Presumptive Eligibility

The Presumptive Eligibility (PE) program gives children under 19 and pregnant women temporary Colorado Medicaid or Child Health Plan Plus (CHP+) medical coverage right away. Your temporary medical coverage lasts for at least 45 days while we process your Medical Assistance application.

Who Qualifies?

  • You must be a child under 19 or a pregnant woman,
  • You must appear to qualify for Colorado Medicaid or CHP+ and
  • You must complete an application for Medical Assistance.

Benefits and Services

If you are a child or pregnant woman who qualifies for Colorado Medicaid Presumptive Eligibility

If you are a child or pregnant woman who qualifies for CHP+ Presumptive Eligibility

 Regular Medicaid Benefits except:

  • Dental services
  • Inpatient (hospital) care, including labor and delivery

Regular CHP+ Benefits except:

  • Dental Services

 

How to apply

You must apply at an approved PE Site. PE sites are clinics, health centers, and community resource centers.

The PE site will help you fill out the Medical Assistance Application, or you can print the application and bring it with you to the PE site. You can also apply through PEAK and print out your completed application and bring it with you to the PE site. You must complete all pages of the application.

We use your completed Medical Assistance application to see if you qualify for Colorado Medicaid or CHP+. After we have made a decision, you will get a letter from us telling you if you qualify for Colorado Medicaid or CHP+.

If you do not qualify for Colorado Medicaid or CHP+, your temporary coverage through the PE program will end. You may have other coverage options.

If you have more questions about this program please call Medicaid Customer Service.