Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
The income limit for the institutional Medicaid program and certain home and community-based waiver programs is determined by the Utah Department of Health. For 2025, the Medicaid income limit for individuals eligible for the Nursing Home (institutional) program is $2,901 per month. To qualify for Medicaid through SSI the income limit for an aged, blind or disabled individual cannot exceed $1,305 per month or $1,763 for a couple.
The Aged, Blind or Disabled Programs are medical assistance programs for individuals aged 65 years or older, blind or disabled. Persons who receive SSI (Supplemental Security Income) or Social Security Disability benefits meet the conditions for disability. If the individual is not on SSI or SSA disability benefits, the State Medicaid Medical Review Board may make a disability decision. If Social Security has not denied disability based on medical evidence, the State Medicaid Medical Review Board can determine disability without considering substantial gainful employment. If the person receives SSI, we do not count income of a spouse or parent; however, assets of a spouse or parent are counted. The SSI person’s income doesn’t count toward the income limit except for Nursing Home or Home and Community Based Waiver clients. Some individuals who lose their SSI payments may still qualify without a spend-down under one of the SSI-protected groups.
Nursing home Medicaid will pay for nursing home and other medical costs. Some different income and asset rules apply for married couples. An individual must meet medical criteria for a nursing home level of care to be eligible for Medicaid in a nursing facility. Income and asset limits are as follows:
Income: Income deductions are different for single people who will be there less than six months. A long-term nursing home resident can keep $45 of monthly income for their personal needs. The rest of the money, in most cases, must be paid to the nursing home.
Assets: Under Spousal Impoverishment law, the nursing home resident is allowed $2,000.00. Subject to certain limits, the spouse at home may keep ½ the total amount of countable assets that the couple owned when the patient entered the nursing home. These limits go up January 1st of each year. Clients must report all annuities in which the client or spouse has an interest. Annuities must name the state as the beneficiary upon the death of the client. For 2025, the non-spouse application is limited to $157,920 in assets.
Transfers of assets for less than the fair market value can result in the person being ineligible for nursing home Medicaid services for a period of time. When an application for Medicaid is made, the eligibility worker will ask for information from the prior 60 months about what the person has done with assets. This is called the look-back period.