Utah Medicaid covers hundreds of thousands of residents across multiple eligibility categories, each with its own income limit tied to the federal poverty level (FPL). For 2026, the 100% FPL baseline is $15,960 per year for one person and $33,000 per year for a family of four. From there, each Medicaid category has a different FPL percentage that determines the cutoff. If you want to quickly check what you qualify for, use the free Benefits Navigator screener to see all programs at once.
Who Qualifies for Utah Medicaid in 2026
Utah expanded Medicaid in January 2020, which means adults ages 19 to 64 without dependent children can qualify, not just families and children. The state program is called the Utah Premium Partnership for Health Insurance (UPP) for expansion adults, but most people simply call it Utah Medicaid.
The main eligibility categories are:
- Adults ages 19 to 64 (expansion): income at or below 138% FPL
- Pregnant women: income at or below 144% FPL
- Children ages 0 to 18: income at or below 205% FPL (Medicaid or CHIP)
- Adults 65 and older or people with disabilities: income and asset rules differ; long-term care programs use a separate income cap
- Cancer Screening Program: women with incomes up to 250% FPL who receive screenings through the program
Beyond income, you generally must be a U.S. citizen or qualifying immigrant, a Utah resident, and meet any category-specific requirements. There is no asset test for children, pregnant women, or expansion adults.
Utah Medicaid Income Limits by Household Size (2026)
The tables below show monthly and annual income limits for the main Medicaid categories, calculated from the 2026 federal poverty guidelines.
Adults Ages 19 to 64 (138% FPL)
| Household Size | Monthly Limit | Annual Limit |
|---|
| 1 | $1,835 | $22,025 |
| 2 | $2,486 | $29,863 |
| 3 | $3,138 | $37,702 |
| 4 | $3,790 | $45,540 |
| 5 | $4,449 | $53,388 |
| 6 | $5,098 | $61,178 |
For each additional person, add approximately $649 per month.
Pregnant Women (144% FPL)
| Household Size | Monthly Limit | Annual Limit |
|---|
| 1 | $1,915 | $22,982 |
| 2 | $2,596 | $31,162 |
| 3 | $3,277 | $39,341 |
| 4 | $3,960 | $47,520 |
| 5 | $4,640 | $55,680 |
| 6 | $5,320 | $63,842 |
Coverage for pregnant women includes full Medicaid benefits throughout pregnancy and continues for 12 months postpartum, regardless of income changes after delivery.
Children Ages 0 to 18 (205% FPL)
| Household Size | Monthly Limit | Annual Limit |
|---|
| 1 | $2,727 | $32,718 |
| 2 | $3,698 | $44,382 |
| 3 | $4,671 | $56,046 |
| 4 | $5,643 | $67,710 |
| 5 | $6,618 | $79,416 |
| 6 | $7,589 | $91,072 |
Children whose family income is above the Medicaid limit may still qualify for Utah CHIP, which uses the same 205% FPL threshold. CHIP covers kids not already insured through employer-sponsored plans.
100% FPL Reference (Used for Some Waiver Programs)
| Household Size | Monthly | Annual |
|---|
| 1 | $1,330 | $15,960 |
| 2 | $1,803 | $21,640 |
| 3 | $2,277 | $27,320 |
| 4 | $2,750 | $33,000 |
| 5 | $3,223 | $38,680 |
| 6 | $3,697 | $44,360 |
Long-Term Care Medicaid in Utah
Utah has separate rules for elderly adults and people with disabilities who need nursing facility care or home and community-based services. These programs include the New Choices Waiver and the Aging Waiver.
For long-term care programs, the income limit is approximately $2,901 per month (300% of the 2026 SSI federal benefit rate). Asset limits also apply: typically $2,000 for a single applicant and higher for married couples where only one spouse needs care. A spouse who remains in the community is protected under rules called the Community Spouse Resource Allowance.
Long-term care Medicaid rules are complex and vary based on the specific waiver or program. Speaking with a Medicaid planning specialist or contacting the Utah Department of Health and Human Services directly is recommended before applying.
What Utah Medicaid Covers
Utah Medicaid provides comprehensive health coverage including:
- Doctor visits and preventive care
- Emergency services
- Hospital stays (inpatient and outpatient)
- Mental health and substance use treatment
- Prescription drugs
- Laboratory and imaging services
- Vision and dental (limited for adults, more comprehensive for children)
- Maternity and newborn care
- Home health services
- Physical, occupational, and speech therapy
For children, coverage is more extensive under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which covers any medically necessary service.
Utah CHIP in 2026
Utah CHIP covers children up to age 19 whose family income falls within or near the 205% FPL range but may not qualify for full Medicaid. CHIP is divided into plans based on income:
- Plan A: 0 to 100% FPL (low or no cost)
- Plan B: 101% to 150% FPL (low monthly premiums)
- Plan C: 151% to 200% FPL (slightly higher premiums, still affordable)
Note: Utah State CHIP closed new enrollment as of January 31, 2026, but children already enrolled remain covered. Families with children who need coverage should apply through the standard Medicaid pathway, which covers children up to 205% FPL. Check with the Department of Workforce Services for current CHIP status.
How to Apply for Utah Medicaid in 2026
There are four ways to apply:
1. Online through myCase
Go to jobs.utah.gov/mycase-app/ui and click "Apply for Benefits." This is the fastest option. You can upload documents, check status, and communicate with your caseworker all in one place.
2. By phone
Call 1-866-435-7414 (toll-free) or 801-526-0950 (Salt Lake County). Lines are open Monday through Friday, 8 a.m. to 5 p.m.
3. By mail or fax
Download the application from medicaid.utah.gov, complete it, and mail to:
Department of Workforce Services
PO Box 143245
Salt Lake City, UT 84114-3245
Or fax to: 1-888-522-9505 (toll-free)
4. In person
Visit any Department of Workforce Services (DWS) office in Utah. Find the nearest location at jobs.utah.gov.
Documents to Gather Before Applying
Having these ready will speed up your application:
- Proof of identity (driver's license, state ID, or passport)
- Social Security number or card for all household members applying
- Proof of Utah residency (utility bill, lease, or mail with your address)
- Proof of income (recent pay stubs, employer letter, or most recent tax return)
- Proof of citizenship or immigration status
- For pregnant women: documentation from a healthcare provider
Processing Timeline
Applications are typically processed within 30 days. Paperwork received by DWS is imaged within 48 business hours. If verifications are missing, benefits may be prorated or delayed, so submit all required documents as soon as possible.
After you apply, your myCase account shows which documents have been received and which are still needed.
Income Counting Rules
Not all income counts the same way for Medicaid. For expansion adults and children, Utah uses Modified Adjusted Gross Income (MAGI) methodology, which includes:
- Wages and salaries
- Self-employment income
- Unemployment benefits
- Social Security benefits (in most cases)
- Alimony received (for divorce agreements prior to 2019)
Things that generally do not count:
- Child support received
- Supplemental Security Income (SSI)
- SNAP benefits
- Most one-time payments and gifts
For long-term care programs, different income counting rules apply and not all income exclusions available under MAGI rules will apply.
Renewals and Continuous Coverage
Once enrolled, Utah Medicaid must be renewed annually. DWS will send a renewal packet before your coverage expires. You can renew through myCase, by phone, or by mail.
If your income or household situation changes during the year (new job, loss of income, new family member), report the change through myCase or by calling DWS. Changes can affect your eligibility and benefit amount.
Missing a renewal deadline can result in a gap in coverage, so keep your contact information updated in myCase so you receive renewal notices.
If You Do Not Qualify for Medicaid
Households with incomes above 138% FPL but under 400% FPL may qualify for premium tax credits on the ACA Marketplace. At 400% FPL and above, you may still qualify for Marketplace plans without subsidies, which offer regulated coverage and guaranteed issue.
Use the free screener at Benefits Navigator to check both Medicaid and Marketplace eligibility at the same time based on your household income and size.
For questions about your specific eligibility, contact the Utah Department of Health and Human Services at 1-866-435-7414 or visit the Utah Medicaid page at medicaid.utah.gov or the Utah state benefits page.
Frequently Asked Questions
What is the income limit for Utah Medicaid for a single person in 2026?
For a single adult ages 19 to 64 under the expansion program, the income limit is approximately $1,835 per month or $22,025 per year (138% FPL). For pregnant women, it is approximately $1,915 per month or $22,982 per year (144% FPL).
Does Utah Medicaid have an asset limit?
For most Medicaid categories, including expansion adults, children, and pregnant women, there is no asset test. Asset limits apply only to long-term care programs, where a single applicant typically cannot have more than $2,000 in countable assets.
Can I apply for Utah Medicaid if I am self-employed?
Yes. Self-employment income counts toward your Medicaid income limit, but you can deduct business expenses first. Your net self-employment income is what gets counted. When applying, bring documentation of your business income and expenses.
How long does it take to get approved for Utah Medicaid?
Applications are generally processed within 30 days. In some cases involving complex situations or missing documentation, it may take longer. Submitting all required documents at the time of application helps avoid delays.
What happens if my income goes up after I enroll?
You are required to report income changes to DWS. If your income rises above the limit for your category, you may lose Medicaid eligibility but could qualify for ACA Marketplace subsidies instead. Use the Benefits Navigator screener to check what you qualify for based on your new income.
Does Utah Medicaid cover dental and vision for adults?
Utah Medicaid covers limited dental services for adults, primarily emergency dental care. Vision is also limited for adults. Children receive more comprehensive dental and vision coverage through EPSDT benefits.
Can undocumented immigrants get Utah Medicaid?
Generally, full Medicaid coverage requires citizenship or qualifying immigration status. However, Utah Medicaid does cover emergency services for individuals regardless of immigration status. Pregnant women with certain immigration statuses may also qualify for full coverage under specific circumstances.
What is UPP in Utah?
UPP stands for Utah Premium Partnership for Health Insurance. It is Utah's expanded Medicaid program for adults ages 19 to 64 who earn up to 138% FPL. It provides the same comprehensive coverage as standard Medicaid.
Is there a waiting period for Utah Medicaid?
There is no waiting period for most Medicaid categories. Once approved, coverage is typically retroactive to the first of the month in which you applied, or in some cases to the first day of the application month. Emergency Medicaid can cover services provided even before you applied in certain situations.
Where can I find the nearest DWS office to apply in person?
Visit jobs.utah.gov and use the office locator tool, or call 1-866-435-7414 to find the nearest Department of Workforce Services location.
