Utah Medicaid pays for long-term care at home instead of in a nursing facility through two Home and Community-Based Services (HCBS) waivers: the Aging Waiver and the New Choices Waiver. These two Utah Medicaid HCBS waivers are built for older adults who need a nursing-facility level of care but want to stay in their own home or community, and both serve people age 65 or older. The New Choices Waiver reaches further, also covering adults ages 18 to 64 who have a physical or other disability and meet that same level of care.

In This Guide

What Are Utah Medicaid HCBS Waivers?

Home and Community-Based Services (HCBS) is the term federal Medicaid uses for long-term care delivered outside an institution, in your own home, a family member's home, or another community setting rather than in a nursing facility. Federal law lets states run these services through a special authority, and Utah uses it to operate two programs for older adults and, in one case, younger adults with disabilities.

Both of Utah's programs are authorized under section 1915(c) of the Social Security Act, the part of the law that lets a state pay for community-based long-term care as an alternative to a nursing facility. The idea behind a waiver is straightforward: the person qualifies for the level of care a nursing facility provides, and the waiver funds a package of supports so they can receive that care at home instead.

Here is the point that trips up a lot of families. A waiver is not the same thing as regular Medicaid coverage. You first have to be eligible for Utah Medicaid, and then you enroll in one of these waivers on top of it to get the home-based services. The next sections walk through each waiver, who qualifies, and how enrollment works.

The Aging Waiver and the New Choices Waiver

Utah's two waivers cover overlapping but different groups of people. The Aging Waiver is the older-adult program, and the New Choices Waiver adds a path for younger adults with disabilities. Here is how they line up.

Aging Waiver New Choices Waiver
Federal name and number Waiver for Individuals Age 65 or Older; federal Centers for Medicare & Medicaid Services (CMS) waiver 0247.R07.00 New Choices Waiver; CMS waiver 0439.R04.00
Who it serves People age 65 or older People 65 or older, and adults 18 to 64 with a physical or other disability
Level of care Nursing-facility level of care Nursing-facility level of care
Federal authority Section 1915(c) Section 1915(c)
Operating agency Utah Division of Aging and Adult Services Utah Medicaid

The Aging Waiver is run by the Utah Division of Aging and Adult Services, the state agency that also handles many other supports for older Utahns. The New Choices Waiver is approved by the federal government through June 30, 2030, so it is a stable, established program rather than a pilot.

If you are 65 or older, either waiver may fit depending on availability and your assessed needs. If you are between 18 and 64 and live with a physical or other disability, the New Choices Waiver is the community pathway to look at first.

Who Qualifies for Utah Medicaid HCBS Waivers?

Qualifying for a waiver comes down to two tests that you have to clear together: a functional test about your level of care, and a financial test about your income and assets.

The functional test. Both the Aging Waiver and the New Choices Waiver require that you need a nursing-facility level of care. In plain terms, that means your health and daily-living needs are serious enough that you would otherwise qualify for nursing-home care. The state assesses this, looking at how much help you need with everyday activities such as bathing, dressing, and managing medications. The waiver exists precisely so that a person at this level of need can stay in the community instead.

The financial test. You also have to meet Utah Medicaid's financial eligibility rules for income and assets. These are the same long-term-care Medicaid money rules that apply to nursing-home coverage, and they carry their own income limits, asset limits, and spousal protections. Because those figures change and depend on your household, we cover them in detail in the guides linked at the end. The short version: a waiver does not skip the financial test, so it is worth confirming your numbers before you apply.

One age-based distinction decides which waiver to pursue: only the New Choices Waiver reaches adults under 65. So if the person needing care is a younger adult with a qualifying disability, that is the waiver to ask about.

What the Waivers Cover

The whole point of a waiver is the package of services it pays for, the everyday supports that make staying at home realistic. Utah's waivers cover a similar set of services designed to keep a person safe and cared for in the community.

Covered services include:

  • Case management to coordinate your care
  • Personal attendant services to help with daily activities
  • Adult day health services
  • Homemaker and chore services
  • Respite care, so a family caregiver can take a break
  • Home-delivered supplemental meals
  • Emergency response systems
  • Environmental accessibility adaptations, such as grab bars or a wheelchair ramp
  • Non-medical transportation

You receive only the services you are assessed as needing, not the entire menu, so a care manager works with you to build a plan around your actual situation. The New Choices Waiver offers a comparable package of home and community supports for the people it serves.

Enrollment and the Aging Waiver's Limited Slots

Here is something to plan around. The Aging Waiver serves a limited number of individuals, which means its enrollment is capped rather than open to everyone who qualifies. A capped program can fill its available slots, so meeting the eligibility rules does not always translate into immediate enrollment. If that is the case when you apply, the state can tell you where you stand and what your options are.

The practical takeaway: apply as early as you reasonably can, and ask the agency directly about current availability rather than assuming a slot is waiting. Because availability shifts over time, the most reliable answer always comes from the program itself, not from a general description like this one.

How to Apply

Applying happens on two tracks that come together: getting onto Utah Medicaid financially, and enrolling in the waiver itself.

For the Aging Waiver, the fastest route is to contact the Utah Division of Aging and Adult Services directly. You can reach the division at (801) 538-3910 or by email at daas@utah.gov to ask about the waiver, eligibility, and current availability. For the New Choices Waiver, start with Utah Medicaid's long-term care and waiver programs.

If you are not already covered by Utah Medicaid, you will apply for it as part of the process. Federal rules require states to accept a Medicaid application several ways, so you can apply online, by phone, by mail, or in person at a local office, whichever is easiest for you. Once your application is in, federal timeliness rules set a limit on how long the state can take to decide: no more than 45 days for most applicants, and up to 90 days when eligibility is based on a disability. If you are close to those limits without an answer, it is reasonable to call and check on your case.

Frequently Asked Questions

Is there a waiting list for the Utah Aging Waiver?

The Aging Waiver serves a limited number of individuals, so its enrollment is capped. That means it can reach its available slots even for people who fully qualify. The most accurate way to find out where things stand is to ask the Utah Division of Aging and Adult Services about current availability when you apply, because the picture changes over time.

Which of the two waivers should I ask about?

Start with age. If the person needing care is under 65, the New Choices Waiver is the one to ask about, because the Aging Waiver is limited to people 65 or older. If they are 65 or older, either waiver can fit, so the deciding factor is availability: ask the Utah Division of Aging and Adult Services which one has an open slot, since the Aging Waiver's enrollment is capped.

Will a waiver pay for a nursing home, or only for home care?

These HCBS waivers fund care in your home and community as an alternative to a nursing facility, not the nursing-facility stay itself. Nursing-home care runs on a separate Medicaid track, and it works differently financially: a resident on nursing-facility Medicaid keeps only a small monthly Personal Needs Allowance (PNA), which federal law sets at a floor of at least $30 a month for an individual. Our Utah nursing home Medicaid guide and Utah Personal Needs Allowance guide walk through that track in detail.

How do I apply, and how long does a decision take?

You can apply for Utah Medicaid online, by phone, by mail, or in person, and you contact the Utah Division of Aging and Adult Services at (801) 538-3910 to ask about the Aging Waiver., Once your application is filed, the state generally has to decide within 45 days, or within 90 days when your eligibility is based on a disability.

Learn More

Find personalized help navigating Utah's HCBS waivers 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.