Why Medicaid Planning Matters Now More Than Ever
As we move through 2025, many seniors and their families face a growing concern: how to afford long-term care without depleting a lifetime of savings. With nursing home costs in many areas now exceeding $10,000 per month, even substantial retirement funds can quickly disappear, leaving little for a spouse’s ongoing needs or as inheritance for loved ones.
Medicaid planning has become an essential strategy for many families, yet it remains widely misunderstood. This post will clarify what Medicaid planning is, why it matters in 2025, and how proper legal guidance can make all the difference.
Utah Medicaid Eligibility Rules in 2025
Understanding Utah’s specific Medicaid rules is crucial for effective planning. Here’s what you need to know about qualifying for long-term care Medicaid in Utah:
Asset Limits
For a single applicant in 2025, Utah maintains the standard $2,000 asset limit for countable resources. Married couples with both spouses applying have a combined limit of $3,000 or $4,000 (depending on the specific program).
When only one spouse applies for Medicaid (known as the “institutional spouse”), the non-applicant spouse (the “community spouse”) has significant asset protections. The community spouse may keep 50% of the couple’s countable assets, up to $157,920, or 100% if the total assets are less than $31,584.
Exempt Assets
Not all assets count toward these limits. In Utah, exempt assets include:
- Your primary home (with limitations)
- Personal belongings and household items
- One vehicle
- Irrevocable funeral trusts
- Non-saleable property
It’s important to note that while your home is generally exempt from Medicaid’s asset calculations, it is not protected from Medicaid’s Estate Recovery Program. Following a beneficiary’s death, Utah’s Medicaid agency may seek reimbursement for care costs from the deceased’s remaining estate, which often includes the home.
Income Limits
Utah’s income requirements vary based on the specific Medicaid program:
- Institutional/Nursing Home Medicaid: No strict income limit, but most income must go toward care costs, leaving just a $45 personal needs allowance
- Home and Community Based Services (HCBS) Waivers: $2,901/month for the New Choices Waiver or $1,255/month for the Aging Waiver (2025 limits)
- Regular Medicaid (ABD): $1,255/month for single applicants or $1,704/month for married couples
For married applicants where only one spouse is applying for Medicaid, the income of the non-applicant spouse is not counted when determining eligibility.
Key Updates for Utah Medicaid in 2025
Several important changes and facts about Utah Medicaid are worth noting this year:
- Effective March 27, 2025, the Social Security Administration reinstated the 100 percent policy to recover overpayments, a change from the 10 percent withholding rate established in early 2024
- For the Utah Aging Waiver program, the individual income limit is $1,305/month (effective March 2025 through February 2026)
- Utah’s application process typically takes between 60-90 days if all documentation is complete and accurate, but processing times may increase for applicants requiring a spend-down program
- The New Choices Waiver (NCW) program in Utah provides home and community-based services for eligible members who would otherwise require nursing facility care, with a goal of moving people from institutional settings to less restrictive community care
- The average cost of skilled nursing care in Utah is now approximately $97,818 annually, making Medicaid planning essential for most families
These updates underscore the importance of staying informed and planning proactively with professional guidance.
Utah-Specific Medicaid Planning Strategies
Utah has a standard 60-month “look-back period” for Medicaid, meaning any gifts or asset transfers made for less than fair market value during this time may result in penalties and periods of ineligibility. Effective and legal Medicaid planning in Utah might include:
1. Family Caregiver Compensation
Utah Medicaid offers programs that allow family members to be compensated for providing care to eligible seniors. Through the Home and Community Based Services (HCBS) Waivers, family caregivers can be paid to assist with daily living activities like bathing, dressing, and meal preparation. This is a legitimate way to transfer assets while ensuring quality care.
2. Spousal Protection Strategies
For married couples where only one spouse needs long-term care, Utah offers important protections for the community spouse (the spouse not requiring care). As mentioned earlier, the community spouse may keep 50% of joint assets up to $157,920 or 100% of assets up to $31,584.
3. Qualified Income Trusts
Unlike some other states, Utah doesn’t use Miller Trusts (also called Qualified Income Trusts) as a solution for applicants with excess income. Different planning approaches will be needed in Utah if income exceeds the limits.
4. Converting Countable Assets to Exempt Assets
In appropriate circumstances, converting countable assets (like excess cash) into exempt assets (like necessary home modifications or medical devices) can help qualify for Medicaid while improving quality of life.
5. Utilizing Home Equity Exemptions
In 2025, Utah allows a home equity interest limit of $730,000 for Medicaid eligibility. Strategic planning around your home’s equity can play an important role in qualifying for benefits while protecting this valuable asset for as long as possible.
When to Begin Medicaid Planning
The short answer: as early as possible.
Many effective Medicaid planning strategies must be implemented well before you need long-term care. Because of strict look-back rules, improper planning can lead to disqualification from benefits. Working with an elder law attorney to develop a comprehensive plan years before you anticipate needing long-term care provides the greatest protection and most options.
Utah Resources and Professional Guidance
Utah offers various resources to help navigate the complex world of Medicaid planning:
- Area Agencies on Aging: For the Aging Waiver program, the referral process begins with your local Area Agency on Aging (AAA), which can be contacted through the Division of Aging and Adult Services at (801) 538-3910
- Authorized Representatives: Utah Medicaid allows applicants to designate an authorized representative (family member, friend, or professional) to assist with the application process
- Professional Guidance Options: In Utah, as in other states, you generally have two professional options when seeking help with Medicaid planning: Elder Law Attorneys specialize in legal aspects of Medicaid and long-term planning. They’re particularly valuable if you have complex assets, business interests, or need comprehensive estate planning alongside Medicaid strategies. C
The choice between these professionals depends on your specific situation, timeline, and financial complexity. For many Utah families, a combination approach—working with both types of professionals—provides the most comprehensive protection.
Take Action Now
Don’t wait until a health crisis forces you into rushed decisions about long-term care. At Kathie Brown Roberts P.C., we provide comprehensive Medicaid planning services tailored to your unique situation. Our approach includes:
- Assessing your current assets and potential long-term care needs
- Developing strategies to protect assets while ensuring eligibility for benefits
- Creating comprehensive legal documents to support your plan
- Guiding you through implementation and application processes
Conclusion
Medicaid planning is not about gaming the system—it’s about understanding the complex rules and legally structuring your affairs to protect what you’ve worked for while ensuring you can access the care you need. With nursing home costs continuing to rise and rules constantly changing, professional guidance has never been more important.
Contact our office today for a consultation to discuss how we can help you develop a Medicaid plan that protects your future and your family’s security.
This blog post is for informational purposes only and does not constitute legal advice. Every situation is unique, and you should consult with a qualified elder law attorney about your specific circumstances.