Utah
What Is Utah Medicaid Long-Term Care?
Utah Medicaid is a joint state and federally funded program offering health coverage to low-income individuals. This page focuses on long-term care eligibility for Utah seniors aged 65 and older. In addition to care in nursing homes, assisted living, and adult foster homes, Medicaid also covers supportive services to help older adults remain at home.
What Types of Long-Term Care Medicaid Are Available in Utah?
What Is Institutional / Nursing Home Medicaid?
This is an entitlement program, meaning all who qualify receive assistance. Services are only available in nursing home settings.
What Are Medicaid Waivers / Home and Community Based Services (HCBS)?
These are not entitlement programs. Enrollment is capped, and waitlists may apply. Services aim to prevent or delay nursing home placement and are provided at home, adult day care, or assisted living.
What Is Regular Medicaid / Aged, Blind or Disabled (ABD)?
This entitlement program provides long-term care benefits for eligible individuals, such as personal care assistance or adult day services, in non-institutional settings.
What Are the 2025 Income and Asset Limits for Utah Medicaid?
What Are the Income and Asset Limits by Program?
Type of Medicaid | Single | Married (both applying) | Married (one applying) |
---|---|---|---|
Institutional / Nursing Home Medicaid | No income limit* $2,000 assets Nursing Home level of care | No income limit* $4,000 assets ($2,000 per spouse) Nursing Home level of care | No income limit* $2,000 for applicant & $157,920 for non-applicant Nursing Home level of care |
Medicaid Waivers / HCBS | Aging Waiver: $1,305/mo (3/1/25–2/28/26) New Choices Waiver: $2,901/mo (1/1/25–12/31/25) $2,000 assets Nursing Home level of care | Aging Waiver: $1,305/mo per spouse New Choices Waiver: $2,901/mo per spouse $4,000 assets ($2,000 per spouse) Nursing Home level of care | Aging Waiver: $1,305/mo (3/1/25–2/28/26) New Choices Waiver: $2,901/mo (1/1/25–12/31/25) $2,000 for applicant & $157,920 for non-applicant Nursing Home level of care |
Regular Medicaid / ABD | $1,305/mo (3/1/25–2/28/26) $2,000 assets Help with ADLs | $1,763/mo (3/1/25–2/28/26) $3,000 assets Help with ADLs | $1,763/mo (3/1/25–2/28/26) $3,000 assets Help with ADLs |
*Except for a $45/month Personal Needs Allowance, Medicare premiums, and possibly a spousal Needs Allowance, nearly all of a nursing home beneficiary’s income must be paid toward care (Patient Liability).
How Is Income Counted for Medicaid in Utah?
What Counts as Income?
Most income sources—like wages, Social Security, pensions, and dividends—count toward Medicaid limits. Some exceptions include Holocaust restitution and VA Aid & Attendance benefits.
How Is Income Treated for Married Couples?
For Nursing Home Medicaid or HCBS Waivers, only the applicant’s income is counted. The non-applicant spouse may receive a Minimum Monthly Maintenance Needs Allowance (MMMNA), which in 2025 is $2,644/month, up to a maximum of $3,948/month.
Is Income Counted Differently for Regular Medicaid?
Yes. For Regular Medicaid (ABD), both spouses’ incomes are considered, and the spousal income protection rule does not apply.
How Are Assets Treated Under Utah Medicaid?
Which Assets Count?
Countable assets include bank accounts, investments, real estate (other than primary residence), and retirement accounts. Non-countable assets include personal belongings, a vehicle, and a home (with conditions).
How Are Assets Evaluated for Married Couples?
Assets are considered jointly owned. For Nursing Home Medicaid or Waivers, the non-applicant spouse can keep up to $157,920 in 2025, or at minimum, $31,584.
What Is the Medicaid Look-Back Period?
Utah enforces a 60-month (5-year) look-back period to review asset transfers. Gifts or undervalued asset transfers may result in a penalty period of ineligibility.
Can the Home Be Exempt from Medicaid?
Under What Conditions Is a Home Exempt?
If the applicant or their spouse lives in the home, or the applicant has “Intent to Return,” the home may be exempt. In 2025, the home equity interest must be below $730,000 if no spouse lives there.
What About After Death?
The home is subject to Medicaid Estate Recovery, meaning the state may claim reimbursement for care costs from the estate unless proper planning is in place.
What Are the Medical Requirements for Long-Term Care Medicaid?
What Functional Need Is Required?
Applicants must require a Nursing Home Level of Care (NHLOC) for Nursing Home Medicaid or Waivers. For Regular Medicaid, help with Activities of Daily Living (ADLs) may suffice.
Can Seniors Qualify If Over the Income or Asset Limits?
What Is the Medically Needy or Spenddown Pathway?
This allows applicants with high medical expenses to qualify despite income over the limit. In 2025, the MNIL is $1,305/month (single) and $1,763/month (couple), with asset limits of $2,000 and $3,000 respectively.
How Does Asset Spend Down Work?
Excess assets can be converted to exempt ones by paying off debt, modifying the home, or prepaying funeral costs. Documentation is essential to avoid violating the Look-Back Rule.
What Is Medicaid Planning?
For those over limits, working with a Medicaid Planner can help qualify for benefits and protect assets like the home. Planning is especially helpful for borderline or complex cases.
What Specific Long-Term Care Programs Are Offered in Utah?
State Plan Personal Care Services Program
This provides help with daily activities such as bathing, meal preparation, and mobility to allow seniors to remain at home.
Aging Waiver
Available to those 65+, this waiver offers services like adult day care, homemaker help, home modifications, and the ability to hire family as caregivers.
New Choices Waiver (NCW)
This helps individuals transition from institutional settings to home or community-based living. It includes assistive devices, respite care, and allows self-direction of services.
How Do Seniors Apply for Utah Medicaid?
What Are the Application Options?
Apply online at myCase, download and mail the paper form, or visit a local Department of Workforce Services (DWS) office. Contact DWS at 866-435-7414 for assistance.
What Should Be Done Before Applying?
Ensure all eligibility criteria are met. If you’re over limits or unsure, consider Medicaid planning for guidance. Understanding the application process can prevent denial.