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Snapshots are informational only. You must apply to find out what programs or waivers you qualify for. If you are not looking to find coverage for an adult, please choose another category.
Click on the program names below to learn more.
If you are enrolled in the Accountable Care Collaborative (ACC), you will receive regular Health First Colorado (Colorado's Medicaid Program) benefits, and you will choose a Primary Care Medical Provider (PCMP). As a member of the ACC, you will also belong to a "Regional Care Collaborative Organization" (RCCO). Your RCCO will help to make sure your doctors and caretakers are working together to meet your health needs.
In order to be enrolled in the ACC you must first be enrolled in Health First Colorado.
Co-pay costs vary depending on the service. View the co-pay amounts per service in the Health First Colorado Benefits & Services Overview.
Full Benefit Medicare-Medicaid Enrollees are people who have both Medicare and Health First Colorado (Colorado's Medicaid Program) coverage. Your benefits, services and doctors won't change if you are part of this program. The Program coordinates your Medicare and Health First Colorado services, promotes cost-savings through improvements in quality of care, and builds on the infrastructure, resources and provider network found in the Accountable Care Collaborative (ACC).
In the ACC: Medicare-Medicaid Program your benefits and services will not change. You will continue to receive Medicare benefits plus regular Health First Colorado benefits. You will keep your doctors and all your Medicare and Health First Colorado benefits. Plus you will also have access to other benefits and services. Nothing changes for you except that all your services will be coordinated in a way that works best for you.
ACC: Medicare-Medicaid Program Benefits
Visit the Health First Colorado Benefits and Services Overview for a full list of benefits.
Visit Medicare’s website for more information on what benefits they offer.
Colorado Medicaid will pay for your Medicare co-payments. You are still responsible for small Health First Colorado co-payments, unless you are pregnant, living in a nursing home, or are under the age of 19. Co-pay costs vary depending on the service. View co-pay amounts by service in the Health First Colorado Benefits & Services Overview.
A Behavioral Health Organization provides Health First Colorado (Colorado's Medicaid Program) members with mental health and substance use disorder care. You do not need a referral from your doctor to go to your Behavioral Health Organization. You do not need to enroll in a Health First Colorado health plan to get behavioral health care. If you need mental health care and/or substance use disorder services, call the Behavioral Health Organization in your area. See the program information page for contact information.
If you or your child are enrolled in Health First Colorado, you will automatically be assigned a Behavioral Health Organization based on where you live. See the program information page for contact information for the BHO in your area.
The Breast and Cervical Cancer Program (BCCP) is for uninsured or underinsured women who have been diagnosed with breast or cervical cancer. BCCP also covers breast and cervical conditions that may lead to cancer if not treated.
In order to apply for this program you must:
Colorado Choice Transitions (CCT) is a program to help transition Health First Colorado (Colorado's Medicaid Program) clients out of nursing homes and long-term care facilities and into home and community-based settings. As a member of the CCT program you would also receive enhanced-services designed to promote independence.
In order to be enrolled in CCT you must:
The Colorado Dental Health Care Program for Low-Income Seniors (Senior Dental Program) provides discounted dental health care services to individuals 60 years of age or older whose income is insufficient to meet the costs of such care.
There is a co-payment max and it is a set fee by procedure.
The Colorado Indigent Care Program (CICP) provides discounted health care services to low income people and families. CICP is not a health insurance program. Services vary by providers.
Co-payments are based on your ability to pay. This is determined by the CICP facility.
The dental benefit provides eligible Health First Colorado (Colorado's Medicaid Program) members up to $1,000 in dental services per year.
Dental services are a program benefit for Health First Colorado members of all ages.
None. See the Health First Colorado Benefits & Services Overview for the list of co-pays per service.
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services.
All Health First Colorado (Colorado's Medicaid Program) coverable, medically necessary services must be provided even if the service is not available under the state plan to other people who qualify for Health First Colorado. Benefits not listed are not considered to be a state plan benefit and are therefore outside of EPSDT coverage and exceptions. No arbitrary limitations on services are allowed, e.g., one pair of eyeglasses or 10 physical therapy visits per year.
Children and Youth ages 20 and younger who are enrolled in Health First Colorado.
Children under the age of 19 do not have co-payments. Co-payment costs for youth ages 19 and 20 vary, see program information page.
Waiver For Persons Who Are Elderly, Blind, or Disabled (EBD) is a program to provide an alternative to nursing facility care for elderly, blind, or physically disabled persons. Effective April 1, 2014 - incorporated services formerly provided under the Persons Living with AIDS/HIV waiver (PLWA).
In order to be enrolled in EBD you must:
Co-pay costs vary, learn more in the program information page
Health First Colorado (Colorado's Medicaid Program) is a public health assistance program for Coloradans who qualify. Children, pregnant women, parents and caretakers, people with developmental, intellectual, and physical disabilities, and adults can all potentially qualify. Note: When you apply for Health First Colorado, you are applying for both Health First Colorado and Child Health Plan Plus (CHP+). You do not need to turn in more than one application for you or your family.
You may be eligible if you meet one of these requirements:
Eligibility requirements can be complex. See the program information page for more information or visit PEAK to see if you qualify.
You might have to pay a small co-payment. If you are age 18 and younger, pregnant or are an American Indian or Alaska Native, you don’t pay co-pays. If you are 19 and older and not pregnant, you are responsible for small co-pays. If you reside in a nursing facility you typically do not have to pay co-pays. Co-pays vary depending on the service. See the Health First Colorado Benefits & Services Overview for the list of co-pays per service.
The Health First Colorado Buy-In Program for Working Adults with Disabilities lets adults with a disability who qualify to "buy-into" Health First Colorado (Colorado's Medicaid Program). If you work and earn too much to qualify for Health First Colorado you may qualify. If you qualify, you pay a monthly premium. Your monthly premium is based on your income.
If the Social Security Administration has not yet stated you are disabled, fill out the release form on the How To Apply page. We will see if you qualify using the Social Security Administration (SSA) listings.
The Health Insurance Buy-In Program (HIBI) is a premium assistance program for Health First Colorado (Colorado's Medicaid Program) member who qualify. If you qualify, HIBI will send monthly payments to you for all or a portion of the cost of your commercial health insurance premiums, and in some cases also reimburses you for deductibles, coinsurance, and co-pays.
Health First Colorado co-payments vary depending on the service. If you are age 18 and younger, pregnant, or living in a nursing facility, you don’t have to pay co-pays. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Medicare Savings Programs (MSP) help people with limited income and resources pay for some or all of their Medicare premiums and may also pay their Medicare deductibles and coinsurance. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles and co-insurance. Medicare Savings Programs are a group of programs Colorado residents can apply for if they have Medicare. Medicare Buy-In is one of the benefits of the Medicare Savings Programs.
Medicare Savings Program - Qualified Disabled and Working Individual (QDWI) pays for your Part A premium.
In order to be enrolled in QDWI you must:
Medicare Savings Program - Qualified Medicare Beneficiary (QMB): pays for your Part A and B premiums, and your Medicare deductibles and co-insurance.
In order to be enrolled in QMB you must meet monthly income and resource limits.
Health First Colorado will pay for your Medicare deductibles and co-insurance. You are still responsible for small Health First Colorado co-payments, unless you are living in a nursing facility. Health First Colorado co-pay costs vary depending on the service. Learn more in the Health First Colorado Benefits & Services Overview.
Medicare Savings Program - Qualifying Individual (QI-1) pays for your Part B premium only
In order to be enrolled in QI-1 you must meet these requirements:
Medicare Savings Program - Specified Low-Income Medicare Beneficiary (SLMB) pays for your Part B premiums only
In order to be enrolled in SLMB you must meet monthly income and resource limits
The Old Age Pension (OAP) Health and Medical Care Program provides limited medical care for Coloradans getting Old Age Pension. If you (or your family or caretaker) get Old Age Pension and make too much to qualify for Health First Colorado (Colorado's Medicaid Program), you may qualify.
The OAP Health and Medical Care Program is also known as the Modified Medical Plan, State Medical Program, Limited Medicaid and OAP State Only Program.
If you do not qualify for the OAP Health and Medical Care Program you may have other coverage options.
Pediatric Personal Care services help Health First Colorado (Colorado's Medicaid Program) members with physical, maintenance and supportive needs such as bathing, dressing, meal preparation and medication reminders.
There are no co-pays.
The Program of All-Inclusive Care for the Elderly (PACE) PACE is a Medicare/Health First Colorado (Colorado's Medicaid Program) managed care program that provides health care and support services to individuals 55 years of age and older. The goal of PACE is to assist frail individuals to live in their communities as independently as possible by providing comprehensive services based upon their needs.
In order to be enrolled in PACE you must:
Co-payments vary depending on the service. See the Health First Colorado Benefits & Services Overview for the list of co-pays per service.
The Supported Living Services Waiver (SLS) is a program to provide supported living in the home or community to persons with developmental disabilities.
In order to be enrolled in SLS you must:
Co-pay costs vary, learn more in the program information page.
When funding limits the availability of services, waiting lists are established for individuals seeking services.Learn about the Department's efforts to ensure that all eligible individuals receive the services they need at the time they're needed, within the constraints of the state's limited financial resources.
