Utah Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Utah.
7.6 million Medicaid long-term care recipients nationwide
Utah Department of Health and Human Services - Division of Medicaid and Health Financing
Processing Time
30-45 days for standard Medicaid; New Choices Waiver applications take 45-60 days. Utah generally has adequate capacity with minimal waiting lists.
Utah Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Utah, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Utah follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Utah Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $7,378/month average (semi-private), $8,100/month (private) (the average monthly nursing home cost in Utah).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Utah
Nursing Home Care
Medicaid pays 100% of nursing home costs in Utah once eligibility is established. The average monthly cost is $7,378/month average (semi-private), $8,100/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
New Choices Waiver - Residential Assisted Living Services: Utah's New Choices Waiver includes services for individuals residing in licensed assisted living facilities (Type I or Type II). Medicaid covers personal care, medication administration, and care coordination through the waiver. Room and board costs are not covered—residents must pay housing costs from their monthly income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Utah offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
New Choices Waiver
Serves individuals age 65+ or adults with physical disabilities who meet nursing facility level of care. Provides adult day care, case management, chore services, environmental accessibility adaptations, home-delivered meals, homemaker services, personal care, respite care, skilled nursing, specialized medical equipment and supplies, and transportation. Approximately 4,800 participants statewide.
Program Details →Community Supports Waiver
Serves adults age 18+ with disabilities who require support to live independently but don't meet nursing facility level of care. More limited services than New Choices Waiver.
Program Details →How to Apply for Medicaid in Utah
Utah Medicaid applications typically take 30-45 days for standard Medicaid; New Choices Waiver applications take 45-60 days. Utah generally has adequate capacity with minimal waiting lists.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Utah through:
- Online at jobs.utah.gov/mycase (Utah Benefits Portal)
- Phone: 1-866-435-7414 (Utah Medicaid Information Line)
- Download application and mail to: Utah Dept of Health, P.O. Box 143106, Salt Lake City, UT 84114-3106
- In-person at Department of Workforce Services office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Utah from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Utah-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreWorking Individuals with Disabilities (WID)
Medicaid buy-in program for working individuals with disabilities. Allows income up to 250% FPL while maintaining coverage.
Learn MoreAging and Adult Services Division Programs
State aging agency providing case management, adult protective services, and senior centers statewide.
Learn MoreNeed Help with Utah Medicaid?
Contact Utah Department of Health and Human Services - Division of Medicaid and Health Financing for specific questions about eligibility, application status, or covered services.