Provo Senior AdvisorDoes Utah Medicaid pay for nursing home care?
Yes. Utah Medicaid pays for long-term care in a Medicaid-certified nursing care facility once the resident meets medical need and financial rules, which is how most long nursing home stays in Utah County are paid for.
The resident contributes most of their monthly income toward the cost, keeping a small personal needs allowance, and Medicaid pays the rest at the facility's Medicaid rate. Ask any nursing home you consider whether it accepts Medicaid for long-term stays and whether a Medicaid bed is available now.
What are Utah's Medicaid resource limits for seniors?
Utah's aged, blind and disabled Medicaid program allows countable resources of $2,000 for one person and $3,000 for a couple, under Utah Admin. Code R414-305-3.
A home, one vehicle and certain other assets are generally not counted, but the rules are detailed and transfers of assets in the look-back period can delay eligibility. An elder law attorney in Utah County can review a family's situation before money is moved.
What happens to the spouse who stays at home?
When one spouse needs nursing-facility-level Medicaid, federal spousal impoverishment rules let the at-home spouse keep a share of the couple's resources and a monthly income allowance; the dollar limits change every January.
Confirm the current figures with the Utah Department of Workforce Services, which handles Medicaid eligibility, before planning around them. We do not print limits we cannot confirm for the current year.
Did Medicaid expansion change long-term care in Utah?
Not directly. Utah fully expanded Medicaid to adults up to 138% of the poverty level on January 1, 2020, but long-term care for people 65 and older runs through the separate aged, blind and disabled pathway with its own resource test.
That is why a parent with modest savings may not qualify for nursing home Medicaid right away, even though a younger relative with similar income qualifies for expansion coverage.
How do Medicaid waivers fit with nursing home Medicaid?
Utah operates nine Medicaid 1915(c) waivers; for older adults, the New Choices Waiver and the Aging Waiver use the same nursing-facility level of care to pay for services in assisted living or at home instead of a nursing home.
A short nursing home stay can open the New Choices path: a Medicaid-paid stay of 90 days or more is one of its qualifying routes. See New Choices and the Aging Waiver.
Side by side
| Utah long-term care Medicaid | Utah expansion Medicaid | |
|---|---|---|
| Who | Aged, blind and disabled applicants | Adults up to 138% of poverty |
| Assets | $2,000 single / $3,000 couple | No asset test for expansion adults |
| Covers | Nursing home care; waivers for services | Medical care, not long-term custodial care |
| Spouse | Spousal impoverishment protections | Not applicable |
Sources: Utah Admin. Code R432-270, Utah DHHS and DLBC pages, MAG Aging & Family Services, CareScout and VA rate tables as cited; see our editorial standards.
