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 138% of the federal poverty level, roughly $1,835 a month 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: in 2026 Utah qualifies a single nursing-home applicant whose monthly income is at or below $2,982, set at 300% of the Supplemental Security Income (SSI) Federal Benefit Rate, and whose countable assets are at or below $2,000.5

This guide covers both tests: Utah's 2026 MAGI income limits by group, the parents and caretaker-relatives pathway, what changes on a 65th birthday, and the long-term-care rules: the $2,000 asset limit, how the 300% SSI standard and patient liability work, the spend-down path, what a nursing-home resident keeps, and how a spouse at home is protected.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 financial eligibility for most programs is determined by the Department of Workforce Services (DWS). That split matters in practice: you apply for benefits through DWS, and the medical program is run by DHHS. For long-term care, both touch your case. Medicaid itself is the joint federal-state program; Utah sets its own rules within the federal 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 to each other. Reading the wrong one is the most common way a family concludes they do not qualify when they do.

• 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 $2,982/month standard this guide leads with, and the one behind nursing-home and waiver Medicaid. It is the track for applicants who are 65 or older, blind, or disabled, and it carries the $2,000 asset limit. 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 and composition follow federal income-tax filing relationships (the tax household), so who is counted, and whose income is counted, can differ from the household rules used on the aged, blind, and disabled track for the very same family.10

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.1,11 Utah expresses these limits as a percentage of the federal poverty level (FPL) rather than as one flat dollar figure, 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, and the gap is not an error. The federal statute writes the new adult group's income standard as 133% of FPL, then applies a mandatory 5-percentage-point MAGI disregard, which lifts the effective ceiling to 138%. Utah publishes the effective, gross figure; the CMS table publishes the statutory base.1,2 For one person in 2026, 138% of FPL works out to roughly $1,835/month, or 138% of the $15,960/year federal poverty guideline for a household of one in the 48 contiguous states and DC.3,2

Two caveats on the table. The children and parent/caretaker percentages are drawn from the CMS national eligibility table, which carries a snapshot date, and Utah's Department of Workforce Services publishes its current limits for those programs as dollar income charts by household size rather than as a percentage.1 Check the DWS chart for the exact dollar figure that applies to your household before acting on a percentage.

Parents and caretaker relatives: Utah's 36% standard

Parents and other caretaker relatives are a federally mandatory Medicaid group, but they are the one MAGI group not pegged to the poverty level. Where children are mandatory to 133% of FPL and the adult group runs to an effective 138%, this group is covered only at the state's old cash-welfare standard, which is typically far below the poverty level. That standard is the AFDC income standard the state had frozen in place before the 1996 welfare-reform law, converted to a MAGI equivalent.12,13 Utah's standard sits at 36% of FPL, well under the poverty line: roughly $649/month for a two-person household, using the 2026 guideline of $21,640/year for two.1,3

For an older Utahn raising a grandchild, this is the group to look to, though Utah's Department of Workforce Services determines who counts as a caretaker relative, so ask them rather than assume. 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 the 36% standard, is generally picked up by the adult group at 138% of FPL instead.2,1 The low standard bites hardest on exactly the caretaker the adult group excludes: one who is 65 or older, or who is enrolled in Medicare. That person is measured on the aged, blind, and disabled track instead, asset test and all.2,4

Turning 65 closes the adult pathway

Because Utah has adopted the expansion, it also has the transition that comes with it. 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 becomes the SSI Federal Benefit Rate of $994/month for an individual rather than 138% of FPL, and a resource test appears where none could legally apply before, defaulting to the SSI standard of $2,000.7,4

The arithmetic is unforgiving. A 64-year-old covered at $1,600/month with modest savings can be over both tests the day they turn 65, without a dollar of their income changing.7,2 The same door closes early for someone under 65 who reaches Medicare through disability, because the adult group excludes anyone enrolled in Medicare.2 If that transition is coming, read the long-term-care and spend-down sections below before coverage lapses: the 300% standard, the medically needy spend-down, and the spousal protections are the pathways that pick up from there.

Children, pregnancy, and CHIP

For household completeness: Utah covers children under 19 through Medicaid at 139% of FPL for ages 0–5 and 133% for ages 6–18, and children above those levels through a separate CHIP program at up to 200% of FPL. Pregnant women are covered at gross income up to 139% of FPL.1 Coverage of children under 19 is federally mandatory down to a floor of 133% of FPL, and states may cover them higher, which is what Utah's 139% and its separate CHIP program do.13 None of these groups face an asset test.4

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

Utah holds to the traditional federal figure. A single nursing-home or waiver applicant is limited to $2,000 in countable assets under Utah Medicaid policy.5 For a married couple where one spouse needs care, 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, like every state, exempts a long list of assets from the count: the home (subject to an equity cap), one vehicle, household goods and personal effects, and prepaid burial arrangements. So the $2,000 applies to things like bank accounts, a second car, and investments, not the roof over someone's head.5

This is a low limit, and it's where most long-term-care planning happens. Couples in particular should read the spousal-protection section below before assuming a married applicant is shut out: the at-home spouse is governed by an entirely different, far larger allowance.

How the Utah Medicaid income limit works for long-term care: the 300% SSI standard

This is the test that governs the nursing-home and waiver applicant, and it is a world away from the MAGI limits above. Here's the part that confuses families who've read about other states. Many income-cap states slam the door on anyone whose income is even a dollar over the limit unless they route the excess through an income trust. Utah handles the over-income applicant differently.

Utah qualifies institutional applicants under an income standard set at 300% of the SSI Federal Benefit Rate. For 2026 the SSI rate is $994/month, so the standard works out to $2,982/month.5,7 An applicant whose gross monthly income is at or below $2,982 meets the income test for nursing-home Medicaid, and for the nursing-facility-level long-term care and waiver programs like the New Choices Waiver, which use the same standard.6

Once someone qualifies, Utah runs a post-eligibility calculation, often called patient liability: the resident's income, minus a set of allowed deductions, is directed toward the cost of their care, and Medicaid pays the balance. So qualifying doesn't mean the care is free; it means Medicaid covers what the resident's own income (after the allowances below) doesn't.5

What about income over $2,982? The spend-down path

If income runs above the standard, Utah doesn't leave the applicant stranded. The state has the over-income applicant spend down to the medically needy income limit: once the applicant has incurred enough in medical or care costs in a given month to cover the gap, Medicaid covers the rest of that month.6 Utah also operates a separate Spenddown program that over-income applicants may use.5 It works like a deductible: an over-income applicant still has a route in.

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

When Utah Medicaid pays for nursing-facility care, the resident contributes nearly all of their monthly income toward the cost of care through the patient-liability calculation above. What they keep for themselves is the Personal Needs Allowance (PNA), money reserved for small personal expenses like clothing, a haircut, or a phone. Utah sets its PNA at $45/month for a nursing-home resident, well above the federal floor of $30/month.5,8

That allowance is one of the figures families are most surprised by; it's deliberately small, because room, board, and care are already covered by Medicaid. (For the national picture on the PNA and how states set it, see our explainer on the Medicaid personal needs allowance.) If there's a spouse or dependent at home, additional income can be shifted to them before the rest goes to the facility, which the spousal section covers next.

The five-year look-back

Utah reviews asset transfers made in the 60 months before a long-term-care application.14 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 transferred value divided by Utah's average private-pay nursing-facility cost.14

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. 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 2026:5,9,15

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets and keep a monthly maintenance allowance in the federal range, on top of the applicant qualifying for Medicaid-funded care.9 Income from the institutionalized spouse can be diverted to bring the at-home spouse up to that allowance before patient liability is calculated.5 The home is generally protected up to the 2026 federal-minimum home-equity limit of $752,000, with equity above that line counted toward eligibility.15

After death: estate recovery

Like every state, Utah runs a Medicaid estate-recovery program. After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment for the cost of that care, with the federal exceptions (a surviving spouse, or a surviving child who is under 21 or disabled) and an undue-hardship waiver.6,16 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, which determines financial eligibility. There are two practical routes.

Long-term-care applicants also go through a level-of-care assessment to confirm they need nursing-facility-level services.6 Apply even if the income looks high: between the $2,982 income standard and the spend-down path, many people who assume they're over the line are not.

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.