Prader-Willi Syndrome Benefits in Utah: 2025 Guide

To get federal disability benefits for Prader-Willi Syndrome, you must meet Social Security’s definition of disability. This means your condition must stop you from doing substantial work for at least 12 months. For children, the rules are different: a child under 18 may qualify if their condition severely limits daily activities. Adults must show they cannot do any job that pays above the Substantial Gainful Activity (SGA) limit. In 2025, SGA is $1,620/month for most people, or $2,700/month if blind. If you worked and paid Social Security taxes, you may qualify for SSDI. If you have low income and resources, you may qualify for SSI. Both programs require medical proof of disability. [^1][^5]

In Utah, people with Prader-Willi Syndrome may qualify for Medicaid if they are disabled and meet income rules. Utah’s Medicaid Aged, Blind or Disabled (ABD) program covers medical costs for disabled adults and children. If you get SSI or SSDI, you often qualify for Medicaid automatically. If not, the State Medicaid Medical Review Board can decide if you are disabled. Utah also offers Medicaid waivers for home and community-based services, which can help with care at home. These waivers may have waiting lists. Utah’s rules follow federal guidelines, but some programs may have extra state rules. [^4][^3]

• Gather medical records showing Prader-Willi Syndrome and how it limits work or daily life.
• Check if you qualify for SSI (low income) or SSDI (work history).
• Apply online at SSA.gov or at a local Social Security office.
• Apply for Utah Medicaid through Medicaid.gov or your local Workforce Services office.
• Consider opening an ABLE account for extra savings. [^5][^4][^6]

• Step 1: Get medical records that show your diagnosis of Prader-Willi Syndrome and how it affects your ability to work or do daily tasks.
• Step 2: Decide if you need SSI (based on income) or SSDI (based on work history). Both require proof of disability.
• Step 3: Apply for Social Security benefits online at SSA.gov, by phone, or in person at a Social Security office. You will need to fill out forms and send medical records.
• Step 4: Apply for Utah Medicaid. If you get SSI or SSDI, you may be automatically enrolled. If not, apply through Medicaid.gov or your local Workforce Services office. You may need to prove disability and income.
• Step 5: If you want to save for disability-related costs, open an ABLE account. Utah’s ABLE program lets you save up to $19,000 per year in 2025 without losing SSI or Medicaid. [^5][^4][^6][^3]

• SSI (Supplemental Security Income): Monthly cash for people with low income and resources who are disabled, blind, or age 65+.
• SSDI (Social Security Disability Insurance): Monthly cash for people who worked and paid Social Security taxes but are now disabled.
• Medicaid: Health coverage for people with low income and disabilities. If you get SSI, you often get Medicaid.
• Medicare: Health coverage for people who get SSDI for 24 months.
• ABLE Accounts: Tax-advantaged savings accounts for people with disabilities. [^5][^4]

• Utah Medicaid Aged, Blind or Disabled (ABD): Medical coverage for disabled adults and children who meet income rules. If you get SSI or SSDI, you often qualify automatically.
• Medicaid Waivers (HCBS): Help with home care, therapy, and support services. These may have waiting lists.
• Utah ABLE Account: Lets you save up to $19,000 per year in 2025 for disability-related costs without losing SSI or Medicaid.
• Supplemental Nutrition Assistance Program (SNAP): Food help for low-income people, including those with disabilities. [^4][^6][^2]

Utah’s ABLE account lets people with Prader-Willi Syndrome save up to $19,000 per year in 2025 for disability-related costs. This money does not count against SSI or Medicaid income limits. You can use it for things like therapy, equipment, or education. To open an account, go to Utah’s ABLE program website. [^6]

For SSI in 2025, the federal income limit is about $943/month for an individual. For SSDI, there is no income limit, but you cannot earn more than the SGA limit ($1,620/month in 2025) and keep full benefits. For Utah Medicaid, income limits vary by program but are often higher for disabled people. [^1][^3][^5]

If your income or living situation changes, you must report it to Social Security and Medicaid. Not reporting changes can lead to overpayments and penalties. Use the SSA’s online portal or call your local office to report changes. [^5][^4]

• Utah Department of Workforce Services
  Phone: 866-286-2379

  Website

  For SSDI and SGA questions.
• Utah Medicaid
  Phone: 800-662-9651

  Website

  For Medicaid eligibility and applications.
• Social Security Administration
  Phone: 800-772-1213

  TTY: 800-325-0778

  Website

  For SSI/SSDI applications and questions.

• Can someone with Prader-Willi Syndrome get SSI in Utah?

  Yes, if Prader-Willi Syndrome limits work or daily life and you meet income rules, you can get SSI in Utah. You need medical proof and to apply through Social Security.

• How do I apply for SSDI with Prader-Willi Syndrome?

  To apply for SSDI, you need a work history and medical proof that Prader-Willi Syndrome stops you from working. Apply online at SSA.gov or at a local office.

• What is the SGA limit for 2025 in Utah?

  In 2025, the SGA limit is $1,620/month for most people with disabilities. If you are blind, it is $2,700/month. Earning above this may stop your SSDI payments.

• Does Utah Medicaid cover Prader-Willi Syndrome?

  Yes, Utah Medicaid covers medical needs for people with Prader-Willi Syndrome if they meet disability and income rules. You may qualify if you get SSI or SSDI.

• Can I work and still get disability benefits in Utah?

  Yes, you can work and keep some benefits if you earn below the SGA limit. Social Security has work incentives to help you keep benefits while working.

• What is an ABLE account and how can it help?

  An ABLE account lets you save up to $19,000 per year in 2025 for disability-related costs without losing SSI or Medicaid. Utah has its own ABLE program.

• Are there Medicaid waivers for Prader-Willi Syndrome in Utah?