Utah Medicaid Aging Waiver

Waiver Description

Utah’s Aging Waiver, formerly called the Utah Aging Waiver for Individuals Age 65 or Older, is designed to assist older individuals with elevated levels of care needs. It provides services that prolong independent living and prevent premature or unnecessary placement in nursing facilities.

Compared to many state HCBS waivers, Utah’s waiver offers a wide range of services beyond just personal care or companionship. For example, support is provided for medical equipment and any home modifications to increase independence. Support is also offered for personal emergency response services, medication reminder systems, caregiver respite, and adult day care. 

The Aging Waiver program allows for consumer direction of personal care services. Via this service model, participants can hire friends and relatives — and even spouses is some cases — to provide personal assistance. This includes assistance with daily living activities, such as bathing, dressing, preparing meals, and light housecleaning. While waiver participants can hire, train, and manage their care provider, the financial aspects of being an employer are handled by a Fiscal Management Agency through this waiver program. 

The Aging Waiver is operated by the Division of Aging and Adult Services (DAAS) within the Utah Department of Human Services.

Eligibility Guidelines

General Requirements

Applicants must be:

• Legal residents of the State of Utah
• At least 65 years of age
• Assessed and in need of nursing home level care
• Financially eligible to receive Utah Medicaid

Financial Requirements

Income Limits

Meeting Utah Medicaid standards is the most complicated component of determining eligibility. As of 2024, the countable income standard for a single applicant is $1,255 per month. In other words, an individual cannot have income greater than this amount. (This amount equals 100% of the Federal Poverty Level, which changes on an annual basis.)

For married couples with only one spouse applying for Medicaid, there are additional rules and exemptions. Non-applicant spouses are referred to as Community Spouses and are permitted a higher level of income and assets to enable them to continue living independently. Given the monthly income of the non-applicant spouse, an applicant spouse may supplement their non-applicant spouse’s monthly income in order to prevent them from becoming impoverished. As of 2024, this amount may be up to $3,853.50 / month.

Asset Limits

For 2024, the countable asset limit for an individual is $2,000. For couples with only one spouse applying, the non-applicant spouse is allowed to keep 50% of the couple’s assets, up to $154,140. If the couple’s assets are under $30,828, the non-applicant spouse can keep all of the assets, up to this amount.

However, many resources are exempt, such as one’s home, provided it is lived in by the applicant, the applicant intends to return to the home, or their spouse lives in it. In addition, the equity value of the home cannot be greater than $713,000. Other exemptions include life insurance policies, given the total face value is not greater than $1,500, irrevocable funeral trusts, one motor vehicle, and household furnishings. 

Over the Financial Limits?

Having too much income does not prevent individuals from receiving Utah Medicaid if they have extraordinarily high medical expenses. This group is referred to as Medically Needy recipients, and the program is often called a Spend-Down program. Certain medical costs may be deducted from one’s countable income, allowing one to still be eligible for this waiver program.

For example, health insurance premiums and out-of-pocket expenses may be deducted. If one’s monthly income, after their medical expenses have been deducted, is less than the monthly income limit, they qualify for Medicaid and can access the waiver services.

Alternatively, Medicaid planners can guide families whose seniors are over the Medicaid income and asset limits. They do so by re-allocating funds to irrevocable funeral trusts, Medicaid compliant annuities, and other Medicaid exempt vehicles. Learn more about this option here.

Please Note: It is vital that persons do not give away assets or sell them for less than fair market value within 60 months of one’s Medicaid application date. This is because doing so is a violation of the Medicaid look-back period and can result in Medicaid denial.

Benefits and Services

In addition to the case management services provided to all waiver participants, the following benefits are available. All of which are chosen to increase the waiver recipient’s ability to function independently of residential care in a nursing home.

• Adult Day Health Services – social and care activities during daytime hours in a group environment
• Chore Services – light yard work and maintenance around one’s home
• Companion Services
• Emergency Response Systems – electronic monitoring and call service for emergencies
• Environmental Accessibility Adaptations – modifications to one’s home
• Financial Management Services – support for consumer directed services
• Home Delivered Meals – hot or prepared meals
• Home Health Aide
• Homemaker Services – laundry, housekeeping, cleaning etc.
• Medication Reminder Systems
• Non-Medical Transportation
• Personal Attendant Program Training
• Personal Attendant Services
• Personal Budget Assistance
• Respite Care Services – to relieve the primary caregiver of their caregiving duties (in-home and out-of-home)
• Specialized Medical Equipment – durable medical equipment for the home
• Transition Services – back into the community

How to Apply / Learn More

This waiver is available statewide in Utah. However, like most HCBS waivers, there are a maximum number of slots available. Eligible individuals may find that they are placed on a waiting list. State officials delay starting benefits and services when the program is oversubscribed.

To get additional information, click here. To apply, one should contact their local Area Agency on Aging and start the process by requesting an assessment of the applicant.