Utah New Choices Waiver: Eligibility, Income Limits, and How to Apply in 2026

What the New Choices Waiver Does

The New Choices Waiver (NCW) is a Medicaid-funded program designed to move seniors out of nursing facilities and back into community settings — their own home, a family member's home, or a licensed Type II assisted living facility. It is one of two primary 1915(c) Home and Community-Based Services (HCBS) waivers Utah operates for elderly residents. The other is the Aging Waiver, which focuses on keeping seniors at home before they enter a facility.

The distinction matters for families navigating a care transition. The NCW is specifically for people already in institutional care who want to leave. If your parent has been in a nursing home for months and could manage at home with support, this is the waiver you need.

2026 Eligibility Requirements

Three conditions must be met simultaneously:

Medical qualification: The applicant must require a Nursing Facility Level of Care (NFLOC), as determined by a registered nurse using the InterRAI assessment. This is the same clinical threshold required for nursing home admission.

Residency duration: The applicant must have resided in a Medicaid-funded nursing facility for at least 90 days, or in a licensed assisted living facility for at least 365 days.

Financial limits (2026):

• Gross monthly income cannot exceed $2,982 (300% of the Federal Benefit Rate)
• Countable assets capped at $2,000 for a single applicant
• Home equity interest cannot exceed $752,000
• The primary residence is exempt if the applicant intends to return or a spouse/dependent lives there

If income exceeds $2,982 but the applicant otherwise qualifies, Utah's Medically Needy spenddown process may apply — the applicant can spend down to $1,330/month using the same rules as the Aging Waiver.

How the NCW Differs from the Aging Waiver

The NCW's higher income threshold ($2,982 vs. $1,330) makes it accessible to seniors whose Social Security and pension income would disqualify them from the Aging Waiver.

Services Covered Under the NCW

Waiver-funded services include personal care assistance, homemaker services, respite care, non-medical transportation, home modifications (grab bars, ramp installations), and adult day care. Under the self-directed option, participants can hire and pay family members as personal care assistants — adult children, siblings, and other relatives over age 16 qualify. Spouses and legal guardians are excluded by federal rule.

The Application Process

1. Contact the Utah DHHS Office of Long-Term Services to initiate the NCW intake process. The intake portal is available through the DHHS Medicaid division.

2. Secure Form 927. This clinical form serves as formal proof that the applicant requires an institutional level of care. The Form 927 filing date establishes when waiver-funded services can begin — delays in filing directly delay coverage.

3. Submit a financial application to the Department of Workforce Services (DWS). DWS processes the income and asset review. Expect documentation requests for bank statements, retirement account balances, and property deeds.

4. Complete the NFLOC assessment. A registered nurse evaluates the applicant's care needs using the InterRAI tool.

5. Develop a person-centered service plan with the assigned case manager, identifying which HCBS services the participant needs and whether the self-directed or agency model applies.

Why Legal Authority Matters for Waiver Applications

Here is where families get stuck: submitting a Medicaid waiver application on behalf of a parent requires legal authority to access their financial records, sign documents, and communicate with DWS caseworkers. Without a durable financial power of attorney, an adult child cannot complete the application.

If the parent still has decision-making capacity, the fix is straightforward — execute a POA with the right provisions (including authority over government benefits and trust creation). If capacity is already gone, the family faces a guardianship or conservatorship petition, which adds weeks and thousands in legal fees before the waiver application can even begin.

The Utah Power of Attorney and Guardianship Kit covers both pathways with step-by-step instructions, including how to structure a POA for Medicaid waiver applications and what to do when capacity is lost.

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