Utah Medicaid
Updated April 8, 2021 Medicaid
Utah Medicaid is the state and Federal partnership that provides medical coverage to eligible needy persons. The purpose of Utah Medicaid is to improve the health of people in Utah who might otherwise go without medical care for themselves and their children.
| Program Name | Utah Medicaid |
| Expanded Medicaid | Yes |
| Website | https://medicaid.utah.gov/ |
| Phone | 800-662-9651 |
| Apply Online | https://jobs.utah.gov/mycase/ |
| Appeal a Denial | https://medicaid.utah.gov/hearings/ |
| Find a Local Office | https://jobs.utah.gov/jsp/officesearch/ |
Eligibility Requirements
To be eligible for Utah Medicaid, you must be a resident of the state of Utah, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
You must also be one of the following:*
- Pregnant
- Be responsible for a child 18 years of age or younger
- Blind
- Have a disability or a family member in your household with a disability
- Be 65 years of age or older
* ACA Medicaid expansion covers eligible low-income adults.
Annual Household Income Limits (before taxes)
| Household Size* | Maximum Income Level (Per Year) |
| 1 | $17,131 |
| 2 | $23,169 |
| 3 | $29,207 |
| 4 | $35,245 |
| 5 | $41,284 |
| 6 | $47,322 |
| 7 | $53,360 |
| 8 | $59,398 |
*For households with more than eight people, add $6,038 per additional person.
Available Services Include:
| Ambulance | Mental health services |
| Birth control | Nursing home |
| Chiropractic | Over-the-counter drugs |
| Home health | Personal care |
| Hospice | Physical/occupational therapy |
| Hospital | Prescriptions |
| Lab and X-ray | Specialists |
| Maternity and midwife services | Speech and hearing |
| Medical supplies | Vision |
Copayments
| Emergency room for non-emergency | $8 |
| Inpatient hospital | $75 |
| Optometrist | $4 |
| Pharmacy | $4 (max $20 per month) |
| Physician Visits | $4 (max $100 per year or 5% of income, whichever is less) |
| Urgent Care | |
| Podiatrist | |
| Outpatient Hospital Services |
The following Utah Medicaid members do not have copays:
- American Indians
- Pregnant women
- Alaska Natives
- Members eligible for EPSDT
- Members on hospice care
The following covered services do not have copays:
- Family planning
- Lab services
- Immunizations (shots)
- Radiology
- Preventative services
- Tobacco cessation services
- Outpatient mental health/substance use disorder treatment
