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.,, 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 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.,

This guide covers both tests: Utah's 2026 MAGI income limits by group, what changes on a 65th birthday, and the long-term-care rules, including the program-by-program income tests, the spend-down path, and how much a spouse at home is actually entitled to keep.

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: 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.

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. Reading the wrong one is the commonest 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.
  • 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, 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.,

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.

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., Utah states these limits as percentages of the federal poverty level (FPL), because the dollar amount moves with household size.

Eligibility group 2026 limit (% of FPL)
Adults 19–64 (Medicaid expansion) 138% (effective)
Parents and caretaker relatives 36%
Pregnant women 139%
Children, ages 0–1 139%
Children, ages 1–5 139%
Children, ages 6–18 133%
Separate CHIP (children) 200%
Pregnant-woman CHIP/BHP coverage Listed as N/A. Utah reports no separate coverage level for this group

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., 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 those guidelines annually, not monthly, so treat the roughly $1,835/month version as your own arithmetic.

One caveat on the table: the children and parent/caretaker percentages come from the CMS national table, which carries a snapshot date, while Utah's DWS publishes current limits as dollar charts by household size. Check the DWS chart for 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 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., Utah's standard is 36% of FPL: roughly $7,790 a year for a two-person household, against the 2026 guideline of $21,640/year for two.,

For an older Utahn raising a grandchild, this is the group to look to, though DWS decides who counts as a caretaker relative. 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%, is generally picked up by the adult group at 138% of FPL instead. One condition rides with that, and it is easy to miss: 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., The low standard bites hardest on the caretaker the adult group excludes anyway: one who is 65 or older, or enrolled in Medicare. That person is measured on the aged, blind, and disabled track, asset test and all.

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. 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 drops from an effective 138% of FPL to Utah's aged-and-disabled standard at 100% of poverty, and a resource test appears where none could legally apply before, at $2,000 for a single person. Ask DWS for the current dollar figure at your household size.,

The arithmetic is unforgiving: someone covered at 130% of poverty with modest savings can be over both tests the day they turn 65, without a dollar of their income changing. The same door closes early for anyone under 65 who reaches Medicare through disability, because the adult group excludes Medicare enrollees. 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, and above those levels through a separate CHIP program to 200% of FPL. Pregnant women are covered to 139% of FPL. Coverage of children under 19 is federally mandatory down to a floor of 133% of FPL, which a state may exceed. None of these groups face an asset test.

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.

"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, and one vehicle per household regardless of value if used for transportation. 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. A pre-need funeral contract is excluded only if it cannot be revoked and cannot be sold, 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 applies to bank accounts, a second car, and investments, not the roof over someone's head.

This is a low limit, and it's where most long-term-care planning happens.

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

This is where summaries of Utah most often go wrong. There is no single 300%-of-SSI income cap across Utah long-term care. The income test differs program by program.

  • 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.
  • 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.
  • 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.,
  • The New Choices Waiver and the Community Transitions Waiver. An applicant 65 or older, or 18 to 64 meeting SSA disability criteria, must 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.

So if you have read that Utah caps long-term-care income at $2,982 and concluded a parent earns too much, check again. 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.

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.

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. One limit matters, and Utah states it plainly: not all Medicaid programs allow spenddown.

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 home and community-based waivers other than the Physical Disabilities Waiver, the figure is far larger: 100% of poverty, $1,330/month in 2026.,

The facility figure is deliberately small, because room, board, and care are already covered, and 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. (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. 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.

There are real exceptions (transfers between spouses, to a 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. 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:,

Protection 2026 Amount What it does
Community Spouse Resource Allowance (CSRA) The greater of $32,532, half the couple's countable assets up to $162,660, a fair-hearing amount, or a court-ordered amount What the at-home spouse keeps, separate from the applicant's $2,000 limit. The last two routes carry no dollar cap.
Monthly Maintenance Needs Allowance (spousal needs standard) Minimum $2,705.00/month (eff. 7/1/2026); maximum $4,066.50/month (changes each January) The monthly income floor for the at-home spouse; income can be shifted from the applicant to reach it.
Home-equity limit $752,000 (2026 federal minimum) Equity in the primary residence above this amount bars long-term-care eligibility.

So a married couple is in a very different position from a single applicant. Income from the institutionalized spouse can be diverted to bring the at-home spouse up to that allowance before patient liability is calculated. Do not read $162,660 as a hard ceiling on assets. Utah's own Medicaid Policy Manual defines the community spouse asset allowance as equal to the greater of four amounts: the minimum allowance, the spousal share not to exceed the maximum, an amount determined at a fair hearing, or an amount determined by a court. The "not to exceed" attaches only to 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.

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 for most married couples the $752,000 line never bites. 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.

After death: estate recovery

After a recipient who was 55 or older and received long-term-care services dies, the state may seek repayment of what Medicaid correctly paid for that care. 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., 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: online, by mail, by fax, or in person at any DWS office. Two routes matter most.

1
Step 1

Apply online through myCase

The myCase portal at jobs.utah.gov/mycase is the DWS benefits portal, where you can submit an application and manage your case.

2
Step 2

Apply in person at a local DWS office

This route is useful for long-term-care applications, which involve more documentation.

Long-term-care applicants also go through a level-of-care assessment. Apply even if the income looks high: between the program-specific tests and the spend-down path, many people who assume they are over the line are not.

Frequently Asked Questions

What is the Utah Medicaid income limit for an adult under 65 in 2026?

An effective 138% of the federal poverty level, about $22,025 a year for one person, through Utah's Medicaid expansion. The group covers adults under 65 who are not pregnant and not enrolled in Medicare. No asset test applies.,,

Does Utah Medicaid count your assets if you are under 65?

Not on the MAGI pathway. Federal law bars any asset test for expansion adults, children, pregnant women, and parents and caretaker relatives. The $2,000 limit applies only on the aged, blind, and disabled track, which is also the nursing-home and waiver track.,

What happens to Utah Medicaid coverage when you turn 65?

The expansion adult group closes, because it covers only people under 65 who are not enrolled in Medicare. Eligibility is reassessed on the SSI-related aged, blind, and disabled track: the yardstick becomes Utah's aged-and-disabled standard at 100% of poverty instead of an effective 138% of FPL, and a resource test appears at $2,000 for a single person. Someone covered at 130% of poverty can be over both tests without their income changing.,

What is the Utah Medicaid income limit for nursing-home care in 2026?

There is no single dollar cap. For nursing-facility Medicaid, income must generally be less than the private cost of nursing home care, and spenddown is allowed. The $2,982/month figure widely quoted for Utah is the limit for the Physical Disabilities Waiver and one of six routes into the New Choices Waiver, not a general Utah long-term-care cap.,

What is the Utah Medicaid asset limit in 2026?

$2,000 in countable assets for a single nursing-home or waiver applicant. Utah gives the home (subject to the equity limit), furniture and most personal items, and one vehicle per household used for transportation as examples of what it does not count, not as a closed list, so ask DWS about anything else. A pre-need funeral contract is exempt only if it cannot be revoked or sold, and the burial-fund portion of it reduces the $1,500 maximum burial fund exclusion. For a married couple, the institutionalized spouse is allowed $2,000 and the at-home spouse keeps a separate, larger share.

What happens if your income is over the Utah Medicaid limit for your program?

Utah runs a Medically Needy program, usually called spenddown: someone who meets every condition except the income limit may agree to spend income down to the Medicaid standard, paying the excess to the state or to a medical provider. Not all Medicaid programs allow it, so a DWS eligibility worker decides whether yours does.

What does a nursing-home resident on Utah Medicaid keep each month?

A Personal Needs Allowance of $45/month on a long-term stay, plus allowed deductions and a spousal or dependent allowance where one applies. On the home and community-based waivers other than the Physical Disabilities Waiver, the client keeps 100% of poverty, $1,330/month in 2026, instead.,

How much can a spouse keep when the other goes into a nursing home in Utah?

More than the $162,660 figure suggests. Utah defines the community spouse asset allowance as the greater of four amounts: a minimum of $32,532; half the couple's countable assets, not to exceed $162,660; an amount set at a fair hearing; or an amount ordered by a court. Only the half-share route carries that cap. The spouse may also keep a monthly income allowance up to $4,066.50. The home is not subject to the equity test at all while that spouse lives in it.,

Learn More

MedicaidMedicaid Income Limits by State: Which Number Applies to YouMedicaid income limits depend on your pathway: expansion adults, aged and disabled, or nursing-home care. See the 2026 figures and your state's exact limits. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidHow Medicaid Estate Recovery WorksMedicaid estate recovery explained: federal law, 51-state matrix, categorical protections, hardship waivers, and 2025-2026 reform updates. Verify before acting. MedicaidThe Medicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, state figures from $30 to $200, and how patient liability is calculated. MedicaidUtah Programs That Help Pay a Senior's Health Coverage CostsUtah Medicare Savings Programs 2026: QMB, SLMB, and QI income limits, what each program pays, Part D Extra Help, and how to apply through Utah DWS via myCase. MedicaidUtah Medicaid Spousal Impoverishment RulesUtah Medicaid spousal impoverishment 2026: CSRA up to $162,660, MMMNA up to $4,066.50/month, no Miller Trust, the home exemption, and expanded estate recovery. MedicaidHow Utah Medicaid Estate Recovery WorksUtah Medicaid estate recovery uses an expanded estate definition that reaches non-probate assets like trusts and jointly held property. See the 2026 rules.

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.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.