Utah Medicaid and CHIP for a Grandchild Living with a Relative Caregiver

You Do Not Need Guardianship to Apply

One of the most common fears among grandparents and relatives raising a child in Utah is that they need a court order before the child can see a doctor. That is not true for health coverage eligibility. A relative caregiver, a legal guardian, or someone holding a § 75-5-103 power of attorney can file a Medicaid or CHIP application on behalf of a minor child. Parental signatures are not required when the child lives in your physical custody and the parents are absent.

DWS processes the application. You sign as a non-parent caretaker and attest that the child resides with you.

Income Rules: Your Income Is Excluded

Utah uses Modified Adjusted Gross Income (MAGI) to determine child health coverage eligibility. When a relative caregiver applies on behalf of a child, the household unit for MAGI purposes consists of the child alone. Your wages, pension, Social Security retirement, and savings are completely excluded.

The income thresholds (as of March 2026) depend on the child's age:

• Children ages 0 to 5: Medicaid covers up to 139% of the federal poverty level
• Children ages 6 through 18: Medicaid covers up to 133% FPL
• Children up to age 19: CHIP covers up to 200% FPL for families above the Medicaid ceiling

For a household unit of two (one child plus counted income sources), the Medicaid limit for a child under 6 is about $2,507 per month. Because your income is excluded, compare the child's countable income with the applicable threshold; DWS makes the eligibility decision.

What Medicaid Covers

Once approved, a child in an urban Wasatch Front county enrolls in a Medicaid Managed Care Organization — SelectHealth Community Care, Health Choice Utah, or Molina Healthcare — for physical health care. Dental care runs through separate plans like Premier Access or Advantage Dental. Behavioral health services go through the county mental health authority (Optum in Salt Lake County, Wasatch Behavioral Health in Utah County, and others by region).

CHIP covers similar services for children whose household income falls between the Medicaid ceiling and 200% FPL.

Retroactive Coverage

Utah Medicaid offers up to three months of retroactive coverage before the month you apply. If the child visited an emergency room, urgent care, or doctor during the 90 days before your application date and you could not pay, request retroactive coverage on the DWS form. Medicaid can cover those unpaid bills.

12-Month Continuous Eligibility

Children approved for Medicaid or CHIP receive 12 months of continuous coverage. Minor fluctuations in the child's income during the certification period will not cause a loss of coverage. At the 12-month mark, DWS attempts an automatic renewal by cross-referencing state databases. If the automatic check cannot verify eligibility, DWS mails a pre-populated renewal form. Sign and return it before the deadline to avoid a coverage gap.

Medicaid Does Not Equal Consent Authority

Getting the child on Medicaid solves the insurance question, but it does not give you legal authority to consent to medical treatment. Routine care is generally fine with a power of attorney or caregiver affidavit. Major surgery, psychiatric treatment, or non-emergency procedures typically require legal guardianship or a specific court order.

If you are facing a medical consent issue, the Utah Kinship School & Medical Consent guide covers the authority each legal arrangement gives you.

How to Apply

File through the myCase portal at jobs.utah.gov. The unified Form 61 application handles Medicaid alongside FEP cash, SNAP, and child care. If you are already applying for the Specified Relative Grant, check the Medicaid box on the same form — submitting both at once saves paperwork and processing time.

For the full picture of how Medicaid fits alongside the cash grant, SNAP, child care, and WIC, the Utah Kinship Financial Help guide maps every program's income rules side by side.

See more Utah guides →