Can I get Medicaid in Utah if I lose my job?

What options are available for Medicaid coverage in Utah if I become unemployed?

If you become unemployed, you may be eligible for Medicaid coverage in Utah. Medicaid provides low-cost or no-cost healthcare to individuals and families based on income, and a change in employment status can make you eligible for coverage, even if you didn’t qualify before. Here’s what you need to know about Medicaid options if you lose your job or experience reduced income in Utah.

1. Eligibility for Medicaid After Job Loss

If you become unemployed, you may qualify for Medicaid in Utah based on your reduced income. Medicaid eligibility is determined by your household income in relation to the Federal Poverty Level (FPL). Losing your job often results in a drop in income, which may make you eligible for Medicaid.

A. Income Guidelines

The income limits for Medicaid are based on a percentage of the Federal Poverty Level (FPL) and vary depending on your household size. For example, adults without dependent children can qualify for Medicaid if their income is up to 138% of the FPL. Here are examples of the 2024 FPL limits:

Household Size138% of FPL (Annual Income)1$20,1202$27,2143$34,3074$41,400

If your income falls below these thresholds after becoming unemployed, you may qualify for Medicaid coverage.

2. Medicaid Expansion for Adults Without Dependent Children

With the Medicaid expansion in Utah, adults without dependent children are eligible for Medicaid if their income is up to 138% of the FPL. This expansion allows more individuals who are unemployed or experiencing financial hardship to access healthcare coverage.

• Unemployed adults without children: If your income is below the threshold, you can apply for Medicaid coverage immediately after becoming unemployed.

3. Special Enrollment Period (SEP) for Medicaid

Unlike the ACA Marketplace, Medicaid does not have an open enrollment period, so you can apply for Medicaid at any time if you become unemployed and meet the income requirements.

A. How to Apply

• Apply online: Visit medicaid.utah.gov or healthcare.gov to submit an online application.

• Apply in person: You can also apply in person at your local Department of Workforce Services (DWS) office.

• Provide proof of income: You’ll need to submit documentation of your current income or unemployment benefits to verify your eligibility.

4. Medicaid Coverage for Families

If you have dependent children, you may qualify for Medicaid under a different set of guidelines. Families with children are eligible for Medicaid if their income is up to 138% of the FPL for parents or guardians.

A. CHIP (Children’s Health Insurance Program)

If your income is too high for Medicaid but you are still struggling to afford healthcare for your children, your children may qualify for CHIP. CHIP provides comprehensive healthcare coverage for children in families with moderate incomes.

5. What Happens If You Find a New Job?

If you find a new job after enrolling in Medicaid, it’s important to report the change in income to the Utah Medicaid office. Depending on your new income level, you may still qualify for Medicaid or be directed to other options such as ACA Marketplace insurance.

A. Reporting Changes

You must report changes in your employment or income status to Utah Medicaid. If your income increases significantly, you may no longer qualify for Medicaid, but you can apply for a subsidized health plan through the ACA Marketplace.

6. Other Healthcare Options If You Don’t Qualify for Medicaid

If you don’t qualify for Medicaid after becoming unemployed but still need affordable healthcare, you can explore other options:

• ACA Marketplace Plans: You may qualify for premium tax credits and cost-sharing reductions to help lower the cost of health insurance if your income is too high for Medicaid.

• COBRA: If you recently lost employer-sponsored health insurance, you may be eligible for COBRA, which allows you to continue your previous employer’s health coverage for a limited time, though it can be more expensive.

Key Takeaways:

• If you become unemployed in Utah, you may qualify for Medicaid based on your reduced household income.

• Utah's Medicaid expansion allows adults without dependent children to qualify if their income is up to 138% of the Federal Poverty Level (FPL).

• Medicaid applications are accepted year-round, so you can apply as soon as you experience a change in employment or income status.

• If you have children, you may qualify for Medicaid or CHIP to ensure your children receive healthcare coverage.

For help applying for Medicaid after becoming unemployed or exploring other healthcare options, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.