How to get Utah Medicaid or low-cost care

Who can get Utah Medicaid

Utah's Medicaid expansion took effect on January 1, 2020, according to KFF, a health policy research group. Utah Medicaid says adults ages 19 through 64 can qualify. They must be U.S. citizens or legal residents, and the income limit depends on how many people live in the home.

The limit for adults is 138 percent of the federal poverty level. That level is the yearly poverty line the government sets in dollars. The dollar limit depends on your household size, and a DWS worker can tell you the current number for your household.

Other groups can qualify under different rules, including children, pregnant people, older adults and people with disabilities. Our Medicaid eligibility guide explains who fits in each one.

Ways to apply for Utah Medicaid

In Utah, the Department of Workforce Services, which people call DWS, takes Medicaid applications. You can apply at any time of year, and coverage generally starts on the first day of the month you apply.

• Apply online through myCase, the state's benefits site, and you will not need a paper form.
• Call 1-866-435-7414 if you have questions about whether you qualify. In Salt Lake County you can also call 801-526-0950.
• Go to any DWS office, and use the zip code search on the Medicaid site to find the closest one.
• Mail or fax a paper application to DWS, and look on the Medicaid site for the address.

To ask about benefits or to find a provider, call a Medicaid Health Program Representative at 1-866-608-9422. Our guide to how to apply for Medicaid lists what to collect before you start.

What changes on January 1, 2027

Two changes begin on January 1, 2027, says Utah Medicaid. They apply to adults in the Adult Expansion and Targeted Adult Medicaid programs. The first is a community engagement rule, which is a work rule. The second moves coverage reviews from once a year to every six months. Members who are American Indian or Alaska Native keep 12-month reviews.

Targeted Adult Medicaid is a separate Utah program for adults without children who have almost no income. They must also meet other rules, such as needing treatment for mental health or for drug or alcohol use.

The work rule asks for 80 hours a month of work, job training, school, volunteering, or a mix. Earning at least $580 a month also counts. Some groups are exempt, such as pregnant and postpartum members and certain caregivers. People on SSI are exempt, and so are members who are medically frail, which means a health problem makes work hard.

Utah says you do not need to do anything now. The state plans to check its own records first, such as pay data and other benefits. For that reason, many members may not need to report much. Keep your address and phone number current in myCase so the letters reach you. The state posts updates on a Medicaid page named OBBBA. That name is short for the 2025 federal law. Our work requirement guide explains the federal rule.

What to do after you apply

Coverage generally starts on the first day of the month you apply, so there is no reason to wait for a new month before you apply. After that, watch your myCase account and your mail for requests from the state. If you do not answer a request, the state may not be able to finish your application.

Reviews will happen every six months in 2027, so put your next review date on a calendar. Update your address in myCase whenever you move. The state says it will send more information and a renewal letter when it is time to act.

If your income is above the Medicaid limit

You can buy a private plan on HealthCare.gov, and many people get help with the monthly cost. That help is called a tax credit, which is money from the government that lowers your plan price. The extra credits that came from a pandemic-era law stopped after 2025. For 2026, the old cap of 400 percent of poverty applies again.

Outside the yearly sign-up period you usually need a life event to join a plan, such as losing job coverage. For the details, see our guide on losing your health insurance, which covers the 60-day window.

Community health centers in Utah

The Association for Utah Community Health is the state's primary care association. It works with the state's health centers and has patient resources, including help with finding a clinic. Fees at health centers depend on income and family size.

You can also try the free Find a Health Center tool. It comes from the federal Health Resources and Services Administration, called HRSA. Enter your zip code to see sites near you. Then call and ask what a first visit costs. Our guide to sliding scale clinics explains how to ask.

Checking a Utah doctor's license

The Utah Division of Professional Licensing runs a free search tool called the Licensee Lookup and Verification System. You can search by name or license number. You can also pick a profession, such as Physician or Osteopathic Physician. To talk to a person, call the division at 801-530-6628, and it answers on weekdays.

Direct primary care and emergencies

Some doctors in Utah offer a kind of care called direct primary care. In this model you pay a flat monthly fee for visits. That fee is not insurance, and it does not cover a hospital stay. Cash-pay doctors are listed by location in our directory.

If you have an emergency, call 911 or go to the nearest emergency room. The hospital must examine you and keep your condition stable even if you are uninsured, because federal law says so.