Anyone who needs healthcare coverage and believes they may be eligible for Medicaid is encouraged to apply for coverage today. Individuals may submit their applications to the Department of Workforce Services (DWS) to enroll in Medicaid Expansion. Submitting an application for benefits does not guarantee coverage. Individuals may also apply in person at a DWS office or by mail. Call 1-866-435-7414 for an application or with questions.
On April 1, 2019, the Centers for Medicare and Medicaid Services (CMS) authorized the Utah Department of Health (UDOH) to expand its Medicaid program. This new waiver called the “Bridge Plan” allows the state to expand Medicaid benefits to parents and adults without dependent children earning up to 100% FPL, about $12,492 for an individual or $25,752 for a family of four.
It is anticipated that approximately 70,000-90,000 adults will be eligible for the Bridge Plan, in which the federal government will cover approximately 70% of the costs and the state will cover the remaining 30%. Approximately 40,000 adults from 101-138% FPL will continue to receive services through the federal Marketplace.
On November 1, 2019, the State submitted a waiver request, called the “Fallback Plan”, to expand Medicaid eligibility for adults to 138% FPL and obtain a 90% federal/10% state match rate. The Fallback Plan includes a self-sufficiency requirement, an enrollment cap, employer-sponsored insurance enrollment, lock-out for intentional program violation provision, premiums for higher income adults, 12-month continuous eligibility for select groups, and housing supports for select groups. If approved by CMS, the Fallback Plan would replace the Bridge Plan. This change could occur as early as January 1, 2020.
These plans are being implemented as directed by Senate Bill 96 (2019 Legislative Session). This bill supersedes previous Medicaid Expansion efforts and replaced Proposition 3 (2018 General Election). Details regarding both plans and SB 96 are available in the Medicaid Expansion: At-A-Glance Chart below.
More information about Utah’s Medicaid Expansion efforts:
If you have questions about eligibility or to apply, call DWS: 1-866-435-7414
If you have questions about Medicaid benefits or providers, call a Medicaid HPR: 1-866-608-9422
If you are a provider and have questions about claims or patient eligibility, call the Medicaid Hotline: 1-800-662-9651
If you are a member of the media, call 801-538-6847.
You may also email questions to: firstname.lastname@example.org