Medicaid Eligibility for Seniors in Utah in 2025

Utah Medicaid Long-Term Care Programs

Utah’s Medicaid program provides long-term care assistance to seniors who cannot afford the care they need to remain safe and healthy. The program is designed to serve those who meet specific medical and financial requirements, offering support in nursing homes, assisted living facilities, and through home-based services.

Utah has three main categories of Medicaid long-term care: Institutional/Nursing Home Medicaid, Medicaid Waivers for Home and Community-Based Services (HCBS), and Regular Medicaid for the Aged, Blind, or Disabled (ABD). Each category has unique eligibility criteria for income, assets, and level of care.

Utah Medicaid Program Description:

Medicaid long-term care programs in Utah provide essential services such as personal care assistance, adult day care, home modifications, and nursing home payments. While institutional care is guaranteed for those who meet the requirements, HCBS Waivers have enrollment caps, often resulting in waiting lists. Home-based services are intended to delay or avoid the need for nursing home admission, allowing individuals to receive care in their own homes or in community settings.

Who is Eligible for Utah Medicaid Long-Term Care?

1. Residency and Citizenship – Applicants must be residents of Utah and either U.S. citizens or have appropriate immigration status.

2. Age/Disability – Applicants must be aged 65 or older, blind, or disabled. Medical requirements depend on the level of care needed, such as nursing home admission or assistance with daily living activities.

3. Income Limitations – The income requirements vary based on the program:
– Institutional/Nursing Home Medicaid: No income limit, but most income must go toward care, leaving a $45 personal needs allowance.
– HCBS Waivers: $2,901/month for the New Choices Waiver or $1,255/month for the Aging Waiver (2025 limits).
– Regular Medicaid (ABD): $1,255/month for single applicants or $1,704/month for married couples.

4. Asset Limitations – Applicants must have countable assets under $2,000 for single applicants or $3,000 for married couples (when both apply). The Community Spouse Resource Allowance allows non-applicant spouses to retain up to $157,920 in assets.

Exempt Assets for Utah Medicaid Applicants:

One home with equity under $730,000 (if the applicant or spouse resides there or intends to return).
One automobile, regardless of value.
Personal belongings, household furnishings, and appliances.
Burial plots and irrevocable burial trusts up to $7,000.
Life insurance with a combined face value of $1,500 or less.

Spousal Rules for Utah Medicaid (2025):

Income Protections: A non-applicant spouse can retain monthly income up to $2,555 or up to $3,948 if housing and utility costs exceed $767/month.

Asset Protections: The community spouse may keep 50% of the couple’s countable assets, up to $157,920, or 100% if assets total less than $31,584.

Getting Paid as a Caregiver in Utah

Utah Medicaid offers programs that allow family members to be compensated for providing care to eligible seniors. Through the HCBS Waivers, family caregivers can be paid to assist with daily living activities such as bathing, dressing, and preparing meals. Compensation varies depending on the program and the level of care required.

Steps to Becoming a Paid Caregiver:

Verify eligibility for the care recipient under Medicaid’s HCBS Waiver programs.
Complete any required caregiver training or certifications.
Work with a Medicaid-approved agency to set up a payment arrangement.

Caregivers may provide up to 40 hours of care per week, depending on medical necessity. Medicaid programs often allow care recipients to retain their income while the state pays the caregiver directly. This ensures families can keep loved ones at home while easing financial burdens.

Medicaid Waivers and Benefits in Utah:

Utah offers several Medicaid programs to support seniors:

Aging Waiver: Provides services like homemaker assistance, meal delivery, and caregiver support.
New Choices Waiver: Helps individuals transition from nursing homes to community-based living, with benefits like assistive technology and respite care.
Regular Medicaid (ABD): Offers personal care assistance and adult day care for those needing help with daily living activities.

How Long Does the Utah Medicaid Application Process Take?

The Utah Medicaid application process typically takes between 60–90 days if all documentation is complete and accurate. Processing times may increase for applicants requiring a spend-down program or the establishment of an income trust. Creating a Qualified Income Trust (QIT), often called a Miller Trust, is essential for applicants over the income limit. Without a properly executed trust, Medicaid benefits will be denied.

Senior Planning can assist with the creation of a Miller Trust and help structure assets to meet eligibility requirements. Working with a professional ensures the application process runs smoothly, avoiding delays and unnecessary denials caused by incomplete submissions or overlooked details.

Does Medicare Pay for Long-Term Care in Utah?

Medicare is not designed to pay for long-term care beyond a qualified short-term stay at a skilled nursing facility (SNF) or rehabilitation center. Generally, Medicare covers up to 100 days of care in an SNF following a qualifying hospital stay. Medicare will not provide coverage for seniors who require ongoing long-term care beyond this period.

For individuals needing extended care in nursing homes, assisted living facilities, or at home, Utah Medicaid is the appropriate program to seek assistance. Veterans may also be eligible for additional benefits through specialized programs designed for long-term care needs.

Can Someone Apply for Utah Medicaid on My Behalf?

Utah Medicaid allows applicants to designate an authorized representative to assist with the application process. This representative can be a family member, friend, or professional. Navigating the application process can be overwhelming, especially for those unfamiliar with Medicaid requirements and procedures. Errors or missing information can lead to significant delays or denials.

Senior Planning specializes in Medicaid applications and can help you or your representative through every step of the process. We can review your situation, ensure all required documentation is complete, and structure your assets to meet Medicaid eligibility. If you believe your application was unfairly denied, we can also assist with assessing the reasons for denial and help you reapply.

Contact Senior Planning for a free consultation to learn more about how we can support you or your loved ones in applying for Medicaid in Utah.