utah medicaid income limits 2020 chart
Maximum Gross Monthly Income Elderly/Disabled 165% of Poverty (Used only to determine household composition – See Section 230-1 and 254) Gross Monthly Income Limits There are several different Medicaid long-term care programs for which Utah seniors may be eligible. 1) Utah State Plan Personal Care Services – assistance with daily living activities is provided via the state Medicaid plan (available to anyone who meets the eligibility requirements) to promote independent living and prevent nursing home admissions. 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. Examples include home modifications, like the addition of wheelchair ramps or stair lifts, prepaying funeral and burial expenses, and paying off debt. To qualify, these individuals must meet income and other eligibility requirements. Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. (SSI) Information, Full When spending down assets, it’s important that one does not give away assets or sell them for less than their value. So just fill out your application the best you can and UPP will contact you if there are any questions. This is because Utah has a Medicaid Look-Back Period, which is a period of 60 months (5 years) that dates back from one’s Medicaid application date. To be clear, there is no spousal income allowance for non-applicant spouses of those applying for regular Medicaid. *, No income limit. Therefore, wait lists may exist. IMPORTANT, not meeting all the criteria below does not mean one is not eligible or cannot become eligible for Medicaid in Utah. Anyone who meets the eligibility requirements will receive assistance. Alternatively, one may opt to take the Medicaid Eligibility Test. However, this page is focused strictly on Medicaid eligibility for Utah elders, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home… More. More on how Medicaid counts income. 288 North 1460 West File Threshold, Earned: Cannon Health Building Examples include employment wages, alimony payments, Veteran’s benefits, pension payments, Social Security Disability Income, Social Security Income, Supplemental Security Income, IRA withdrawals, and stock dividends. It is vital that one does not give away assets or sell them for less than fair market value in an attempt to meet Medicaid’s asset limit. You may also call your local office for more information. This can be done by paying excess income to the state of Utah or paying a provider for medical services / goods. So adults age 19-64 with household incomes up to 138% of the poverty level are now eligible for Medicaid in Utah… For Utah elderly residents (65 and over) who do not meet the eligibility requirements in the table above, there are other ways to qualify for Medicaid. However, one can “spend down” assets by spending excess assets on non-countable ones. Medicaid is a wide-ranging health insurance program for low-income individuals of all ages. However, this is not the case when one spouse of a married couple applies for regular Medicaid. An individual must qualify each month for continued coverage.                 SSI for Couple receiving In-kind Support: For questions or assistance, seniors can also contact DWS at 866-435-7414. The limit is $10,000 for one person and $15,000 for a couple. $522.00 (+$3.13 State Supplement), Full Basically, if the non-applicant spouse, who is also called a community spouse or well spouse, has income under $2,155 / month, as of 7/1/20 (this figure changes each year in July), he or she is entitled to a portion of the applicant spouse’s income (to bring the non-applicant spouse’s income to $2,155 / month). To clarify, this income can come from any source. However, for Medicaid eligibility purposes, there are many assets that are not counted. 2) Utah Aging Waiver for Individuals Age 65 or Older – also referred to as the Aging Waiver, this home and community based services Medicaid waiver allows program participants to hire the caregiver of their choosing, including some relatives. However, this page is focused strictly on Medicaid eligibility for Utah elders, aged 65 and over, and specifically for long term care, whether that be at home, in a nursing home, or in an assisted living facility. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible. One’s primary home, given the Medicaid applicant lives in it or has “intent” to return to it, and his or her equity interest in it is not more than $595,000 (in 2020), is exempt. *While there is no income limit for nursing home Medicaid, as indicated in the chart above, a beneficiary must pay nearly all of his or her monthly income to the nursing home. If one is found to be in violation of the look-back period, one will be penalized with a period of Medicaid ineligibility. Further complicating eligibility are the facts that the requirements vary with marital status and that Utah offers multiple pathways towards Medicaid eligibility. Medicaid-funded nursing home beneficiaries are entitled to only a personal needs allowance of approximately $45 / month, and if applicable, pay a monthly income allowance to a non-applicant spouse. Each spouse’s monthly income determines how much each spouse must pay towards the cost of care. SSI for Couple living alone: $1,175.00 (+$4.60 State Supplement) In other words, they are exempt. Income includes the following: wages that you and your spouse earn, child support, alimony, Social Security, etc. By using our website, you agree to our terms of use and privacy policy. (To locate your local office, click here). Eligibility is determined by the Department of Workforce Services (DWS). The monthly income limit for individuals who are blind or disabled, and who work at least a few hours each month, is 250% FPL. There is a resource test for Medicaid for the Working Disabled. Salt Lake City, UT 84116, Early and Periodic Screening, Diagnostic and Treatment, Living Well with Chronic Conditions Program, Medicaid for Long-Term Care and Waiver Programs, Utah’s Premium Partnership for Health Insurance, UAMRP (Utah Access Monitoring Review Plan). For Medicaid eligibility purposes, any income that a Medicaid applicant receives is counted. Make note, the Medically Needy Pathway does not assist one in spending down extra assets for Medicaid qualification. This is because in Utah, as mentioned previously, Medicaid has a “Look-Back” period of 5 years. Medicaid is a state/federal program that pays for medical services for low-income pregnant women, children, individuals who are elderly or have a disability, parents and women with breast or cervical cancer. Jointly funded by the state and federal government, it provides health coverage for various groups of Utah residents, including pregnant women, parents and caretaker relatives, adults with no dependent children, disabled individuals, and seniors. SSI for Single living alone: $783.00 (No State Supplement)            SSI for Single receiving In-Kind Support: Medicaid expansion in Utah: Key takeaways. The federal government covers 90% of the costs for these services, with the state covering the remaining 10%. Read more or connect with a Medicaid planner. During this time frame, Medicaid checks all past transfers, including ones made by a non-applicant spouse, to ensure no assets were sold or given away for less than they are worth. The expansion extends Medicaid eligibility to Utah adults whose annual income is up to 138% of the federal poverty level ($17,608 for an individual or $36,156 for a family of four). To be eligible for Medicaid, you must meet a program type and meet the rules for Utah residency, income, and citizenship. For married couples, with non-applicant spouses’ of institutional Medicaid applicants or HCBS Medicaid waiver applicants with insufficient income in which to live, there is a Minimum Monthly Maintenance Needs Allowance (MMMNA). This is referred to as the Community Spouse Resource Allowance (CSRA) and is intended to ensure the non-applicant spouse has sufficient funds from which to live. Once one has spent his or her income down to the income limit, Medicaid will kick in for the remainder of the spenddown period, which is one month in Utah. There is no spousal resource allowance for non-applicant spouses of regular Medicaid applicants. Medicaid Policy TABLE VII - Income Limits for Medical & Medicare Cost-Sharing Programs … Said another way, if one meets the income requirements for Medicaid eligibility, but not the asset requirement, the above program cannot assist one in eliminating extra assets. These programs have slightly different financial and medical (functional) eligibility requirements, as well as varying benefits. In order to apply for Medicaid in Utah, senior residents can do so online at myCase, download and submit a completed paper application (applications are found half way down the webpage), or apply in person at their local Department of Workforce Services (DWS) office. Being over the income and / or asset limit(s), or being uncertain if eligibility criteria are met, can result in a denial of benefits. 3) Regular Medicaid / Aged and Disabled – this is an entitlement program for assistance at home or adult day care. 3) Utah Medicaid New Choices Waiver (NCW) – this Medicaid waiver assists seniors and disabled individuals who currently live in an assisted living facility or nursing home to transition back to living in one’s home or the home of a relative. $12,200             Unearned: $1,100              Qualifying Relative Limit: $4,200, Single:  $281            Couple:  $411.66. We know there are many rules regarding income, and it’s hard to remember them all. We know there are many rules regarding income, and it’s hard to remember them all. (Please see chart, above.) Copyright © 2020 All rights reserved. 2) Medicaid Waivers / Home and Community Based Services (HCBS) – with these programs, there are participant caps for enrollment. In this situation, the income of both the applicant spouse and the non-applicant spouse is counted towards eligibility. Benefits include aid with mobility, preparation of meals, bathing, grooming, and toiletry. (The amount of the home’s value owned by the applicant is his or her equity interest in the home). Use of this content by websites or commercial organizations without written permission is prohibited. (This figure will increase in January 2021.) 1) Institutional / Nursing Home Medicaid – this is an entitlement program for assistance only in nursing home facilities. Benefits are provided at home, adult day care, or in assisted living. When just one spouse of a married couple is applying for nursing home Medicaid or a HCBS Medicaid waiver, only the income of the applicant is counted. In Utah, the agency that administers the Medicaid program is the Utah Department of Health. There is also a minimum standard, which is $25,728, and if a couple’s joint assets are equal to or less than this amount, the non-applicant spouse can retain 100% of it. See our Resource Limits – Medicaid page. This may include paying unpaid medical bills, prescription drugs, private health insurance, and medical expenses that Medicaid does not cover. Income includes the following: wages that you and your spouse earn, child support, alimony, Social Security, etc. The home is also exempt, regardless of any other circumstances, if the applicant is married and his or her spouse lives in it. For additional information about applying for long-term care Medicaid, click here.


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