Program Description
The Utah State Plan Medicaid Personal Care Services provides in-home care to low-income seniors so they can continue living independently in the community. Assistance with everyday activities, like eating, dressing, grooming, mobility, and meal preparation, help to prevent unnecessary nursing home placements, as well as delay the need for placement.
Personal Care Services is part of the Utah State Medicaid plan. There are no waiting lists for the services, as this is an entitlement program.
Eligibility Guidelines
General Requirements
There is no specific age requirement in order to qualify for Personal Care Services. However, functional criteria must be met.
- A physician must deem Personal Care Services necessary.
- An applicant’s assistance needs cannot be so severe that they are limited to their bed.
- The individual must demonstrate an inability to perform at least two of the following activities:
- Administer own medicine due to lack of memory
- Toiletry – urinal, toilet, bedpan
- Bathe or shower
- Skin care
- Move from location to location – includes using assistive devices, such as walkers and wheelchairs
- Grooming
- Preparation of meals – includes planning and cleanup
Financial Requirements
For those 65 years of age or older, the income and asset eligibility requirements are as follows.
Income Limits
As of 2024, an individual cannot have an income that exceeds $1,255 per month. The income limit for a couple is $1,703.
Asset Limits
The asset limit for a single individual is $2,000, while a married couple is permitted $3,000 in assets. However, certain items, such as one’s primary home, are considered exempt, given the individual (or their spouse) lives in it and it is valued under $713,000 (in 2024).
Over the Financial Limits?
Utah residents who exceed these income and asset limits but still cannot afford their care costs still might qualify for this program by working with a Medicaid planning professional. They are trained to assist applicants who find themselves in this very situation and are well versed in reallocating income and assets so that it isn’t counted toward the limits. For instance, extra income can be deposited into a Miller Trust, also referred to as a Qualified Income Trust, and an Irrevocable Funeral Trust can be used to lower one’s countable assets.
A Word of Caution 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
Based on a care plan prescribed by a doctor, several personal care services may be available, up to 60 hours each month:
- Medication management – includes reminders to take medication / watching person take medication
- Grooming assistance – bathing, skin, nail, and oral care, shaving
- Meal Preparation and tasks associated with it
- Mobility – assistance with walking and use of assistive devices
- Shopping for essential goods
- Medical transportation
- Household tasks for health/safety purposes, such as moving home furniture to allow an individual to more easily move about the home
Services can be provided by a state-approved home care agency or by someone who the senior chooses, given the individual meets Medicaid’s provider qualifications.
How to Apply / Learn More
If an individual is currently enrolled in Medicaid in Utah, they should contact their local Department of Human Services (DWS) office to learn more about personal care services or to apply for this option.
If an individual is not currently on Medicaid, one must apply for Medicaid. This can be done here or by going to your local DWS office. Click here to find the office located closest to you.
For more information, call 866-435-7414. One can also learn more about the State Plan Medicaid Personal Care Services program via the Utah Medicaid Provider Manual.