Key threshold: If your income is below $22,025 (individual) or $45,540 (family of 4), you likely qualify for Utah Medicaid with free or very low-cost coverage. No premiums, no deductibles.
Utah Medicaid Income Limits 2026
The following table shows the key income thresholds for Utah in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
If your household income falls below the 138% FPL column, you qualify for Utah Medicaid. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
About Utah Medicaid
Who Qualifies for Utah Medicaid
If you're a Utah resident wondering about your healthcare options, Utah Medicaid is a vital program that provides coverage to many individuals and families. Adults with incomes up to 138% of the Federal Poverty Level (FPL) can qualify. For a single adult, this means an annual income of approximately $21,597 as of 2025, while a family of four could qualify with an annual income up to around $42,768. Beyond income, you must also be a U.S. citizen or legal resident and a Utah resident. Children with household incomes up to 205% FPL and pregnant women with incomes up to 144% FPL are also eligible. Utah Medicaid also covers seniors and individuals with disabilities, though specific income and asset limits apply to these groups. As of February 2026, over 325,000 people are enrolled in Utah Medicaid, demonstrating it's a significant and active program.
If You're Near the Income Line
If your income is slightly above the Utah Medicaid threshold, you likely won't be left without affordable healthcare. You'll transition to the federal HealthCare.gov marketplace, where you may qualify for significant subsidies to help pay for your health insurance. For example, with a benchmark Silver plan costing around $497 per month, subsidies can drastically reduce what you actually pay based on your income. Keep in mind that your income can fluctuate, and if it drops below the Medicaid limit, you can reapply for Utah Medicaid at any time. Utah recently concluded its Medicaid unwinding process in April 2024, during which eligibility for all members was reviewed. If you lost coverage during this period, you are encouraged to reapply if your circumstances have changed.
What Utah Medicaid Covers
Utah Medicaid offers comprehensive benefits, typically with little to no cost-sharing for most services. This includes prescriptions, maternity care, mental health services, preventive care, urgent care, and family planning. Utah also has several Home and Community-Based Services (HCBS) waivers designed to help individuals with disabilities and seniors receive care in their homes and communities instead of institutions. These waivers, such as the New Choices Waiver and the Community Supports Waiver, provide services like personal care assistance, respite care, and home modifications, promoting independent living. For long-term care programs, asset limits generally apply, typically around $2,000 for a single applicant.
Tips for Applying
Navigating healthcare eligibility can sometimes present challenges. While Utah Medicaid aims for smooth processing, it's crucial to be prepared for potential documentation requirements. During the recent unwinding period, the Department of Workforce Services averaged 12 days for application decisions. If your contact information changed during the pandemic, ensure it's updated with the Department of Workforce Services to receive important notices. Utah Medicaid also offers retroactive coverage for up to three months prior to your application date if you qualify. To get started or if you have questions, contact the Utah Department of Health and Human Services or visit TakeCareUtah.org for free, nonprofit assistance with both Medicaid and HealthCare.gov.
Marketplace Insurance in Utah
Utah residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Utah costs approximately $497/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Utah might pay for a Silver plan after subsidies, based on the $497/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $417/mo |
| 200% FPL | $31,920 | ~$173/mo | $324/mo |
| 250% FPL | $39,900 | ~$277/mo | $220/mo |
| 300% FPL | $47,880 | ~$392/mo | $105/mo |
| 400% FPL | $63,840 | ~$497/mo | $0/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Utah. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Utah uses the federal marketplace at HealthCare.gov.
How to Apply for Utah Medicaid
Medicaid enrollment is open year-round — there's no deadline. You can apply through any of these channels:
- Online: Apply through HealthCare.gov — the system automatically checks your Utah Medicaid eligibility when you enter your income. Or apply directly through Utah Medicaid.
- Phone: Call Utah's Medicaid helpline for guided help with your application.
- In person: Visit your local human services office or a certified application counselor.
You'll need proof of income (pay stubs or tax returns), proof of Utah residency, and Social Security numbers for household members.
Calculate Your Subsidy in Utah
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Utah.
Frequently Asked Questions
How much can I earn and still qualify for Utah Medicaid?
In 2026, the Medicaid income limit in Utah is 138% of the federal poverty level: $22,025 per year for an individual, $29,863 for a household of 2, $37,702 for 3, and $45,540 for a family of 4.
Does Utah have Medicaid expansion?
Yes, Utah has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Utah Medicaid.
Can I get ACA subsidies in Utah?
Utah residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the Utah Medicaid program called?
Utah's Medicaid program is known as Utah Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
How do I keep my health insurance if I lose Medicaid in Utah?
If your Utah Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Does working disqualify me from Medicaid in Utah?
Yes. Medicaid eligibility in Utah is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($22,025 for an individual), you qualify for Utah Medicaid even if you work full-time. Many Utah Medicaid enrollees are working adults.
Utah Medicaid vs. marketplace insurance — which is better?
Medicaid (Utah Medicaid) is free or near-free with no premiums or deductibles. Marketplace plans in Utah average $497/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.