If you live in Utah and need affordable health coverage, Medicaid may be an option for you and your family. Utah expanded Medicaid in 2020 through its Utah Premium Partnership (UPP) program, which means more adults now qualify than ever before. Understanding the current eligibility rules, income limits, and application process can help you get the coverage you need. This guide covers everything you need to know about Utah Medicaid eligibility in 2026, including who qualifies, income thresholds by household size, and step-by-step instructions for applying.
You can also check your eligibility for Medicaid and other assistance programs using our free benefits screener. For a broader look at programs available in the state, visit our Utah Benefits Overview.
Who Qualifies for Utah Medicaid in 2026?
Utah Medicaid covers several groups of residents, each with its own income limits. The main eligibility categories include:
- Adults ages 19 to 64 with household income up to 138% of the Federal Poverty Level (FPL)
- Children up to age 19 with household income up to 205% FPL (through Medicaid or CHIP)
- Pregnant women with household income up to 144% FPL
- Parents and caretaker relatives with income up to 138% FPL
- Seniors age 65 and older and individuals with disabilities (income and asset limits apply)
- Former foster care youth up to age 26
To qualify, you must also be a Utah resident and a U.S. citizen or qualified immigrant. There is no asset test for most categories (adults, children, and pregnant women), but asset limits do apply for seniors and individuals with disabilities applying for long-term care Medicaid.
2026 Utah Medicaid Income Limits
Income limits for Utah Medicaid are based on the 2026 Federal Poverty Level guidelines, which were updated in January 2026. The table below shows annual and monthly income limits for the most common eligibility categories.
Adults (Ages 19 to 64) at 138% FPL
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $22,025 | $1,835 |
| 2 | $29,863 | $2,489 |
| 3 | $37,702 | $3,142 |
| 4 | $45,540 | $3,795 |
| 5 | $53,378 | $4,448 |
| 6 | $61,217 | $5,101 |
For households larger than 6, add approximately $7,838 per year for each additional person.
Children (Up to Age 19) at 205% FPL
Children in Utah can qualify for Medicaid or CHIP with higher income limits:
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $32,718 | $2,727 |
| 2 | $44,362 | $3,697 |
| 3 | $56,006 | $4,667 |
| 4 | $67,650 | $5,638 |
| 5 | $79,294 | $6,608 |
| 6 | $90,938 | $7,578 |
Pregnant Women at 144% FPL
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 1 | $22,982 | $1,915 |
| 2 | $31,162 | $2,597 |
| 3 | $39,341 | $3,278 |
| 4 | $47,520 | $3,960 |
| 5 | $55,699 | $4,642 |
| 6 | $63,878 | $5,323 |
Pregnant women in Utah receive full Medicaid coverage throughout pregnancy and for 12 months after giving birth (postpartum coverage).
Note: These income limits are based on Modified Adjusted Gross Income (MAGI). The figures above are estimates based on the 2026 Federal Poverty Level guidelines. Actual eligibility is determined by the Utah Department of Health and Human Services when you apply.
What Does Utah Medicaid Cover?
Utah Medicaid provides comprehensive health coverage, including:
- Doctor visits and specialist care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance abuse treatment
- Preventive care and screenings
- Lab work and X-rays
- Emergency room visits
- Dental care (limited for adults, more comprehensive for children)
- Vision care for children
- Maternity and newborn care
- Home health services
- Durable medical equipment
Children enrolled in CHIP receive a similar set of benefits, including dental and vision coverage.
How to Apply for Utah Medicaid: Step by Step
Applying for Utah Medicaid is straightforward. You have several options:
Option 1: Apply Online (Recommended)
- Visit the myCase portal at https://jobs.utah.gov/mycase/
- Create an account if you do not already have one
- Click "Apply for Benefits" and select health coverage
- Complete the application with your personal information, household details, and income
- Upload documents if requested (proof of income, identity, residency)
- Submit your application and save your confirmation number
Option 2: Apply by Phone
Call the Utah Medicaid eligibility line at 1-866-435-7414 (Monday through Friday). A representative can help you apply over the phone.
Option 3: Apply in Person
Visit your local Department of Workforce Services (DWS) office. You can find your nearest location at jobs.utah.gov.
Option 4: Apply by Mail or Fax
Download a paper application from medicaid.utah.gov/apply-medicaid and mail or fax it to your local DWS office.
Option 5: Apply Through Healthcare.gov
During open enrollment or a special enrollment period, you can also apply at Healthcare.gov. If you qualify for Medicaid, your application will be forwarded to the state.
What to Expect After Applying
- Utah typically processes Medicaid applications within 45 days (or 90 days for disability-based applications)
- You will receive a notice by mail with the decision
- If approved, your coverage may start as early as the date you applied or the first of the month
- If denied, you have the right to appeal
Documents You May Need
When applying, have the following ready:
- Social Security numbers for all household members
- Proof of income (pay stubs, tax returns, or employer statements)
- Proof of Utah residency (utility bill, lease, or mail with your address)
- Proof of citizenship or immigration status
- Information about any current health insurance
Utah Medicaid vs. CHIP: What is the Difference?
Both Medicaid and CHIP provide health coverage for children in Utah, but they work a bit differently:
- Medicaid covers children in families with income up to about 144% FPL at no cost to the family
- CHIP covers children in families with income between 144% and 205% FPL, with small premiums and copays
- When you apply, the state automatically determines which program your child qualifies for
You do not need to apply separately for CHIP. A single application covers both programs.
Special Programs and Situations
Former Foster Care Youth
If you were in foster care in Utah and aged out at 18 or older, you may qualify for Medicaid coverage until age 26, regardless of your income.
Emergency Medicaid
Undocumented immigrants and certain other non-citizens who do not qualify for full Medicaid may still receive coverage for emergency medical conditions, including labor and delivery.
Aged, Blind, and Disabled Medicaid
Seniors (65 and older) and individuals who are blind or disabled may qualify under different rules that include asset tests. In 2026, the asset limit is generally $2,000 for an individual. Income requirements vary, and a spend-down option may be available for those over the income limit.
Long-Term Care Medicaid
For nursing home care or home and community-based services, Utah Medicaid has stricter financial requirements. There is a 60-month look-back period for asset transfers. If you need long-term care planning help, consider consulting with a Medicaid planning professional.
Frequently Asked Questions
How do I know if I qualify for Utah Medicaid?
The fastest way to check is to use our free benefits screener, which checks your eligibility for Medicaid and other programs in minutes. You can also call 1-866-435-7414 for assistance.
Does Utah have a Medicaid coverage gap?
No. Utah expanded Medicaid in 2020, so there is no coverage gap. Adults with income up to 138% FPL can qualify for Medicaid, and those with higher incomes may qualify for subsidized Marketplace coverage.
Can I apply for Utah Medicaid at any time?
Yes. Unlike Marketplace health insurance, Medicaid has no open enrollment period. You can apply any time of year.
How long does it take to get approved?
Most applications are processed within 45 days. Disability-based applications may take up to 90 days.
What if my income changes after I am enrolled?
You must report income changes to the Department of Workforce Services. If your income goes above the limit, you may lose Medicaid eligibility but could qualify for subsidized Marketplace coverage instead.
Is there a cost for Utah Medicaid?
Traditional Medicaid has no premiums or copays for most enrollees. CHIP may have small monthly premiums (typically $0 to $75 per family, depending on income) and nominal copays for some services.
Can I use Medicaid while pregnant in Utah?
Yes. Pregnant women with income up to 144% FPL qualify for full Medicaid coverage during pregnancy and for 12 months after delivery.
Take the Next Step
If you think you or your family might qualify for Utah Medicaid in 2026, do not wait to apply. Coverage can begin as early as your application date, so every day you delay could mean missed benefits.
Use our free benefits screener to check your eligibility for Medicaid and over 10 other assistance programs in just a few minutes. You can also visit the Utah Benefits Overview page to explore all programs available in the state.
For direct application, visit myCase or call 1-866-435-7414 to get started today.
