Low-income residents in Utah may apply for medical assistance through Medicaid, a federal- and state-funded health care program. To qualify for Medicaid in Utah:
- Individuals must meet program criteria and the rules for citizenship, residency, and income.
- Continued coverage is contingent on qualifying each month.
- The income limit is 100% of the Federal Poverty Level.
- One person may have up to $2,000 in assets, while a couple may have up to $3,000 in assets.
Financial eligibility takes into account assets, including cash, easily liquidated items, bank accounts, vehicles and vacation residences. Each Medicaid program has different standards for counting assets, but none counts primary residences.
If monthly income exceeds the Medicaid limit, an eligibility worker can determine if a person may qualify for the
spend-down, or Medicaid Medically Needy, program. A participant would agree to spend-down monthly income to the Medicaid limit by either paying a medical provider for some medical bills or paying monthly income over the Medicaid limit to the state. Note that not all Medicaid programs allow this option.
Elderly residents who qualify for Supplemental Security Income or Social Security disability are automatically eligible for Medicaid.
The state offers several Medicaid programs, including the Aged, Blind or Disabled program for people aged 65 years and older. This provision covers care services such as home health, personal attendant care and services commonly provided in health care facilities.
Home and Community-Based Services Waiver Programs Medicaid, via various
HCBS waiver programs, covers long-term care, including assisted living, for applicants who qualify medically and financially. These services are designed to help people live comfortably and safely in their homes or in the community.
Aging Waiver The
Aging waiver provides services to help Utah seniors remain in community-based settings such as assisted living facilities or family homes. This program supports independent living as much as possible. To qualify, individuals must be at least 65 years of age and require nursing facility level of care. Services under the Aging waiver program include:
- Adult companion services
- Adult day health services
- Chore services
- Personal attendant services
- Community transition
- Nonmedical transportation
- Home-delivered meals
- Supportive maintenance from a home health aide
The income limit is 100% of the Federal Poverty Level, adjusted yearly. An individual may have up to $2,000 in assets, but spousal limits are
complex. This waiver has a spend-down provision. Contact the Division of Aging and Adult Services for more information at (801) 538-3910.
Community Supports Waiver The
Community Supports waiver provides services for Utah residents with intellectual disabilities so that they can remain in their homes or other community-based settings. This waiver offers many of the same benefits as the Aging waiver and has no age restrictions. However, there’s a waiting list, and beneficiaries must meet stringent requirements:
- Must have functional impairment in at least three areas of major life activity
- For intellectual disabilities, the onset of the condition must have occurred prior to age 18; for other conditions, the onset must have occurred before age 22
- Must meet the level of care criteria for admission to an intermediate care facility for people with intellectual disabilities
The Community Supports waiver has financial eligibility rules much like those of the Aging waiver. The Division of Services for People with Disabilities at (801) 538-4200 can give further information.