Utah Medicaid Income Limits 2026: Adult and CHIP Chart

Applying costs nothing, and Utah Medicaid pays providers directly rather than giving you cash. Our national Medicaid income limits guide puts Utah next to every other state.

Utah Medicaid Income Limits by Household Size (March 2026)

Utah's Table VII lists 10 household sizes and 15 income standards, and a child's sixth birthday alone lowers the family's line by a few percent. Per the DHHS table effective March 1, 2026, these are the monthly limits for the main family groups:

Source: Utah DHHS, Medicaid Policy Manual Table VII (opens in a new tab), "Effective Date: March 1, 2026." Utah doesn't publish an "each additional person" amount; the table stops at 10. The 2026 program summary says the 5% FPL deduction applies to Adult Expansion, pregnancy, children's Medicaid and CHIP but not to PCR.

\ Table VII prints $5,550 for a family of four at 200%. Twice the 2026 HHS guideline for four ($33,000 a year) is $5,500 a month, and Utah's hospital presumptive eligibility manual doesn't list this column, so ask DWS which figure it applies if your family's income falls between the two.*

Yearly equivalents and the 5% deduction

Sources: yearly Adult Expansion figures from the DHHS Medicaid Expansion page (opens in a new tab). The deduction column adds 5% of the 2026 HHS poverty guideline ($67 for one person and $91 for two, as Table VII lists; Grantsights calculated the larger sizes the same way). The CHIP column is 200% of the 2026 HHS poverty guidelines (opens in a new tab), a Grantsights calculation.

Seniors, disability and long-term care limits

Sources: DHHS Table VII (opens in a new tab), Table II-A (opens in a new tab) and the 2026 Utah Medical Program Summary (opens in a new tab). Table VII lists the 2026 SSI rate as $994 for a single person and $1,491 for a couple.

How Utah Counts Your Income

Utah sorts applicants into 2 income systems, and the Department of Workforce Services (DWS) eligibility worker checks MAGI programs first before moving to the others, according to the Medicaid Policy Manual's eligibility decision rules (opens in a new tab).

MAGI programs include Adult Expansion, Parent/Caretaker Relative, Pregnant Woman, children's Medicaid and CHIP. Per the 2026 program summary, the deductions are "5% FPL and expenses from Schedule 1 of the IRS 1040 form," so adjustments such as student loan interest and educator expenses come off your gross income. None of these groups has an asset test. The household is based on who files taxes together, and a pregnant woman's household includes her unborn child.

The 5% deduction is $67 a month for one person and $91 for two in Table VII, and about $114 for three and $138 for four by the same formula. Parent/Caretaker Relative Medicaid doesn't get it.

Non-MAGI programs cover Aged, Blind, Disabled Medicaid, the Medicare cost-sharing programs, long-term care and the medically needy groups. These use SSI-style deductions: a $20 general exclusion, then $65 and half of the remaining earned income, plus health premiums and some medical bills. They also count assets, including a spouse's or parent's.

For example, a family of three in Utah earning $3,250 a month gross (one parent, a 3-year-old and a 9-year-old) lands in three places. After the roughly $114 deduction, countable income is $3,136. The parent is specifically $108 over the $3,028 Adult Expansion limit and far over the $678 PCR standard, so the parent doesn't qualify. The 3-year-old qualifies under the $3,165 limit for children under 6. The 9-year-old is over the $3,028 line for ages 6 to 18 but under CHIP's 150% tier ($3,415), so that child moves to CHIP. If the parent's job offers insurance, Utah's Premium Partnership (UPP) can reimburse up to $150 a month toward the parent's premium.

Utah Medicaid Asset Limits

$2,000 for one person and $3,000 for two is the asset limit for Aged, Blind, Disabled Medicaid and the medically needy programs, according to the 2026 Utah Medical Program Summary; the medically needy limit adds $25 for each additional person. MAGI programs, including Adult Expansion and CHIP, have no asset limit.

• Medicaid Work Incentive: $15,000 for any household size, with certain retirement accounts exempt.
• Nursing home spousal protection: Table II-A (effective October 1, 2026) sets the spouse at home's share of assets between $32,532 and $162,660, and a home equity limit of $752,000.
• Look-back: the eligibility worker reviews 60 months of asset and income history for long-term care, and transfers for less than fair market value can delay coverage.
• Annuities: the program summary says long-term care applicants must report every annuity and name the state as beneficiary.

The asset limits for QMB, SLMB and QI-1 change each January and sit in Table II of the manual, which Grantsights couldn't open on November 3, 2026, so they're left out here.

Expansion vs Non-Expansion: Utah's Position in 2026

Utah adopted full Medicaid expansion after CMS approval on December 23, 2019, so 133% of poverty plus the 5% deduction covers adults 19 to 64 with or without children, according to the DHHS Medicaid Expansion page (opens in a new tab). The Medicaid.gov eligibility levels table (opens in a new tab) (as of December 1, 2023) lists Utah at 133% for expansion adults, 139% for pregnant women and children under 6, 133% for children 6 to 18, 200% for CHIP and 36% for parents. In a non-expansion state the picture is starker; our Texas Medicaid income limits guide shows it. Our guides for Arizona, Nevada, Idaho and Colorado cover nearby expansion states.

Utah also requires Adult Expansion members to enroll in their employer's health plan if DWS tells them to; Medicaid then reimburses the employee share of the premium and covers copays and deductibles for Medicaid services.

Utah's expansion trigger. Under Utah Code 26B-3-210(4), as amended in the 2026 General Session and effective May 6, 2026, if the federal match for expansion adults is reduced below 90%, the state's authority to run the expansion ends the day after the Legislature adjourns the next general session. Within 60 days of learning the match will drop, DHHS must propose ways to keep the expansion within funding, from pausing provider rate increases to closing enrollment. The law also requires closing enrollment if expansion costs are projected to exceed the year's appropriation. Grantsights found no DHHS notice that either condition has been met.

What changes under H.R. 1. According to the DWS Adult Expansion page and the Utah Medicaid H.R. 1 site (opens in a new tab):

• Community engagement starts January 1, 2027 for Adult Expansion and Targeted Adult Medicaid. Members need 80 hours a month of work, volunteering, job training or half-time school, or $580 a month in income (seasonal workers can average $580 over six months). New applicants are checked on the month before they apply; current members are checked at renewals due in March 2027 or later.
• Six-month reviews start January 1, 2027 for the same two programs. American Indians and Alaska Natives with verified status stay on 12-month reviews; DHHS asks them to send proof by January 1, 2027.
• Retroactive coverage shrinks on January 1, 2027 to 1 month before the application month for Adult Expansion and 2 months for most other programs, down from 3.
• Already in effect since October 1, 2026: Medicaid for noncitizens is generally limited to green card holders with 5 years in the U.S., Cuban and Haitian entrants and COFA migrants. Refugees, asylees and humanitarian parolees may no longer qualify, though children and pregnant people may still have options.
• Exclusions include people who are medically frail, parents or caregivers of a child 13 or younger, veterans with a 100% disability rating, people in foster care or formerly in foster care, American Indians and Alaska Natives, and pregnant or postpartum members.

Utah's own history matters here: its first work requirement took effect January 1, 2020, was suspended April 1, 2020, and lost CMS approval on August 10, 2021, according to DHHS. The 2027 rule comes from federal law instead. Separately, DHHS says Targeted Adult Medicaid members may move to Adult Expansion starting July 1, 2027.

What Utah DHHS Doesn't Tell You About the Income Limits

Grantsights found 5 gaps between how Utah publishes its limits and how they work for a household:

1. Utah's pregnancy limit sits well below its neighbors'. Grantsights analysis of Table VII and New Mexico's 2026 chart shows a pregnant woman in a two-person household qualifies in Utah up to $2,507 a month, $2,002 less than New Mexico's $4,509. Arizona's line for the same household is $307 higher than Utah's. A pregnant Utahn just over the limit should ask about Medically Needy Pregnant Woman coverage, which works with a spenddown.
2. The parent limit is a distraction. PCR stops at $678 a month for three, but parents also qualify through Adult Expansion. Grantsights analysis of Table VII found Adult Expansion allows $2,350 more a month for a household of three.
3. Nursing home Medicaid has no published income cap. Instead of a fixed limit, Utah compares income to the private cost of care, and Table II-A puts the average private-pay nursing home rate at $7,344 a month. A resident with $3,500 a month in income can generally still qualify, then pays all but $45 a month toward care.
4. One CHIP figure doesn't match the formula. Table VII's $5,550 at 200% for four people is $50 above twice the HHS guideline. It's a small gap, but it matters to a family right at the line.
5. CHIP requires no other insurance. The program summary says CHIP is for children without access to other health insurance. A child with employer coverage should be checked for Medicaid instead.

Common Mistakes and Red Flags

Watch for these when you check Utah eligibility:

• Using after-tax pay. DWS compares gross income, minus Schedule 1 adjustments and the 5% deduction, to the limit.
• Ignoring the employer plan rule. A common mistake is turning down workplace insurance after Utah asks you to enroll. If you're required to join and don't, you lose Adult Expansion Medicaid.
• Assuming 2025 numbers. The DHHS expansion history still cites $17,608 a year for one person from an earlier year; the March 2026 limit is $21,228.
• Missing a 30-day request. DWS says that if it needs more details about work or activities, you may have to send a form within 30 days or lose coverage. Check myCase, mail, email and texts.
• Underestimating what the kids qualify for. Children under 6 qualify at a higher limit than their parents, and CHIP reaches 200% of poverty.
• Paying to apply. Applying through myCase, by phone or at a DWS office is free. A red flag is any site, caller or "enrollment helper" that asks for a fee, gift cards or your bank login. DWS and DHHS don't charge.

How to Apply for Utah Medicaid and How Long It Takes

DWS must decide most applications within 30 days, or 90 days when you're claiming a disability, according to Section 703-5 of the Utah Medicaid Policy Manual (effective September 1, 2024). Coverage generally starts the first of the month you apply, per DHHS.

1. Online: through myCase at jobs.utah.gov (opens in a new tab), which also shows your renewal date.
2. By phone: DWS at 1-866-435-7414. For questions about applying for Medicaid or CHIP, DHHS lists 1-877-543-7669, and a Medicaid health program representative at 866-659-6176.
3. In person: at a DWS employment center.

Have pay stubs, tax information, Social Security numbers and proof of citizenship or immigration status ready. For long-term care, add five years of bank statements and records of any property or annuities. If you also need food help, our Utah food stamps guide covers SNAP, which uses different limits.

What to Do If You're Denied

You have 90 days from the date of the notice to request a fair hearing, according to the DWS Fair Hearing Request form (opens in a new tab) (revised March 2025). Ask within 15 days of a notice that cuts or ends Medicaid and your coverage can continue during the appeal, though you may have to repay it if DWS wins. Coverage doesn't continue for an application denial or a review closure.

Call 1-877-837-3247, fax 877-824-6534, or mail the form to DWS Fair Hearings, PO Box 143245, Salt Lake City, UT 84114-3245. The form says not to submit hearing requests through myCase. Before filing, check the household size and income DWS used and whether the 5% deduction was applied; calling your eligibility team at 1-866-435-7414 sometimes fixes the problem faster. Utah legal aid offices can help at no cost.

If You're Over the Utah Medicaid Limit

Being slightly over the Adult Expansion line still leaves at least 6 routes, and the best bet for many working adults is UPP. Per the 2026 program summary, UPP pays up to $150 a month per adult and $140 per child toward employer insurance for households up to 200% of poverty.

• Marketplace coverage: adults over about 138% of poverty can buy a plan with premium tax credits through HealthCare.gov (opens in a new tab), and losing Medicaid opens a special enrollment period.
• CHIP: up to 200% of poverty for children without other insurance.
• Spenddown: Aged, Blind, Disabled and medically needy programs let you qualify by paying the difference between countable income and the limit, or by using medical bills.
• Medicare savings programs: a Utahn with Medicare and up to $1,796 a month (one person) can get help with Part B premiums through QI-1, and more help below that through SLMB and QMB.
• WIC: because Utah's pregnancy limit is only 139%, many expecting Utahns who miss Medicaid still fit WIC's 185% line; our WIC income limits guide lists the amounts.
• Seniors facing a spenddown: our SSI income limits guide and help for seniors programs list cash and in-home help outside Medicaid.

Utah families sorting out several programs at once can check the percentage bands in our federal poverty guidelines guide, food limits in our SNAP income limits guide and winter heating help in our LIHEAP income limits guide. Grantsights' free eligibility checker lists official programs for rent, utilities and similar needs. It doesn't decide Medicaid eligibility or file an application; it points you to the official places to apply.

FAQ: Utah Medicaid Income Limits

What is the income limit for Utah Medicaid in 2026?

$1,769 a month for one adult and $3,658 for four, effective March 1, 2026, before the 5% deduction.

How much can a family of 4 make and get Medicaid in Utah?

$3,658 a month for adults; $3,823 for children under 6; CHIP up to 200% of poverty.

What is the Utah Medicaid income limit for pregnant women?

$2,507 a month for two and $3,165 for three, at 139% of poverty.

What is the CHIP income limit in Utah?

200% of poverty, or $4,554 a month for a family of three.

What are the Medicaid income and asset limits for seniors in Utah?

$1,330 a month and $2,000 in assets for one person.

Is there an income limit for nursing home Medicaid in Utah?

No fixed cap; income is compared with the private cost of care.

When do Utah Medicaid work requirements start?

January 1, 2027, for Adult Expansion and Targeted Adult Medicaid members.

How long do I have to appeal a Utah Medicaid denial?

90 days from the notice; 15 days to keep Medicaid during the appeal.

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Sources

1. Utah DHHS: Medicaid Policy Manual Table VII, Income Limits for Medical and Medicare Cost-Sharing Programs (opens in a new tab), effective March 1, 2026
2. Utah DHHS: Medicaid Policy Manual Table II-A, Long Term Care figures (opens in a new tab), effective October 1, 2026
3. Utah DHHS and DWS: Utah Medical Program Summary 2026 (opens in a new tab) - program rules, deductions and asset limits
4. Utah DHHS: 2026 Hospital Presumptive Eligibility Training Manual (opens in a new tab) - income chart effective March 1, 2026
5. Utah DHHS: Medicaid Expansion (opens in a new tab) - history, yearly limits and TAM change from July 1, 2027
6. Utah DWS: Adult Expansion Medicaid (opens in a new tab) - H.R. 1 community engagement rules
7. Utah Medicaid: H.R. 1 changes (opens in a new tab) - six-month reviews, retroactive coverage and noncitizen changes
8. Utah Code 26B-3-210, Medicaid expansion (opens in a new tab), effective May 6, 2026
9. Utah DHHS: Medicaid Policy Manual 703-5, Eligibility Decisions (opens in a new tab)
10. Utah DWS: Fair Hearing Request form 490 (opens in a new tab), revised March 2025
11. HHS ASPE: 2026 Poverty Guidelines (opens in a new tab)
12. Medicaid.gov MAGI eligibility levels (opens in a new tab) - Utah row, December 1, 2023 data
13. HealthCare.gov: Lower costs on Marketplace coverage (opens in a new tab)