Utah Medicaid Income Limits (2026)

Utah Medicaid is a full-expansion program that covers adults ages 19 to 64 with household income up to 138% of the Federal Poverty Level, a threshold equal to $22,025 per year for a single adult and $45,540 per year for a family of four in 2026. Utah voters approved Medicaid expansion through Proposition 3 in November 2018, and full coverage at 138% FPL launched in January 2020 after CMS authorized the expansion on December 23, 2019. Utah Medicaid is administered jointly by the Utah Department of Health and Human Services (DHHS) and the Department of Workforce Services (DWS), which handles eligibility determinations and the application portal. The 2026 Federal Poverty Level baseline is $15,960 for a single person in the 48 contiguous states, with a $5,680 increment per additional household member, making 138% FPL figures straightforward to verify against the ASPE HHS poverty guidelines published at aspe.hhs.gov.

Utah Medicaid eligibility splits into several population groups with different income thresholds. Adults who qualify under expansion (138% FPL) include both parents and childless adults ages 19 to 64. Pregnant women qualify at a slightly higher 139% FPL threshold throughout pregnancy and for 12 months postpartum. Children have a two-tier structure: children ages 0 to 5 qualify up to 144% FPL, while children ages 6 to 18 qualify up to 138% FPL for Medicaid, then continue to CHIP at up to 200% FPL. Aged, blind, and disabled Utahns who qualify under SSI-related rules have separate asset tests and income calculations that differ from the MAGI (Modified Adjusted Gross Income) approach used for expansion adults, children, and pregnant women. Long-term care Medicaid applies a 60-month lookback for asset transfers and an asset test of $2,000 for an individual.

The household-size table below shows 2026 Utah Medicaid income limits across the three main covered populations. Utah uses the same MAGI rules as all ACA-expansion states: no asset test for MAGI categories (adults, children, pregnant women), projected annual income from the most recent tax return or current pay stubs, and a 5% income disregard that is applied by the federal formula before the FPL percentage test. If your household income falls above the Utah Medicaid limit but below 400% FPL, you likely qualify for ACA marketplace subsidies through Healthcare.gov. If you have children whose family income exceeds the Medicaid threshold, check Utah CHIP at chip.utah.gov, which covers children up to 200% FPL. If you or a family member is 65 or older with limited income and Medicare coverage, check the Medicare Savings Programs section toward the bottom of this page.

Utah Medicaid income limits by household size (2026)

The 2026 Utah Medicaid income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = expansion-group threshold (138% FPL, ages 19-64). Children column = higher child threshold (144% FPL for ages 0-5; ages 6-18 use 138% FPL). Pregnancy column = Pregnant Woman Medical program (139% FPL). Add roughly $5,680 of annual income per additional household member.

Utah Medicaid eligibility requirements (non-income)

Beyond income, Utah Medicaid applicants must meet non-income requirements that vary slightly by population group. The rules below apply broadly across MAGI categories (expansion adults, children, pregnant women); aged, blind, and disabled populations face additional SSI-related asset and income rules.

• Utah residency: applicant must currently live in Utah with the intent to remain. No minimum length-of-residence requirement applies; temporary residents who intend to stay qualify. Homeless individuals may use the address of a shelter or DWS office.
• U.S. citizenship or qualifying immigration status: U.S. citizens, lawful permanent residents (subject to the federal 5-year bar in most cases), refugees, asylees, and certain other qualified immigrants are eligible. Undocumented individuals generally do not qualify for full Utah Medicaid but may receive emergency Medicaid for life-threatening conditions.
• Social Security Number: required for each household member applying for Utah Medicaid coverage. Applicants who do not have an SSN must provide one or apply for one as a condition of eligibility unless requesting only emergency Medicaid.
• Age requirements by category: expansion Medicaid covers adults ages 19 to 64. Children under 19 are covered under the children's categories (0-5 at 144% FPL; 6-18 at 138% FPL) or CHIP. Adults 65 and older are covered through aged Medicaid using SSI-linked rules, which often coordinate with Medicare.
• Asset test: NOT required for MAGI Medicaid categories (expansion adults, children, pregnant women). Asset test DOES apply for aged, blind, and disabled categories with a $2,000 limit for an individual and $4,000 for a couple. The primary home, one vehicle, and certain burial accounts are excluded from the asset count. Long-term care Medicaid also applies a 60-month lookback period for asset transfers.
• Other coverage: Utah Medicaid coordinates as the payer of last resort when other insurance exists. Applicants who have access to employer-sponsored insurance may be required to enroll in it under Utah's Premium Partnership program, in which case Medicaid may pay the premium and out-of-pocket costs.

What income counts for Utah Medicaid

Utah Medicaid uses Modified Adjusted Gross Income (MAGI) rules for expansion adults, children, and pregnant women. MAGI is based on the household's projected annual income as reported on a federal income tax return, before most deductions but after a set of federally mandated exclusions. Utah applies the standard federal 5% income disregard, which effectively raises the practical threshold slightly above the nominal percentage. Aged, blind, and disabled populations use SSI countable-income rules instead of MAGI, which involve different inclusion and exclusion categories.

Income sources included

• Wages, salaries, tips, and overtime pay (gross, before payroll taxes and pre-tax deductions)
• Net self-employment and 1099 / gig-economy earnings after allowable business expenses
• Social Security retirement (SSRB) and Social Security Disability Insurance (SSDI) benefits (note: SSI payments are excluded)
• Unemployment insurance compensation
• Pensions, annuities, and taxable retirement-account distributions (401k, IRA withdrawals)
• Rental income, interest, dividends, and capital gains
• Alimony received under divorce decrees finalized before January 1, 2019 (post-2018 alimony under TCJA is not taxable income and therefore not counted)

Income sources excluded

• Supplemental Security Income (SSI) payments (a distinct federal program from SSDI; SSI is not counted as MAGI income)
• Child support received (not taxable income under federal tax law)
• Veterans Affairs (VA) disability compensation, pension, and education benefits (GI Bill)
• Federal and state income tax refunds, including refundable credits (EITC, Child Tax Credit)
• SNAP (food assistance), TANF cash assistance, and most other needs-based public benefits
• Workers' compensation payments for workplace injuries
• Loan proceeds, gifts, and one-time inheritances received during the year

How to apply for Utah Medicaid in Utah

Utah Medicaid applications are processed by the Department of Workforce Services (DWS), which handles eligibility determinations for Medicaid, CHIP, SNAP, and other assistance programs. Applications can be submitted online through the myCase portal, by phone, by mail, or in person at any DWS office. The same application form covers medical assistance, food assistance, and financial assistance, so many applicants can determine eligibility for multiple programs at once.

1. 1. Gather your documents: photo ID or other identity verification for the head of household, Social Security Numbers for every household member applying for coverage, proof of Utah residency, proof of citizenship or qualifying immigration status, and recent income documentation (pay stubs, employer letter, or self-employment records).
2. 2. Go to jobs.utah.gov/mycase to create an account and start an online application, or call DWS at 1-866-435-7414 to apply by phone, or visit a DWS office in person.
3. 3. Complete the application by listing all household members, reporting all income sources, and indicating the type of assistance needed (medical, food, financial, or a combination).
4. 4. Upload or mail your supporting documents through myCase, or bring them to a DWS office. DWS will contact you by mail or phone if additional documentation is needed; respond promptly to any requests.
5. 5. Sign the application electronically in myCase or by hand on a paper form. Keep a copy of the confirmation number from your submission.
6. 6. Wait for DWS to mail your eligibility determination notice, typically within 45 days for most cases. Pregnant women may receive an expedited determination within 15 days under federal rules. If approved, your coverage start date will be listed on the notice.

Official portal: jobs.utah.gov/mycase

Documents needed

• Photo ID for the head of household (Utah driver's license, state ID, or passport)
• Social Security Numbers for every household member applying for coverage
• Proof of Utah residency (utility bill, lease agreement, bank statement, or signed letter from someone you live with)
• Proof of U.S. citizenship or qualifying immigration status (birth certificate, U.S. passport, Certificate of Naturalization, lawful permanent resident card, asylee letter, or refugee documentation)
• Last 30 days of pay stubs or a letter from your employer showing current wages (or 12 months of self-employment records if self-employed or working 1099 gigs)
• Most recent federal income tax return if available, or a signed statement that none was filed
• For pregnant women: written verification of pregnancy from a licensed medical provider
• For aged, blind, or disabled applicants: bank statements, vehicle titles, and any disability determination letters from the Social Security Administration

Processing timeline: Utah DWS has 45 days to make an eligibility determination for most Utah Medicaid applications. Pregnancy applications are typically processed within 15 days under federal expedited-processing rules. Disability-related applications may take longer if a medical determination is required. You can check the status of your application at any time through the myCase portal at jobs.utah.gov/mycase.

Common reasons applications get denied

• Household income above the applicable FPL threshold for the population group (the most common reason; expansion adult limit is 138% FPL, $22,025 for an individual or $45,540 for a family of four in 2026).
• Failure to provide requested documentation within DWS's follow-up window (common: missing pay stubs, missing proof of residency, or missing immigration documents).
• Federal 5-year bar for newly arrived lawful permanent residents (certain categories including pregnant women, children under 21, and refugees are exempt).
• Asset test failure for aged, blind, or disabled applicants (countable resources exceed $2,000 for an individual or $4,000 for a couple).
• Application outside the eligible age range (expansion Medicaid is for ages 19 to 64; children's Medicaid covers birth through 18; adults 65 and older are covered under aged Medicaid with SSI-linked rules).

If your child's family income is above the Utah Medicaid limit

Utah CHIP (the Children's Health Insurance Program) extends coverage to children under age 19 in households with income above the Medicaid threshold and up to 200% of the Federal Poverty Level. For a family of four in 2026, that is roughly $66,000 per year. Utah CHIP offers low-cost or free health coverage with copays and premiums that are lower than most private plans. Apply for Utah CHIP through the same DWS myCase portal at jobs.utah.gov/mycase or through the dedicated CHIP website at chip.utah.gov. DWS will automatically screen your child for Medicaid first; if they do not qualify for Medicaid, DWS routes them to CHIP evaluation.

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older or on Medicare with limited income

Utah administers three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries. The Qualified Medicare Beneficiary (QMB) program covers Medicare Parts A and B premiums, deductibles, and coinsurance for individuals with income up to 100% FPL (approximately $1,330 per month in 2026). The Specified Low-Income Medicare Beneficiary (SLMB) program pays Part B premiums for individuals with income up to 120% FPL (approximately $1,596 per month). The Qualifying Individual (QI) program also pays Part B premiums for income up to 135% FPL (approximately $1,795 per month), funded through a federal block grant with limited annual slots. All three programs have an asset test. Enrollment in any MSP automatically qualifies you for federal Extra Help (Low-Income Subsidy) which reduces Medicare Part D prescription drug costs. Apply through DWS at jobs.utah.gov/mycase or call 1-866-435-7414.

Read the Medicare eligibility guide

Frequently Asked Questions