Utah Medicaid Income Limits
Updated August 2026
Utah uses MAGI income rules for expansion Medicaid, children's coverage, and pregnant women. Most MAGI-based groups have no asset test. Seniors and adults applying for long-term care Medicaid use separate non-MAGI rules that include asset tests.
Utah Medicaid income limits by coverage group (2026 approximate)
| Coverage group | FPL % | ~Monthly limit (1 person) | ~Annual (family of 4) |
|---|---|---|---|
| Adults 19–64 — Expansion | 138% FPL | ~$1,769/mo | ~$43,896/yr |
| Pregnant women | ~144% FPL | ~$1,807/mo | Verify with DHHS |
| Children (Medicaid + CHIP) | Up to 200% FPL (CHIP extends higher) | Varies by age | ~$62,400/yr at 200% |
| Seniors 65+ and adults with disabilities (LTC) | Non-MAGI rules | Separate rules | Asset test applies |
Adults 19–64 — Expansion
- FPL %
- 138% FPL
- ~Monthly limit (1 person)
- ~$1,769/mo
- ~Annual (family of 4)
- ~$43,896/yr
Pregnant women
- FPL %
- ~144% FPL
- ~Monthly limit (1 person)
- ~$1,807/mo
- ~Annual (family of 4)
- Verify with DHHS
Children (Medicaid + CHIP)
- FPL %
- Up to 200% FPL (CHIP extends higher)
- ~Monthly limit (1 person)
- Varies by age
- ~Annual (family of 4)
- ~$62,400/yr at 200%
Seniors 65+ and adults with disabilities (LTC)
- FPL %
- Non-MAGI rules
- ~Monthly limit (1 person)
- Separate rules
- ~Annual (family of 4)
- Asset test applies
No asset test for expansion Medicaid
Utah expansion Medicaid, children's Medicaid, and the pregnant women's coverage group use MAGI rules with no asset test. A savings account, vehicle, or home equity does not affect eligibility for these groups.
Utah's MAGI income calculation excludes child support received by custodial parents, most irregular one-time income, and income of household members not in the tax filing unit. If you are uncertain whether an income source counts, apply — DHHS makes the determination.
Utah's employer-sponsored insurance (ESI) requirement and income
Utah is distinctive among expansion states in requiring some members to enroll in available employer-sponsored insurance. This requirement is not about income limits — it is about access to employer coverage. If DHHS determines that an employer plan is cost-effective, the expansion member must enroll in that plan and Medicaid acts as secondary coverage, paying the employee premium share.
Utah's Community Engagement Requirement — which would have required some expansion adults to work or participate in approved activities — was withdrawn after CMS determined in August 2021 that work requirements are not consistent with Medicaid's objectives. No community engagement requirement is currently in effect for Utah's standard expansion population, though this may change under H.R. 1 (2025) implementation.
Income and asset rules for seniors and long-term care
Utah Medicaid for seniors and adults with disabilities uses non-MAGI rules. The countable asset limit for a single individual is generally $2,000. For married couples, federal spousal impoverishment protections apply. Contact the Aging and Adult Services division at 1-877-424-4640 or your local Area Agency on Aging for current eligibility thresholds and LTSS program details.
Medicare Savings Programs (QMB) in Utah
For Utah residents on Medicare, help with premiums and cost-sharing comes not from Medicare but from three Medicare Savings Programs (MSPs) run through Utah Medicaid and the Department of Health and Human Services (DHHS) — the same agency that administers the coverage groups described above, though these programs use their own separate income rules.
| Program | Situation | Monthly income limit |
|---|---|---|
| QMB | Individual | $1,350 |
| QMB | Married couple | $1,824 |
| SLMB | Individual | $1,616 |
| SLMB | Married couple | $2,184 |
| QI | Individual | $1,816 |
| QI | Married couple | $2,455 |
QMB
- Situation
- Individual
- Monthly income limit
- $1,350
QMB
- Situation
- Married couple
- Monthly income limit
- $1,824
SLMB
- Situation
- Individual
- Monthly income limit
- $1,616
SLMB
- Situation
- Married couple
- Monthly income limit
- $2,184
QI
- Situation
- Individual
- Monthly income limit
- $1,816
QI
- Situation
- Married couple
- Monthly income limit
- $2,455
Qualified Medicare Beneficiary (QMB), the top tier, pays the Part A premium when one is owed, the full $202.90 monthly Part B premium in 2026, and all Medicare deductibles, coinsurance, and copayments. Utah providers, like providers everywhere, are prohibited by federal law from billing a QMB enrollee for any of these costs.
Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) enrollees get only the Part B premium covered. QI funding is capped each year and distributed first-come, first-served, requiring a fresh application annually — Utahns near the income threshold should apply promptly once the new year begins. QMB, SLMB, and QI enrollees are all automatically enrolled in Extra Help, which limits 2026 covered-drug costs to $12.65 per prescription.
Utah Medicaid
Visit the official Utah Medicaid websiteIncome Limits in Nearby States
Related guides
Income Limits
Current income cutoffs by state and household size, tied to the Federal Poverty Level.
Read more →Spend-Down
How to qualify by deducting medical bills from income that's above the limit.
Read more →QMB Program
What the QMB program covers, what a QMB card proves, and how to apply.
Read more →