Member Frequently Asked Questions

To save you time, we've answered many of the most common questions about Health First Colorado (Colorado's Medicaid Program), Child Health Plan Plus, and other topics below. If you still can't find the answer you need, get in touch with us.


 

Child Health Plan Plus Frequently Asked Questions

What is Child Health Plan Plus (CHP+)?

Child Health Plan Plus (CHP+) is low-cost health and dental insurance for Colorado’s uninsured children and pregnant women. CHP+ is public health insurance for children and pregnant women who earn too much to qualify for Health First Colorado (Colorado's Medicaid Program), but not enough to afford private health insurance. Get more information.

What kind of benefits are included in Child Health Plan Plus (CHP+)?

See: About Child Health Plan Plus

When can I start using benefits for Child Health Plan Plus (CHP+)?

See: About Child Health Plan Plus

When should I apply for Child Health Plan Plus (CHP+)?

You can apply for Child Health Plan Plus (CHP+) at any time. CHP+ does not have an open enrollment period.

Are children of state employees eligible for Child Health Plan Plus (CHP+)?

Yes, the children of Employees of the State of Colorado may qualify for Child Health Plan Plus (CHP+). Employees of the State of Colorado must meet income and eligibility criteria for the program.

How do I apply for Child Health Plan Plus (CHP+)?

See: How To Apply

How is Child Health Plan Plus (CHP+) different from Health First Colorado?

See: About Child Health Plan Plus and HealthFirstColorado.com for more information.

How long will it take to find out if I qualify for Child Health Plan Plus (CHP+)?

If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify.

Is there an open enrollment period for Child Health Plan Plus (CHP+)?

You can apply for Child Health Plan Plus (CHP+) at any time. CHP+ does not have an open enrollment period.

Are there co-pays or enrollment fees for Child Health Plan Plus (CHP+)?

See: Child Health Plan Plus Fees

My child is currently a member of Health First Colorado or Child Health Plan Plus (CHP+). If I think I may qualify for Health First Colorado do I need to apply or will I be automatically enrolled since my child is already getting benefits?

You will need to complete an application even if your children are currently enrolled in Health First Colorado (Colorado's Medicaid Program) or Child Health Plan Plus (CHP+). You can apply at any time. For more information visit How To Apply.

What doctors take Child Health Plan Plus (CHP+)?

See: The Child Health Plan Plus (CHP+) section of Find a Doctor.


Medicare/Medicaid Frequently Asked Questions

I have Medicare (or will have Medicare soon). How do I get help with the Medicare costs?

Members can apply for assistance with their Medicare costs at the county department of human/social services where they live.

Will I get a refund of all the Medicare premiums I paid?

Maybe. If a refund is due, it will only go back to the month Buy-In began. Some programs can be backdated up to three (3) months prior to the application date, if the member qualifies. The Qualified Medicare Beneficiary (QMB) program begins the first of the month after the application date. QMB cannot be backdated.

When will I get my refund of paid Medicare premiums?

Usually within a month after the county approves eligibility. If it takes longer than a month, contact your county human services office, or the State Buy-In Officer.

How will I get my refund of paid Medicare premiums?

The refund comes the same way your regular social security payment comes, direct deposit or paper check. The refund can come any day of the month.

Will the Medicare Savings Program (MSP) pay my Medicare deductible and co-insurance?

The Qualified Medicare Beneficiary (QMB) Medicare Savings Program (MSP) will pay the Medicare deductible and co-insurance. The other MSP programs (SLMB, QI-1, QDWI) will only pay the Medicare premiums.

How do I get help with my Medicare Part D costs?

Contact the State Health Insurance Assistance Program (SHIP) toll-free at 1-888-696-7213.


Provider Search Tool Frequently Asked Questions

What is the provider search tool?

The Department of Health Care Policy and Financing website contains a provider search tool that offers a resource for Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus members to search for and contact providers including physician and dental services. Members who use this tool to search for providers should keep in mind that they also need to contact the individual provider to confirm the provider is accepting new patients.

Why is there a need for a provider search tool?

The Department maintains all Health First Colorado provider information and works to make this information accessible so that members can find providers to deliver covered services.

What information does the provider search tool contain?

The provider search tool search results provide a list of providers sorted by providers’ names:

  • Provider Legal Name / Doing Business As name
  • Provider Type Description
  • Specialty Description
  • Location Address, City, State, and Zip
  • Phone number
  • Website links
  • Languages spoken
  • Accepting New Patients status

How frequently is provider information updated?

A report of providers is used to update the provider search tool on our websites twice a month.

What other criteria are used?

Providers must have billed an electronic or paper claim in the last 12 months.

How do members use the search tool?

Members can search for providers by location, provider type, specialty, and/or name.

How do providers update their contact information?

Providers can update their contact information and new patient status anytime via the Provider Web Portal.


Pregnant Women Frequently Asked Questions

If I have a health question or concern, who should I call?

Health First Colorado (Colorado's Medicaid Program) offers a free 24-hour, 7 days a week Nurse Advice Line  at 1-800-283-3221. Help is available in both English and Spanish.

What is the Nurse Home Visitor Program?

The Nurse Home Visitor Program (NVHP) is a special program for qualifying women who are pregnant with their first child. The program is also for these first children up to their second birthday. NHVP offers case management and health education services to moms and their first babies in order to help them get the medical and social services that they need.

How much are my co-pays?

You have no co-pays for Health First Colorado-covered services and prescriptions while you are pregnant and for two months after your pregnancy ends.

Can I get help to quit smoking?

  • Contact the Colorado QuitLine at 1-800-QUIT-NOW (1-800-784-8669) for free coaching and support.
  • Talk with your health care provider about the benefits and risks of taking smoking cessation medications while you are pregnant. Health First Colorado covers two 90-day courses of smoking cessation medication with counseling to help you quit.

Are prenatal vitamins covered?

Prenatal vitamins are a free benefit for all pregnant women. Talk with your health care provider about the benefits of taking a prenatal vitamin every day. A prescription is required.

Can I get transportation to my appointments?

Free Non-Emergent Medical Transportation (NEMT) is available if you have no other means of transportation to get to and/or from health appointments for Health First Colorado-covered services. See the Non-Emergent Medical Transportation page for details.

Can I get help for depression?

Mental and behavioral health services are available to Health First Colorado (Colorado's Medicaid Program) members. All Health First Colorado-covered mental and behavioral health services are provided through Behavioral Health Organizations. Please contact the Behavioral Health Organization in your area to set up an appointment.

How do I enroll my newborn in Health First Colorado?

If you are a woman enrolled in Health First Colorado (Colorado's Medicaid Program) or CHP+ when your baby is born, you can add your newborn to your case online by reporting a change through your PEAK account at Colorado.gov/PEAK, or using the PEAKHealth mobile app. Your baby will then be automatically enrolled in health coverage until his or her first birthday.

There is also an option to report the birth of your baby to your county of residence human services office or a Medical Assistance (MA) site case worker near you. Once your baby is added to your case and you have their State ID, you are able to take your baby to the doctor.

Are breast pumps covered?

Health First Colorado (Colorado's Medicaid Program) may provide breast pumps to some members in limited cases.

  • Manual breast pumps for premature infants and infants in critical care are available for purchase.
  • Electric breast pumps are only available for purchase for premature infants and infants in critical care, and only if the infant is expected to be hospitalized for 54 days or more. Electric breast pump rental is available if the infant is expected to be hospitalized less than 54 days. Electric breast pumps require prior approval by Health First Colorado.

Breast pumps must be prescribed by a physician, physician assistant or nurse practitioner. Breast pumps must be purchased from an approved supplier, which are often pharmacies.

If you do not qualify for a breast pump through Health First Colorado, you may be able to receive a breast pump from Colorado’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC). For more information, call the WIC program at 1-800-688-7777 to see if you are eligible for the WIC program and meet qualifying criteria for the pump loan program.


Former Foster Care Youth Frequently Asked Questions

What is the former foster care youth Health First Colorado extension?

Qualifying former foster care youth from Colorado can now get free Health First Colorado (Colorado's Medicaid Program) coverage up until the age of 26. Former foster care youth who qualify for the extension do not have to pay co-payments for services.

Who qualifies for the former foster care youth Health First Colorado extension?

Youth in foster care under the state's or tribes' responsibility and also enrolled in Health First Colorado (Colorado's Medicaid Program) qualify for the extension. Former foster care Health First Colorado extends medical assistance to age 26 for former foster care youth that were in Colorado foster care at ages 18, 19, 20 or 21 and enrolled in Health First Colorado. You are considered a former foster care youth if you were under the following types of care:

  • Certified kinship care
  • Non-Certified kinship care (when the county has custody)
  • Foster home care
  • Group home care
  • Group center care
  • Children’s Habilitation Residential Program (CHRP)
  • Residential Child Care Facilities (RCCF) programs
  • Psychiatric Residential Treatment Facilities (PRTF) programs
  • Independent living programs or
  • Youth committed to the Division of Youth Corrections living in one of the above, non-secure locations

I was in foster care but emancipated out before my 18th birthday or was permanently adopted (left foster care). Can I qualify for the Health First Colorado extension?

No, you must have been in foster care at ages 18, 19, 20 or 21 and enrolled in Health First Colorado (Colorado's Medicaid Program) to qualify. If you left foster care before your 18th birthday, you do not qualify for the extension.

You may still be able to qualify for regular Health First Colorado. To find out how go to the How To Apply page.

I was a foster care youth in another state. Can I qualify for the Health First Colorado extension?

No, you must have been in foster care in Colorado to qualify.

I was in Youth Corrections until I was 18 years old. Can I qualify for the Health First Colorado extension?

Yes, if you were in Youth Corrections on or after your 18th birthday and were receiving Health First Colorado (Colorado's Medicaid Program) at the time, you may qualify for the extension.

What benefits and services does Health First Colorado cover?

Health First Colorado (Colorado's Medicaid Program) offers the following benefits and services: doctor visits, behavioral health, hospitalization, rehabilitative services, laboratory services, outpatient care, prescription drugs, emergency care, dental care, maternity care, and newborn care.

Health First Colorado also covers preventive and wellness services including aspirin use, blood pressure screening, breast cancer screening, cholesterol screening, depression screening, healthy diet counseling, sexually transmitted disease prevention counseling, tobacco use screening and counseling, and others.

For more information see our Health First Colorado Benefits & Services page or contact the Health First Colorado Customer Contact Center.

Are dental services covered by Health First Colorado?

Yes, beginning April 1, 2014 all Health First Colorado (Colorado's Medicaid Program) members will have access to dental services. Youth under 21 will be able to get additional dental services. Family Health Coordinators can tell you more about the dental service you may be able to get if you are under 21.

I think I may qualify for the Health First Colorado extension for former foster care youth but have not been contacted. What should I do?

You should contact your local county Human Services office. They can help figure out if you qualify for the Health First Colorado (Colorado's Medicaid Program) extension.

As a qualifying former foster care youth, do I have to pay co-payments for services?

No, former foster care youth do not have to pay co-payments for Health First Colorado-covered services. For more information see our Benefits & Services page or contact the Health First Colorado Customer Contact Center.

I am a qualifying former foster care youth and am attending college outside of Colorado. Can I qualify for the Health First Colorado extension?

If you retain residency in Colorado while you are temporarily out of the state for school, you can qualify for the Health First Colorado extension. Health First Colorado (Colorado's Medicaid Program) will cover services provided by out-of-state providers on a case-by-case basis. You should contact the Health First Colorado Customer Contact Center for more information on seeing a provider outside of Colorado.

As a qualifying former foster care youth, do I have access to Early Periodic Screen Diagnosis and Treatment (EPSDT) services as part of the Health First Colorado extension?

Once you reach the age of 21, you can no longer get Early Periodic Screening, Diagnosis and Treatment (EPSDT) services. Adult services are provided and you do not have co-payments. If you are a qualifying former foster care youth from age 18 through age 20, Early Periodic Screening, Diagnosis and Treatment Services will still be available to you. Check out this list of people on page 4 who can tell you more about the additional services you may be able to get if you are under 21.

Do I need to do anything to ensure I can get my health services?

It is important to keep your address up to date with your county Human Services office. We need your up-to-date mailing address to make sure you get your Health First Colorado card in the mail and other important letters from us. You can also update your address online through Colorado.gov/PEAK.

You can also view your Health First Colorado card from the PEAKHealth mobile app. PEAKHealth is for current Health First Colorado and Child Health Plan Plus (CHP+) members. You must have a Colorado.gov/PEAK account or create one to sign in. PEAKHealth can be downloaded at the Apple iTunes Store or Android/Google Play App Store for free. PEAKHealth is not for people who want to apply for benefits. With the PEAKHealth app and a PEAK Account you can:

  • Update your income and upload your paystub
  • Update your contact and household information
  • Set up payments for Child Health Plan Plus (CHP+) enrollment fees or the Health First Colorado Buy-in program premiums
  • Learn about how to stay healthy
  • Find a Health First Colorado or CHP+ doctor
  • View an electronic version of your Health First Colorado card
  • View your Health First Colorado or CHP+ benefits

Do I need to provide anything else to my county Human Services office?

Each year you will be sent a Health First Colorado Recertification Letter. The letter will ask you if anything has changed, such as your address or a change in your incarceration status. You will need to let us know if anything has changed. If nothing has changed, you will still get your services. You can also update your address online through Colorado.gov/PEAK.

I received a Proof of Eligibility Letter. Do I need to always use this?

A Proof of Eligibility Letter was sent to you because your name was not in the automated Health First Colorado (Colorado's Medicaid Program) system. Your name is now in our system. You no longer need to show your Proof of Eligibility Letter to providers.

I needed to call Health First Colorado to get my prescriptions filled from January through April 2014. Do I still need to do this?

No, you no longer have to call Health First Colorado (Colorado's Medicaid Program) to get a prescription filled. Your provider can now refill your prescription.

When will I receive my Health First Colorado card?

Health First Colorado cards will be sent to the last known address we have on file for you. Make sure you update your address with your county Human Services office every time you move. You can also update your address online through Colorado.gov/PEAK.

You can also view your Health First Colorado card from the PEAKHealth mobile app. PEAKHealth is for current Health First Colorado and Child Health Plan Plus (CHP+) members. You must have a Colorado.gov/PEAK account or create one to sign in. PEAKHealth can be downloaded at the Apple iTunes Store or Android/Google Play App Store for free. PEAKHealth is not for people who want to apply for benefits. With the PEAKHealth app and a PEAK Account you can:

  • Update your income and upload your paystub
  • Update your contact and household information
  • Set up payments for Child Health Plan Plus (CHP+) enrollment fees or the Health First Colorado Buy-in program premiums
  • Learn about how to stay healthy
  • Find a Health First Colorado or CHP+ doctor
  • View an electronic version of your Health First Colorado card
  • View your Health First Colorado or CHP+ benefits

Can I reinstate my Health First Colorado benefit if I resume residency in Colorado or am released from incarceration?

Yes, report your new address and status to your county Human Services office.

I am a former foster care youth who qualifies for the Health First Colorado extension. Can I update my address through Colorado.gov/PEAK?

Yes, if you qualify for the Health First Colorado (Colorado's Medicaid Program) extension you can create a login for Colorado.gov/PEAK and update your mailing address and other information about you online. You will need to provide the following information to set up an account on Colorado.gov/PEAK:

You can also view your Health First Colorado card from the PEAKHealth mobile app. PEAKHealth is for current Health First Colorado and Child Health Plan Plus (CHP+) members. You must have a Colorado.gov/PEAK account or create one to sign in. PEAKHealth can be downloaded at the Apple iTunes Store or Android/Google Play App Store for free. PEAKHealth is not for people who want to apply for benefits. With the PEAKHealth app and a PEAK Account you can:

  • Update your income and upload your paystub
  • Update your contact and household information
  • Set up payments for Child Health Plan Plus (CHP+) enrollment fees or the Health First Colorado Buy-in program premiums
  • Learn about how to stay healthy
  • Find a Health First Colorado or CHP+ doctor
  • View an electronic version of your Health First Colorado card
  • View your Health First Colorado or CHP+ benefits

I am a former foster care youth who qualifies for the Health First Colorado extension. Can I request a new Health First Colorado card through Colorado.gov/PEAK?

Yes, if you qualify for the Health First Colorado (Colorado's Medicaid Program) extension you can request a new Health First Colorado card online. You will need to provide the following information to set up an account on Colorado.gov/PEAK:

You can also view your Health First Colorado card from the PEAKHealth mobile app. PEAKHealth is for current Health First Colorado and Child Health Plan Plus (CHP+) members. You must have a Colorado.gov/PEAK account or create one to sign in. PEAKHealth can be downloaded at the Apple iTunes Store or Android/Google Play App Store for free. PEAKHealth is not for people who want to apply for benefits. With the PEAKHealth app and a PEAK Account you can:

  • Update your income and upload your paystub
  • Update your contact and household information
  • Set up payments for Child Health Plan Plus (CHP+) enrollment fees or the Health First Colorado Buy-in program premiums
  • Learn about how to stay healthy
  • Find a Health First Colorado or CHP+ doctor
  • View an electronic version of your Health First Colorado card
  • View your Health First Colorado or CHP+ benefits

Where can I get more help?

If you are under the age of 21, Health First Colorado (Colorado's Medicaid Program) has individuals in your community called Family Health Coordinators who can help you learn about what benefits you get with Health First Colorado.

 
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