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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
1-888-222-2542 (Monday – Friday, 8a. m. – 5 p.m.)
You may apply at any Department of Workforce Services (DWS) office. Please click here opens in a new tab and type in your zip code to find an office near you.
Decision. For medical assistance, we have 30 days to process your application. We have 90 days if you claim to be disabled, unless you need more time.
Maximum Income Per Month (Before Taxes) Family SizePER MONTHPER YEAR 1 $2,510 $30,120 2 $3,407 $40,884 3 $4,304 $51,648 4 $5,200 $62,4005 more rows
Decision. For medical assistance, we have 30 days to process your application. We have 90 days if you claim to be disabled, unless you need more time. must mail the notice 10 days before we do this.
1-888-222-2542 (Monday – Friday, 8a. m. – 5 p.m.)
Adults under age 65 (with or without dependent children) in Utah can get Medicaid coverage if their household income is up to 138% of the poverty level.
States are required by federal law to approve or deny Medicaid applications within 45 days, or 90 days for applications that require a disability determination.
Medicaid is a medical program for people who have low-income and limited resources. To be eligible for Medicaid, you must meet a program type and meet the rules for Utah residency, income, and citizenship. An individual must qualify each month for continued coverage.