Medicaid

The State of Utah, Department of Human Services, Division of Aging and Adult Services, Health Insurance Information Program, is committed to making available as much information as possible to ensure beneficiaries make informed choices about their health insurance.

The Health Insurance Information Program does not determine eligibility for, or administer any of the services mentioned in this web site. Please contact the appropriate agencies directly for your individual determination of eligibility and services.

Medicaid is a joint Federal and State program that provides payment for some medical costs for certain individuals who are older, have low incomes and limited assets, or are disabled. Most of your health care costs are covered if you qualify for both Medicare and Medicaid. Medicaid recipients may also receive benefits such as nursing home care and outpatient prescription drugs.

Medicaid is administered by the State Department of Health according to federal guidelines. For more information, you can call the Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651.

The Centers for Medicare and Medicaid approves Medicaid operations in the state.

General Information Included on this Web Page

Eligibility
Enrollment
Financial Eligibility Requirements
Benefits
Other Available Programs
Other Low Income Programs
Emergency Medical Services
Utah Medical Assistance Program

Eligibility

Applicants must be a citizen or permanent resident of the United States to qualify for full Medicaid benefits.

Medicaid covers primarily low-income people. There are asset limits and income standards that must be met to be eligible for Medicaid. Financial Eligibility Requirements

Groups that are Automatically Eligible for Medicaid
If you are currently receiving benefits from either of the following programs, you are entitled to apply for Medicaid benefits. For more information, you can call the Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651.

Persons currently receiving Supplemental Security Income, (SSI)

Supplemental Security Income is a federal financial assistance program administered by the Social Security Administration for elderly, disabled, and blind individuals based on need.

People who are age 65 or older, disabled, or blind may benefit from the Supplemental Security Income program if they have low income and resources.

Persons currently receiving temporary financial services under the Family Employment Program, (FEP)

The Family Employment Program is available at all state employment centers. The program serves eligible families with dependent children and families where no dependent children reside but a woman is pregnant and in her third trimester. Household composition determines the participation requirements of the family. For more information on this program please contact the State of Utah Department of Workforce Services.

Other Groups that May be Eligible for Medicaid
Persons from the following groups may be entitled to apply for Medicaid benefits. Eligibility is based on your individual financial position. Financial Eligibility Requirements

Persons age 65 and older
Persons residing in a skilled nursing facility
Persons who are are blind
Persons who are legally disabled
Children who are under the age of 18
Adults who care for a child under the age of 18

Enrollment

Application Forms
Applications forms for Medicaid programs are available at the Bureau of Eligibility Services offices. Please contact the Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651.

Mail-in applications are accepted. Many hospitals and nursing homes have application forms on site.

Application Procedure

Applicants must complete an application form and an interview. They must also provide all necessary proofs. For people unable to complete the process, a responsible adult may be designated, in writing, to act on behalf of the applicant.
At the interview, the applicant will be asked for documentation of the following:

Proof of age and citizenship
Proof of Social Security Number
Liquid assets including checking and savings account statements
Proof of vehicle ownership
Other assets such as buildings and land other than the homestead
Trusts
Life and health insurance policies, and burial plans
Proof of all income
Proof of medical expenses such as health insurance premiums and medical bills. Include any unpaid bills on which payment is owed if the applicant chooses to use these as a deduction.

Applicants will receive a brochure explaining their rights and responsibilities. The eligibility worker must send a notice to approve or deny the application within 30 days of the date of application, or within 90 days if the application is based on a disability. A denial notice must explain the reason for denial. The right to appeal a decision is explained on the back of all notices.

Third-Party Liability

Third-Party Liability means a person or business other than the client who is responsible for the client's medical bills. The third party could be Medicare or private insurance. In the case of young children, parents are responsible for support to age 19.
As a condition of eligibility, clients must provide information about third-party liability and assign their right to collect these benefits to the State while they receive Medicaid.
The Office of Recovery Services may contact other agencies and individuals who may be responsible to pay medical bills, such as health or accident insurance companies. When children have medical expenses, an absent parent may be contacted to help pay the medical bills.

Selection of Health Care Provider

All Medicaid clients, with the exception of nursing home residents, must choose a Health Maintenance Organization, (HMO), in the areas of Utah where an HMO is available. In the areas where a Health Maintenance Organization is not available, clients may continue to choose a primary physician.
A Medicaid Eligibility Case Manager can give detailed information concerning Medicaid benefits, spend-down, and health care selection choices.

Coordinating Medicare Benefits with Medicaid

For people who qualify for both Medicare and Medicaid, Medicaid pays:

The monthly premiums for Medicare Part A and Part B.
The deductibles for Medicare Parts A and B.
The coinsurance payments for Medicare Parts A and B.
Services covered by Medicaid even though not covered by Medicare, such as prescriptions.

Submitting Claims to Medicaid when covered by Medicare:

Medicare providers submit claims directly to Medicare. The patient is not responsible for any paperwork.
Medicare pays their portion first. Then the claim is sent automatically to Medicaid to pay the remainder, unless the Medicaid recipient has additional health insurance coverage, in which case that provider would be billed before Medicaid would pay.
Medicare and Medicaid pay the provider directly. The patient handles no checks as with Medicare Part B unassigned claims.

NOTE:

There are two exceptions to this general rule:

A co-payment for use of a hospital Emergency Room will be charged to a Medicaid recipient when the diagnosis is for a non-emergency condition; and
When a client has agreed to pay certain medical expenses, the Medicaid card instructs the medical provider when to collect a payment from the client as part of the spend-down obligation.

Voluntary Participation in Medicaid by Providers

Physicians and other providers are not required to serve Medicaid recipients.
Recipients should determine whether or not a provider accepts Medicaid before receiving services. To be covered by Medicaid, the patient must present the Medicaid card before receiving services whenever possible. It is the patient’s responsibility to show the Medicaid card to each provider and find out if the provider will accept Medicaid for the service given.

Financial Eligibility Requirements

Asset Standards
Asset Limits
People with assets above the limits are not eligible for Medicaid. The limits are:

For one person - $2000 in countable assets
For two persons - $3000 in countable assets

Countable Assets
Resources which are not exempt, (see below for a list of exempt assets), count when they are legally available to the Medicaid applicant. If not available, they are not countable. Countable resources include, but are not limited to, cash on hand, savings accounts, checking accounts, stocks, bonds, pension funds, real estate, and some vehicles.

Exempt Assets - Assets that do not count towards the limit.

Home: The home and adjoining land do not count as an asset as long as the applicant lives in the home or if absent, intends to return to the home. If the home is exempt due to an intent to return, the client or representative must express the intent in writing.
Life Insurance: If the total face value of all life insurance policies the client owns on the same person, when added together does not exceed $1500, these policies are an exempt resource. However, the face value of these policies are deducted from the $1500 funeral burial fund exemption.
If the total face value exceeds $1500, the cash surrender value is an available resource.

If the client does not have an irrevocable funeral plan valued at $1500 or more, then enough of the cash value of the life insurance policies can be applied to total $1500 for burial expenses. Any remaining cash value is counted as a resource. The cash surrender value includes dividends and interest.

Policy additions are amounts of insurance purchased with dividends, increasing the death benefit and cash value, and are also a countable resource.

Accumulations are dividends left in the custody of the company to accumulate interest like money in a bank account. They are not part of the value of the policy but are counted as an asset.

Money in the bank, up to $1500, can be put into an account specifically designated as funds set aside for burial. No interest accrued is counted. No funds can be withdrawn.
Burial space: Fully-paid burial plots, crypts, or mausoleums of any value do not count, for a client or immediate family members.
Irrevocable Funeral Plan or Burial Trust: A prearranged burial trust held by a funeral home or bank does not count when the trust cannot be revoked. For deposits in a bank, there must be a trust document showing that the account is for burial and can only be paid to a specific mortuary. The interest earned on these trusts is also excluded. The portion of an irrevocable funeral plan or burial trust that exceeds $7000 after subtracting the value of fully paid burial spaces may be considered a transfer of assets. Exempt items from the $7000 limit include casket, marker, and vault.
Vehicles: The value of a vehicle used for medical visits or for employment does not count. For all other vehicles, the equity value of each vehicle counts as a resource.

Income Standards
The Medicaid program does not have an income limit. Instead, there is an income standard.

Qualified persons who have income equal to or less than the standard are eligible for Medicaid. When income is more than the standard, the person may choose to "spend down" to qualify for Medicaid. (Information on Spend Down Obligation is included later in this section.)

The income standard is for countable income, after deductions, (see Types of Income and Income Deductions). To calculate countable income, add Earned Income to Unearned income. Income eligibility standards for Medicaid vary, to determine your eligibility please contact Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651.

The income standard is higher for people 65 and over, or for those who are disabled, and have a countable income of $759 or less for one person and $1015 or less for two persons. Persons over 65 or who are disabled also receive a $20 income disregard per household.

Types of Income

Earned income such as wages
Unearned income such as Social Security benefits, pension benefits, gifts, inheritances, bank interest, and annuity income.

Income Deductions

Earned Income - You are allowed a deduction of $65 plus 1/2 of your gross wages minus the initial $65.
Unearned Income - You are allowed a deduction of $20 per household for aged, blind, or disabled persons.
Medical Expenses - Deductions are allowed for three types of medical expenses:
1. Premiums paid for health insurance;
2. Medical services within three months of application not covered by any third party such as Medicare or private insurance; and
3. The unpaid balances of medical bills that will not be covered by Medicaid, Medicare or private insurance.

Spend Down Obligation

In Utah, the Medicaid program allows a spend-down process for people who qualify for Medicaid but whose income is more than the income standard. The spend-down obligation ("Spend-down") means the difference between a person's countable income and the Medicaid income standard.
Spend-down is figured each month based on income received or expected to be received. A Medicaid applicant is told if he or she has a spend-down and the amount. Whenever the amount changes, a notice is sent to clients, who have a spend-down to notify them of the new spend-down amount.
Spend-down is useful for persons whose medical expenses are greater than their spend-down amount. People who have a spend-down receive a form to complete each month before they can qualify for Medicaid.
People with a spend-down have two decisions to make each month concerning their spend-down. They mark their decisions on the spend-down form and turn it in to the Medicaid eligibility worker.
Clients must first decide whether they expect their medical bills to be more than their spend-down or less than their spend-down. If medical bills are expected to be more than the spend-down, the client continues to the second choice. If medical bills are expected to be less than the spend-down, the client should request that the Medicaid case be closed. Clients may reapply at any time.
If the client expects medical bills to be more than the spend-down, their second decision is which method to use to meet the spend-down. There are two choices:
1. Cash: The client may pay the spend-down in cash to the State and immediately qualify for Medicaid. Medicaid pays for all covered services that month.
2. Medical Bills: Medical bills, paid or unpaid, may be used instead of cash to meet the monthly spend-down. Once the medical bills total at least the spend-down amount, the spend-down obligation is met. The client is then eligible for Medicaid for that month, and Medicaid pays for all other covered services that month.
  For persons enrolled in an HMO incurred bills cannot be used to meet the spend-down obligation. When unpaid medical bills are used to meet the spend down, the client is responsible to pay the provider.
People 65 and over or who are disabled pay no spend-down if their net countable income is at or below 100 percent of the federal poverty limit ($759 per month for an individual and $1015 per month for married persons) effective April 2002.
If their income exceeds this poverty limit, their net income will be compared to the current basic maintenance standard, and a spend-down will be calculated. Deductions for health insurance premiums and medical bills are allowed for this group.

The Buy Out
The buy out is a federal law which allows the state to purchase group health insurance for an individual who is eligible for Medicaid when it is cost effective for the state.

Currently employed applicants or recipients who are not participating in the employer sponsored group health insurance may be required to enroll with Medicaid, paying the premiums for this insurance as one of the Medicaid-covered benefits.

In some instances, group health insurance through an employer may be purchased by an individual within the first 63 days and is referred to as COBRA coverage. Frequently it will be in the State's best interest to purchase this coverage if an individual has a major medical problem and has just terminated employment.

Coverage for children (up to age 26) who have recently been removed from their parents' insurance may be able to continue under this coverage. If major medical expenses are expected (for instance, pregnancy expenses), it may be cost effective for the State to pay the premiums to cover the child.

Benefits

Coverage
Medicaid covers the costs of most medically necessary services. It can allow health insurance premiums as a deduction and pay Part B Medicare premium. ALL medically necessary services for children are covered.

For qualified persons, Medicaid can cover medical bills even when the services were provided as much as three months before an application was submitted to Medicaid. For example, a Medicaid application is made in September. If requested, Medicaid can look at eligibility to cover medical bills back to June 1.

Mandatory Services
Certain services are available to all Medicaid recipients. These include the following:

Inpatient hospital services.
Outpatient hospital services.
Laboratory and X-ray services.
Skilled Nursing Facility care for adults.
Home health care services for qualified individuals.
Physician services.
Rural health clinic services.
Family planning services.
Early periodic screening, diagnosis, and treatment services for those under age 21.

Optional Services
At the State's option, the Utah Medicaid program also provides other medical services. They include the following:

Dental care, eyeglasses, and vision screening
Prescription drugs and limited over-the-counter medications.
Clinic services.
Hearing aids.
Intermediate nursing care services.
Artificial limbs.
Durable medical equipment.
Therapy of various types.
Hospice care.
Personal care.
Transportation to medical services.
The cost of Medicare premiums.
The cost of private group health insurance premiums when cost-effective; that is, when the premium cost is less than Medicaid benefits that would otherwise be paid.

Other Available Programs

CHILDREN'S HEALTH INSURANCE PROGRAM SERVICES, (CHIPS)
Effective July, 1998 a new health care program for children was introduced to the State of Utah. It will be administered by the State Department of Health. This program is referred to as the "CHIPS" program (Children's Health Insurance Program Services). It is intended to provide health care benefits to low-income children not covered by private insurance and not eligible for Medicaid. CHIP allows expansion of health insurance coverage for uninsured children. To be eligible for CHIP, the family gross countable monthly income must be equal to or less than 200 percent of the federal poverty level. Maximum countable income is based on family size. Assets do not count when determining CHIP eligibility. Health care services for this program are provided by PEHP, AFC, and United Kids Care. For more information on this program please contact your local state Department of Health.

In rural areas clients will be under a fee for service plan with private providers. Benefits include hospital services, physician services, lab services, prescription drugs, mental health services and preventative care. Preventative care includes routine physicals, immunizations, vision screenings, hearing screenings and basic dental services.

PREMATURE INFANTS
Medicaid assistance is available, without counting parents income or assets, for premature babies with a birth weight of under 1200 grams.

The parent/s need to apply for Supplemental Security Income the month the baby is born, and also apply for Medicaid assistance.

To qualify, without counting parents' incomes or assets, the baby must have been born in or on the way to the hospital and not have gone home. When the baby is discharged to go home, the parents' income and assets will need to be counted the month following the month the baby returned home in order to determine continued eligibility for Medicaid and Supplemental Security Income assistance.

SKILLED NURSING FACILITY RESIDENTS: ELIGIBILITY FOR MEDICAID
Medicaid pays the nursing home cost of care for residents who qualify. The nursing home must complete a Pre-admission and Continued Stay review before Medicaid will cover the cost of care.

NOTE: Most nursing home Medicaid recipients pay an amount toward the cost of their care based on their gross monthly income minus allowable deductions.

Asset Limits
If the resident is married with a spouse living at home, see "Spousal Impoverishment Rules" .

People with assets above the limits are not eligible for Medicaid. The limits are:

$2000 in countable assets for one person
$2000 in countable assets for married persons when both are in a nursing home

Home: The home and adjoining land do not count as long as the spouse lives in the home. If the applicant lives in a nursing home, the home may be exempt if one of these three conditions is met:
1. The applicant intends to return to the home. ( If the home is exempt due to an intent to return, the client or representative must express the intent in writing.);
2. The applicant will be in the nursing home less than six months; or,
3. A reliant relative lives in the home. Reliant relatives are any relatives who claim to rely upon the client for financial help, medical need, or any other reason. Relatives include spouses, child, stepchild, grandchild, parent, stepparent, in-laws, siblings, grandparent, aunt, uncle, niece, nephew, cousin.
Life Insurance: If the total face value of all life insurance policies the client owns on the same person, when added together does not exceed $1500, these policies are an exempt resource. However, the face value of these policies are deducted from the $1500 funeral burial fund exemption.
If the total face value exceeds $1500, the cash surrender value is an available resource.

If the client does not have an irrevocable funeral plan valued at $1500 or more, then enough of the cash value of the life insurance policies can be applied to total $1500 for burial expenses. Any remaining cash value is counted as a resource. The cash surrender value includes dividends and interest.

Policy additions are amounts of insurance purchased with dividends, increasing the death benefit and cash value, and are also a countable resource.

Accumulations are dividends left in the custody of the company to accumulate interest like money in a bank account. They are not part of the value of the policy but are counted as an asset.

Money in the bank, up to $1500, can be put into an account specifically designated as funds set aside for burial. No interest accrued is counted. No funds can be withdrawn.

Assigning Cash Value To The State Of Utah Office Of Recovery Services:
For nursing home or home and community-based waiver services, only the cash value, dividend value and accumulation value of a whole life insurance policy can be disregarded if the policy is assigned to the State of Utah Office of Recovery Services.
1. The client must be the owner of the policy and the insured.
2. The client must irrevocably assign the rights and benefits of the policy to the State of Utah Office of Recovery Services.
3. The policy must be paid in full either prior to or at the time the assignment is made.
After the clients death, the State will distribute the benefits of the policy in the following manner:
1. Up to $7000 will be paid to the family or a designated funeral home to cover burial expenses.
2. An amount will be retained by the State for the total amount of medical assistance paid on behalf of the client.
3. Any amount remaining will be paid to the beneficiary named by the client.
Burial space: Fully-paid burial plots, crypts, or mausoleums of any value do not count, for a client or immediate family members.
Irrevocable Funeral Plan or Burial Trust: A prearranged burial trust held by a funeral home or bank does not count when the trust cannot be revoked. For deposits in a bank, there must be a trust document showing that the account is for burial and can only be paid to a specific mortuary. The interest earned on these trusts is also excluded. The portion of an irrevocable funeral plan or burial trust that exceeds $7000 after subtracting the value of fully paid burial spaces may be considered a transfer of assets. Exempt items from the $7000 limit include casket, marker, and vault.
Vehicles: The value of a vehicle used for medical visits or for employment does not count. For all other vehicles, the equity value of each vehicle counts as a resource.

Income Standards
To qualify for Medicaid, most nursing home residents contribute part of their monthly income to help pay for their nursing care costs. If a long-term resident (more than six months), the resident may keep $45 a month for personal needs. However, when the resident can realistically expect to return home within six months (with a doctor's statement), an additional income allowance may be given. Also, veterans who receive a reduced VA pension of $90 may keep this payment for personal needs (instead of the $45 allowance). All other monthly income is paid to the State.

Spousal Impoverishment Rules

A portion of the resources and income of a married nursing home resident is protected for the spouse living at home. The amount of protected resources is based on the amount of resources held the month the married person enters the nursing home. Resources are not based on the month application is made for Medicaid.
If there is any chance that a spouse may need Medicaid to cover nursing home costs, ask the Medicaid case manager for an assessment of resources for the month the spouse enters a nursing home. The assessment is FREE! It protects a share of resources for the married person living at home.
Protecting Assets: Usually the spouse at home may keep one half the resources held the month the husband or wife entered the nursing home. However, there is both a minimum amount and a maximum amount of resources that are protected by federal rules. The protected amount is increased each year.

Minimum amount of protected resources:
Medicaid rules protect $17,856 (January 1, 2002) as the minimum share of resources for the spouse of a nursing home resident. If total assets are less than $35,712, the spouse's share is $17,856. The remainder is the client's share.
Maximum amount of protected resources:
Medicaid rules set a maximum share of resources for the spouse of a nursing home resident. The maximum is $89,280 (January 1, 2002). If total assets are more than $176,560, the spouse's assessed share is $89,280 and the remainder is the client's share.
The spouse's share may exceed the maximum amount only through a fair hearing or a court order. The assessment is done only once, and the amount remains the same forever.
The nursing home resident may qualify for Medicaid once his or her share of resources is $2000 or less.
Three easy steps to protect the resources of a spouse of a nursing home resident:
- Go to or call Medicaid Eligibility Services. The office are listed under Department of Health: Bureau of Eligibility Services.
- Ask for an assessment of resources.
- The worker will tell the spouse how much of the resources are protected.

Protecting Income: As with Assets, a monthly share of income is protected for the spouse of a nursing home resident. The monthly amount is increased each year.
1. The spouse living in the home keeps his or her own income.
2. If the spouse's income is less than $1407 a month (July 1, 2001) minimum amount, the spouse may keep enough of the nursing home resident's income to bring the spouse's income up to $1407 per month. The share may be higher if there are other dependents or high costs for rent/mortgage, or utilities, but cannot exceed $2232 (January 1, 2002) maximum amount.
3. The monthly income protected for the spouse at home may exceed the limit only when a higher amount is established by a fair hearing or court order.
4. The minimum amount changes each July, so the spouse's amount can go up each July. The maximum amount changes each January.

Divestment: Transferring resources for less than fair market value
This policy applies only to those applying for Medicaid to cover the cost of nursing home care.

Transfer of a home by a nursing home resident does not affect eligibility if the transfer was made to:
- The resident's spouse.
- The resident's child under age 21, or a child who is blind or disabled.
- The resident's brother or sister who has an equity interest in the home and who lived with the resident for at least one year immediately before the resident entered the nursing home.
- A son or daughter who lived in the resident's home for at least two years immediately before the resident entered the nursing home and who provided care to the resident, which permitted the resident to remain in the home rather than be in a nursing home.
Presumption of improper transfer: When a nursing home resident or spouse gives away countable resources within a certain period of time before applying for Medicaid, the law presumes that the transfer was made to become eligible for Medicaid.
If a person transferred resources before August 11, 1993, for less than fair market value, there is no disqualification from Medicaid if the transfer was more than 30 months prior to date of application. If the transfer was within thirty months, there may be a period of disqualification from Medicaid.
A person transferred resources after August 11, 1993 for less than fair market value, there may be a disqualification from Medicaid if the transfer was within 36 months prior to the application date.

Sanction Period
Sanction period begins the month the assets were transferred, not the month the person enters the nursing home. The length of the sanction period is determined by dividing the value of the assets by the current average private pay rate for nursing homes.

Transferring Resources

Trusts
The availability of assets from a trust is viewed differently depending on when the trust was established, the creator of the trust, ownership of the assets in the trust, assignment of beneficiary, and access to the trust. Trusts need to be individually evaluated by the Medicaid Eligibility Case Manager.
Estate Recovery and Liens
The State, through Office of Recovery Services, has the right to recover from the recipient's estate all Medicaid funds expended on a recipient who is 55 years of age or older and has received Medicaid, Qualified Medicare Beneficiary or Specified Low-Income Medicare Beneficiary assistance, if all of the following conditions are met:
1. No surviving spouse
2. No surviving children under age 21
3. No surviving blind or disabled children
Office of Recovery Services may file probate and/or place liens on the assets in the estate to assure its claim on the estate. Liens are not placed on the recipient's assets before the recipient's death and death of the surviving spouse.
For more information please contact the Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651.

Other Low Income Programs

Home and Community Based Waivers
A collection of waivers that provide certain groups of clients enhanced medical benefits designed to help them stay at home rather than be institutionalized.

The Aging waiver for Home and Community Based Care is for individuals 65 and over.The waiver allows coverage of services not otherwise available under Medicaid to individuals who would be in a nursing home or institution if they did not have these services.

Clients who are eligible for the Aging Waiver for Home and Community Based Care would be medically appropriate for institutional care. This waiver offers incentives for clients to remain in their own homes. These clients are eligible for medical services that are not generally available to Medicaid recipients, such as adult day care programs, emergency response systems, in-home care and respite care.

Qualified Medicare Beneficiary Program
A program that pays ALL costs associated with Medicare for those who qualify. This program pays: Medicare premiums for Hospital, (Part A), and Medical Insurance, (Part B); the yearly deductible for Medicare Hospital, (Part A), and Medical Insurance, (Part B); and the Medicare co-payment.

Specified Low-Income Medicare Beneficiary Program
A program that pays the Medicare Part B insurance premiums for those who qualify.

Emergency Medical Services - A Limited Medicaid Program

Eligibility Requirements:
Persons who are not legal and permanent residents of the U.S. may qualify for the Emergency Medical Program, which is a limited services Medicaid program. The applicant must meet all other qualifications for Medicaid other than citizenship and Social Security number requirements.

Medicaid Benefits

Benefits are limited to emergency services only.
Emergency services generally are for life-threatening conditions, including labor and delivery.

Utah Medical Assistance Program

The Utah Medical Assistance Program is for people who are not eligible for Medicaid or Medicare. The Utah Medical Assistance Program provides or pays for medical care for eligible people.

The Utah Medical Assistance Program is administered by the State, using only state money.

Eligibility Requirements:

The person must be a legal and permanent resident of the U.S. and a resident of Utah. The asset limit is $500 for one person, and $750 for two or more people.
The monthly income standards vary and are for Gross Income before any deductions (including taxes) are taken out. Like Medicaid, a spend-down is allowed to qualify for the Utah Medical Assistance Program. However, the maximum spend-down allowed is $50. (For more information on Spend Downs go to the Financial Eligibility Requirements section.)

Limited Benefits

The Utah Medical Assistance Program pays only for services to treat the following conditions:
1. Acute conditions.
2. Life-threatening disorders.
3. Life threatening chronic conditions (hypertension, diabetes, epilepsy, etc.).
4. Conditions which, if left untreated, would result in irreversible blindness.
The Utah Medical Assistance Program does not pay for:
1. Chronic, non-life threatening conditions.
2. Cosmetic procedures.
3. Injuries which occurred while skiing.

Medicaid

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