parent's or spouse's path into Utah Medicaid long-term care at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.