Application Resources for Partners
Please note: The information on this page is intended for Eligibilty Sites and Community Partners. If you would like to apply for Medicaid or Child Health Plan Plus, click here.
Beginning October 1, 2013, the Departments of Health Care Policy and Financing and Human Services, and Connect for Health Colorado will use standardized, common applications to determine eligibility for medical and public assistance. Consumers will have the option to apply online through PEAK, or Connect for Health Colorado, in person, by mail or by calling toll free 1-800-221-3943 or TDD 1-800-659-2656.
Click here for a Quick Reference Guide to the New Paper Applications
Click here for Additional Guidance on the new Paper Application (updated 10/21/2013)
Application for Health Coverage & Help Paying Costs
The Application for Health Coverage & Help Paying Costs, also known as the Medical Only Application or Single Streamlined Application, can be used by consumers to apply for health care coverage. This application is for health care coverage only.
Application for Public Assistance
The Application for Public Assistance, also known as the Single Purpose Application, can be used by consumers to apply for both health care coverage and food and cash programs.
Spanish application—coming soon
Additional Information Needed for Colorado Medical Programs
The Additional Information Needed for Colorado Medical Programs, also known as the Supplemental Page, should be used by consumers if they:
Completed the prior “Application For Medical Assistance (Medical Only Application)”
Completed the prior “Application for Public Assistance (Single Purpose Application)”; or
Are currently enrolled in a medical program and are reporting income or any other changes.
Spanish Supplemental Page—coming soon