Utah Medicaid will now cover COVID-19-related diagnostic testing and services for uninsured individuals. This new program will be effective through the duration of the public health emergency.  Covered services include COVID-19 testing, as well as serological tests to determine the presence of the virus antibodies. Related services covered include the administration of the test and evaluations related to testing, such as x-rays.

Uninsured individuals are eligible for the new “COVID-19 Uninsured Testing Coverage” without regard to income or assets. To qualify, an individual must be uninsured, and meet citizenship and Utah residency requirements.  Individuals are considered uninsured if they are not enrolled in another federal health care program, such as Medicare or Veterans Health Administration coverage, or a commercial group or individual health plan.

Individuals may apply online. A representative from the Utah Department of Health (UDOH) will determine eligibility. A decision will be made within two to three business days and the individual will receive notification of the decision. If approved, coverage begins on the first day of the application month.  The individual will receive a Medicaid card within a few days of the approval.  

The application also serves as a full Medicaid and/or Children’s Health Insurance Program (CHIP) application, unless the person opts-out. It may take up to 30 days for a decision to be made. If the individual does not qualify for Medicaid or CHIP, the COVID-19 Uninsured Testing Coverage will continue until the last day of the month in which the public health emergency ends. If the individual qualifies for Medicaid or CHIP, the COVID-19 Uninsured Testing Coverage will end but the individual will receive enhanced medical coverage through a regular Medicaid or CHIP program, which includes COVID-19 testing and treatment.

Health care providers who have conducted COVID-19 testing or provided treatment for uninsured individuals on or after February 4, 2020, have been able to submit claims reimbursement through the Health Resources and Services Administration (HRSA).  However, HRSA is the payer of last resort and is subject to available funding.  Utah’s new Medicaid reimbursement program, now available through the end of the public health emergency period for testing and testing related services, offers enhanced funding and is not restricted by a finite federal budget.

Additional Resources:

Frequently Asked Questions for Applicants/Individuals

Frequently Asked Questions for Providers

Coverage and Reimbursement Lookup Tool

State of Utah’s Official Coronavirus Updates and Information 

Cobertura De Prueba COVID-19 Sin Seguro