Utah State Plan Personal Care: Utah 2026 Guide
Utah Medicaid’s state plan Personal Care Services pay for help with activities of daily living for Medicaid members who live at home. It is a regular Medicaid benefit, provided through enrolled home health or personal care agencies.
This guide covers who qualifies for State Plan Personal Care, what help is included, how to start, and where it fits among Utah’s other long-term care options. For the full statewide rules on income, assets, spouses and the look-back, see our Utah Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
What State Plan Personal Care is
A registered nurse from the provider agency assesses the person, and services are delivered under a plan approved by the person’s physician. Personal care is limited in hours and does not include the broader services of the waivers.
Personal care is hands-on help with everyday activities such as bathing, dressing, eating, using the toilet and moving around, plus related tasks like light housework when they support the person’s care. As a state plan benefit, it is an entitlement in Utah, so there is no enrollment cap for people who qualify. It is narrower than a waiver, though, and the number of hours depends on an assessment.
Who qualifies in 2026
Utah’s basic requirements are that a person must:
- be enrolled in Utah Medicaid;
- need help with activities of daily living because of a medical condition;
- have services ordered by a physician; and
- live at home.
The money test. Because State Plan Personal Care is a regular Medicaid service, the applicant must first be on Utah Medicaid, and for older adults the regular income limit is often lower than the special long-term care limit used for nursing homes and waivers. As a result, some people qualify for nursing home Medicaid but not for state plan home care, or only with a spend-down.
Personal care follows the member’s Medicaid group rules, which for many older adults is about 100 percent of the federal poverty level, with a spend-down possible above that.
Utah’s 2026 long-term care Medicaid numbers, from our state guide:
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | Nursing home: no fixed cap (income goes toward the cost of care). New Choices Waiver: $2,982 a month. Aging Waiver: 100% FPL ($1,330 a month) with a spend-down above that |
| Asset limit (single applicant) | $2,000 |
| Asset limit (couple, both applying) | $3,000 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Minimum $32,532 / maximum $162,660 |
| Spouse at home: monthly income allowance | $2,705 to $4,066.50 |
| Personal needs allowance (nursing home) | $45 a month |
| Look-back period | 60 months (5 years) |
Couples. State plan programs often count a married couple’s resources together, without the full spousal impoverishment protections.
Services State Plan Personal Care can cover
Help is authorized in hours a week or month, based on the assessment. Depending on need, State Plan Personal Care can include:
- bathing and grooming
- dressing
- toileting
- eating
- mobility and transfers
- light housekeeping related to the person’s care
Limits. State Plan Personal Care is not 24-hour care and does not cover room and board or general housekeeping; skilled nursing and therapy are separate Medicaid services. A waiver can add services such as respite and home changes when needs grow.
How to apply for State Plan Personal Care
The usual path is:
- Make sure the person is on Utah Medicaid.
- Request an order from the physician.
- Choose an enrolled agency, whose nurse assesses needs.
- Services are authorized under a plan of care.
- Services start.
Staying organized. Copy every form before you send it and keep a simple call log. During the assessment, describe a typical bad day rather than a good day, and have a family member present who knows how much help is really needed. Memory problems, falls and the need for supervision all count, even when the person can still do some tasks alone. If the answer is no, the written notice explains how to request a fair hearing and the deadline.
Waiting lists and timing
There is no enrollment cap, but hours are limited.
State Plan Personal Care is not capped, so there is no formal waiting list. Even so, the application, the assessment and finding an aide can each add weeks.
How it relates to nursing home Medicaid
Many State Plan Personal Care recipients have needs below a nursing home level of care. When needs grow beyond it, a waiver or nursing home becomes the next step. Nursing home coverage uses different, often more generous income rules.
Planning ahead for State Plan Personal Care
Families usually look into State Plan Personal Care after a health event or when a caregiver is stretched thin. A bit of preparation helps. Begin with a list of daily tasks, the people who handle them, and the gaps that appear when a caregiver is away. That list supports the assessment and shows where paid help would make the biggest difference.
Paperwork usually includes bank statements, income letters, insurance cards, and proof of identity and residence in Utah. Holding on to five years of records now saves time if fuller long-term care Medicaid is needed later. Legal documents matter too. A durable power of attorney and a health care directive let a trusted person act on applications without a guardianship.
Check in on how the arrangement is working every few months; a reassessment can adjust hours or services. A running log of health changes helps with every later review.
Tips for families
Before the assessment, list every task the person needs help with, how often, and how long it takes. If a relative wants to be the paid worker, check the program’s rules early, since rules on paying relatives, training and background checks vary. If hours seem too low, a written decision and a fair hearing are the remedy.
Many families find it worthwhile to talk with a Certified Medicaid Planner before applying for State Plan Personal Care. A planner who knows Utah’s rules can review income and assets, explain which program fits, map the timing against any waiting list, and help with the paperwork. Fees vary: roughly $500 to $6,000 for application help, $2,500 to $15,000 or more for full planning, and $150 to $600 an hour for advice.
Related pages
- Utah Medicaid guide
- Utah Aging Waiver
- In-home care and Medicaid
- Activities of daily living
- Consumer-directed care
- Paid family caregivers
- HCBS waivers explained
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.