Utah Medicaid income limits for 2026 are tied to a percentage of the Federal Poverty Level (FPL). For most adults, it’s 138% of FPL thanks to expansion. Kids and pregnant women get higher cutoffs. It all comes down to your household size, how they calculate your income, and what group you’re in.
If you’re wondering to know like:
• Do I even qualify for Medicaid in Utah?
• What’s the max I can make and still get it?
• Is this gross pay or after taxes?
This breaks it down in easy way—charts, MAGI stuff, assets, expansion info, and what to do if life changes.
What Is Medicaid in Utah?
Medicaid is that federal-state health insurance setup run nationally by CMS and handled in Utah by the Department of Health and Human Services.
It covers low-income folks for basics like doctor visits, hospital stays, meds, etc. Mainly helps:
- Adults
- Kids
- Pregnant women
- Seniors
- People with disabilities
Utah went with Medicaid expansion under the ACA, so way more adults can get in now.
Utah Medicaid Income Limits 2026 (Based on FPL)
Every year HHS drops new FPL numbers, and states base limits off percentages of that.
For most adults in 2026, the big one is:
138% of the Federal Poverty Level
Here’s the approximate annual income range (final numbers drop from federal updates, but this is based on current trends).
Medicaid Expansion Adults (Age 19–64)
| Household Size | Approx. 138% FPL Annual Income |
| 1 | ~$21,000–$22,000 |
| 2 | ~$29,000–$30,000 |
| 3 | ~$36,000–$38,000 |
| 4 | ~$44,000–$46,000 |
Quick monthly math: Just divide by 12. Like $22,000 a year? That’s roughly $1,833/month.
If you’re at or under that, you should qualify under expansion.
Income Limits for Children (Medicaid & CHIP)
Kids usually get higher limits than adults.
Utah runs CHIP right alongside Medicaid for families who make too much for regular Medicaid but still need help.
Typical cutoff:
• Up to around 200% FPL for kids
So yeah, parents might not qualify, but the kids often do.
Income Limits for Pregnant Women
Pregnant? You get some of the best limits—often around 200% FPL or higher.
Covers:
• Prenatal stuff
• Delivery
• Postpartum care
Pregnancy basically opens the door wider in Utah.
Seniors (65+) and People With Disabilities
For folks 65+ or with disabilities:
- Limits often tie to SSI rules from Social Security.
- Assets usually matter here.
- Long-term care has its own financial setup.
These are different from the expansion stuff.
How Income Is Calculated: MAGI Explained
People always ask: gross or net?
For most (adults, kids, etc.), it’s Modified Adjusted Gross Income (MAGI).
MAGI counts:
- Wages (before taxes)
- Self-employment earnings
- Unemployment
- Taxable Social Security
Doesn’t count:
- SNAP
- Child support you receive
- Some veteran benefits
Basic math:
Adjusted Gross Income
- Tax-exempt interest
- Certain foreign income
= MAGI
Get MAGI wrong and your app gets held up or denied. Double-check it.
Do Assets Count in Utah Medicaid?
Depends who you are.
Expansion Adults:
- No asset test at all.
- Bank accounts? Usually don’t matter.
Seniors & Long-Term Care:
- Yes, assets count—savings, investments, extra property.
- Primary home is mostly safe (with equity caps).
Medicaid Expansion in Utah
Utah did expansion under ACA, so childless adults can qualify up to 138% FPL.
Before? A ton of low-income adults had zero options.
Now? Working folks, part-timers, gig workers, self-employed—if income fits, you’re good.
What If You Work Full-Time?
Totally fine.
Lots think full-time work kills it. Nope—it’s purely about income level, not if you’re employed or how many hours.
Full-time pay under 138% FPL? You can still get coverage.
What Happens If Your Income Changes Mid-Year?
Big one—report changes to Utah Medicaid ASAP.
If income goes up:
- Might lose eligibility.
- Could switch to Marketplace plans with subsidies.
That’s the “income cliff”—tiny raise and boom, over the line.
Medicaid vs Marketplace in Utah
Over the limit? Marketplace might hook you up with tax credits.
| Feature | Medicaid | Marketplace Plan |
| Premium | Usually $0 | Income-based |
| Deductible | Low or none | Varies |
| Income Range | Up to 138% FPL | 100%+ FPL |
| Asset Test | No (expansion) | No |
If you’re right on the edge, check both.
How to Apply for Medicaid in Utah (Step-by-Step)
Easy options: online, phone, or in person.
Step 1: Gather Documents
- ID
- SSNs
- Pay stubs
- Tax return (if you have it)
Step 2: Apply Online
Hit up the Utah DHHS portal.
Step 3: Submit Verification
Upload whatever they ask for quick.
Step 4: Receive Decision
Takes a few weeks usually, depending on docs.
Medicaid Managed Care in Utah
Most people end up in managed care plans.
Means:
- Pick a plan
- Choose your main doctor
- Stick to network providers
Bigger networks in places like Salt Lake. Rural spots (St. George, etc.) might mean longer drives for specialists.
Always check: Is my doc in-network? Specialists close by?
Redetermination & Annual Renewal
Coverage isn’t forever.
Every year:
- Fill out renewal forms
- Verify income
- Update household stuff
Ignore notices? Coverage can end.
Medicaid Estate Recovery (For Seniors)
For long-term care folks over 55, Utah might try to get some costs back from your estate after you pass.
Doesn’t hit regular expansion adults, but good to know for seniors/families planning ahead.
Decision Framework: Do You Qualify?
Quick checklist:
- Age 19–64? → Check if under 138% FPL.
- Pregnant? → Higher limits kick in.
- Got kids? → They often qualify higher.
- 65+ or disabled? → SSI-style review.
Close to the line? Apply anyway—they crunch the real numbers.
Local Considerations in Utah
- Local offices
- Rural doctor shortages
- Managed care networks
- Travel for specialists
Cities have more options; rural areas, double-check access.
Common Mistakes to Avoid
- Mixing up gross vs MAGI
- Not reporting income jumps
- Thinking bank accounts kill expansion eligibility
- Skipping renewal stuff
- Not applying cause you’re “close”
When unsure, just apply—they sort it.
Official & Helpful Resources
For accurate eligibility requirments and applications, visit these official sources:
- Utah Medicaid Official Income Limits & Application
- Federal Medicaid Guidelines & FPL Updates (CMS)
Helpful related guides:
- Learn about Food Stamp Restrictions 2026 including SNAP income and eligibility guidelins.
- Compare with Florida Medicaid Income Limits 2026 to understand state-by-state differences.
FAQs – Utah Medicaid Income guidelines 2026
- What is the income limit for Medicaid in Utah in 2026?
Most adults at 138% FPL. Kids/pregnant higher. - Is Utah a Medicaid expansion state?
Yep, full ACA expansion. - Does Utah Medicaid check bank accounts?
Not for expansion adults. Yes for seniors/long-term. - Can I get Medicaid if I work full-time?
Yes—if income stays under the limit. - What is 138% of FPL for a family of four?
Usually mid-$40,000s, depending on final federal numbers. - How long does Medicaid approval take in Utah?
Few weeks after docs are in. - Do children qualify at higher income levels?
Yeah, often up to ~200% FPL via Medicaid/CHIP. - What happens if my income increases?
Report it—you might shift to Marketplace.
Conclusion
Utah Medicaid for 2026 mostly runs on 138% FPL for expansion adults. Kids, pregnant women, seniors, disabled folks have their own rules.
