Utah Medicaid points older adults who need long-term care at home to two Home and Community-Based Services (HCBS) waivers: the Aging Waiver and the New Choices Waiver.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT These two Utah Medicaid HCBS waivers are built for people who need a nursing-facility level of care but can be supported in the community, and both serve people age 65 or older.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT The New Choices Waiver also reaches adults ages 18 to 64 who have a physical or other disability and meet that same level of care.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT But the two waivers start from different places: the Aging Waiver is built to help older adults stay in their homes or other community settings, while the New Choices Waiver's primary goal is moving people out of institutional care into a less restrictive community setting.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
In This Guide
- What Are Utah Medicaid HCBS Waivers?
- The Aging Waiver and the New Choices Waiver
- Who Qualifies for Utah Medicaid HCBS Waivers?
- What the Waivers Cover
- Enrollment and the Aging Waiver's Limited Slots
- How to Apply
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 runs several waivers under it. Utah Medicaid directs older adults to two of them, one of which also serves younger adults with disabilities.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Both of those waivers 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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT 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.
Those two are not the only option an older adult may fit. The federal list of Utah's waivers also includes the Physical Disabilities Waiver, which serves people 65 or older and adults 18 to 64 with physical disabilities who meet a nursing-facility level of care.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Additional services it may provide include personal care assistance, consumer training and personal emergency response services, and applications for it go through the Division of Services for People with Disabilities (DSPD), not the aging network.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
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 main waivers for older adults cover overlapping but different groups of people, and they serve them at different moments. The Aging Waiver is the older-adult program built to help someone stay at home or in another community setting; the New Choices Waiver's primary goal is moving people out of institutional care into the community, and it also reaches younger adults with disabilities. Here is how they line up.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
| 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 |
| What it is built for | Helping older adults remain in their homes or other community settings | Moving people out of institutional care into a less restrictive community setting |
| Level of care | Nursing-facility level of care | Nursing-facility level of care |
| Federal authority | Section 1915(c) | Section 1915(c) |
| Where to start | Utah Division of Aging and Adult Services, which operates it; referral begins with your Area Agency on Aging | Utah Medicaid's long-term care and waiver programs |
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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT 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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Which one applies to you usually comes down to where the person is living right now, not just their age. If they are at home and you are trying to keep them there, the Aging Waiver is the program built for that.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT The New Choices Waiver is built for the other direction: Utah describes its primary goal as moving people out of institutional care into a less restrictive community setting.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT If the person is living at home rather than in a facility, ask Utah Medicaid directly whether New Choices fits their situation before you count on it.
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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT In plain terms, that means your health and daily-living needs are serious enough that you would otherwise qualify for nursing-home care. For the Aging Waiver, the referral starts with your local Area Agency on Aging, and a case manager there must evaluate whether the waiver is appropriate for the person.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT 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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Those rules carry their own income limits, asset limits, and spousal protections, and because the 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.
The setting test. One age-based distinction narrows the field: of the two main waivers, only New Choices reaches adults under 65, though the Physical Disabilities Waiver also serves adults 18 to 64 with physical disabilities.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT But age is not the whole story, because the New Choices Waiver's primary goal is moving people out of institutional care into a community setting.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT So a younger adult with a qualifying disability who is living at home should confirm with Utah Medicaid whether New Choices or the Physical Disabilities Waiver fits before building a plan around either one.
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 lists the Aging Waiver's services in detail, and the New Choices Waiver provides a similar package.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Aging Waiver services include:
- Case management to coordinate your care
- Personal attendant services to help with daily activities
- Adult companion services
- Adult day health services
- Homemaker and chore services
- Community living services
- Respite care, so a family caregiver can take a break (it can be provided in a long-term care setting)
- Supportive maintenance home health aide services
- Home-delivered supplemental meals
- Emergency response systems and medication reminder systems
- Environmental accessibility adaptations and specialized medical equipment
- Fiscal management services and personal budget assistance
- Non-medical transportation
You receive only the services you are assessed as needing, not the entire menu, so the plan is built around your actual situation.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT The New Choices Waiver offers a similar package of home and community supports for the people it serves.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
Can a family member be the paid caregiver? On the two main waivers, yes, within limits. On the Aging Waiver, Personal Attendant Services can be self-directed, and relatives other than legal guardians and spouses may provide waiver services, so an adult child can be the paid attendant; a spouse may be paid only for care the state approves as extraordinary care.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (lists UT Waiver for Individuals Age 65 or Older (0247.R07.00)). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT On the New Choices Waiver, relatives who are not legally responsible for the participant can be hired through Self-Administered Services, and a spouse may be paid only for approved extraordinary care and no more than the care plan approves. The 2021 version of the waiver capped a spouse at 40 hours a week; the current waiver took effect in July 2025, so ask the case manager what limit applies now.Centers for Medicare & Medicaid Services. (n.d.). UT New Choices Waiver (0439.R04.00) - State Waivers List - Medicaid.gov (CMS). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83336 Our guides to Utah Aging Waiver family caregiver pay and Utah New Choices Waiver family caregiver pay walk through who can be paid and how to start.
Enrollment and the Aging Waiver's Limited Slots
Here is something to plan around. The Aging Waiver serves a limited number of individuals, so there may not be room for everyone who qualifies.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Utah Medicaid also warns that space in its home and community-based waivers is limited and may not be available in all areas.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT 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 to ask about the waiver, eligibility, and current availability.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT 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, whichever is easiest for you; check Utah Medicaid's own instructions for the channels it runs.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907 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 you apply on the basis of disability, except in unusual circumstances such as a delay caused by the applicant or an examining physician.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 Those are caps on the agency rather than a promised decision date, and note which one covers you: the 90-day window turns on applying on the basis of disability, so an older applicant seeking waiver care is usually on the 45-day standard. 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, and Utah Medicaid says space in its waivers is limited and may not be available in all areas.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT That means there may not be room even for someone who fully qualifies. 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 where the person is living. If they are at home, the Aging Waiver is usually the one to ask about, because the New Choices Waiver's primary goal is moving people out of institutional care into a community setting.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Utah 1915(c) Waiver Factsheet (Aging 0247.R07.00, New Choices 0439.R04.00, Physical Disabilities 0331.R06.00, Community Supports 0158.R08.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Age then narrows it further: the Aging Waiver is limited to people 65 or older, while the New Choices Waiver also reaches adults 18 to 64 with a physical or other disability.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT A younger adult with a physical disability can also ask about the Physical Disabilities Waiver.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Because the Aging Waiver serves a limited number of people, ask the Utah Division of Aging and Adult Services about current availability as well.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT
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.Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Nursing-home care runs on a separate Medicaid track, and it works differently financially: a resident's income goes toward the cost of care after certain deductions, starting with a monthly Personal Needs Allowance (PNA).U.S. Government Publishing Office. (2024). 42 U.S.C. 1396a(q) — Minimum monthly personal needs allowance deduction (govinfo.gov, United States Code, 2024 Edition). govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396a.htm Federal law sets that allowance at no less than $30 a month for an individual and lets each state set it higher, and other allowances, such as one for a spouse still living at home, are deducted too.U.S. Government Publishing Office. (2024). 42 U.S.C. 1396a(q) — Minimum monthly personal needs allowance deduction (govinfo.gov, United States Code, 2024 Edition). govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title42/html/USCODE-2024-title42-chap7-subchapXIX-sec1396a.htm 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.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907,Centers for Medicare & Medicaid Services. (1915). Utah Waiver Factsheet - Medicaid.gov (1915(c) HCBS waivers). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/UT Once your application is filed, federal rules give the state at most 45 days to decide, or at most 90 days when you apply on the basis of disability, except in unusual circumstances.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 Those are ceilings on the agency, not a guarantee your answer arrives by that date, and the state can't use them as a reason to deny you.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912
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