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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 individual with physical or developmental disabilities, please choose another category. Click on the program names below to learn more.
The BI waiver is a program to provide a home or community-based alternative to hospital or specialized nursing facility care, for persons with a brain injury.
Co-pay costs vary. Learn more in the program information page
The Children With Autism Waiver (CWA) provides home or community-based alternatives for children with a medical diagnosis of autism who are most in need due to the severity of their disability. Note: This waiver ended June 2018
Children ages 18 and younger do not pay co-pays.
The Waiver for Children with Life Limiting Illness provides a home or community-based alternative to children with a life limiting illness.
Children who are:
Ages 18 and younger Receiving hospital level of care Determined by case manager to be safely served in the community Receiving at least one CLLI waiver benefit per month while enrolled in the waiver Meet the medical criteria: Physician-certified diagnosis of a Life Limiting Illness Disability determination by the Social Security Administration Meet the financial criteria: Income is less than 300% the Supplemental Security Income allowance per month Countable resources less than $2,000
Counseling/Bereavement Services Expressive therapy Palliative/Supportive care Respite Care Services
Children 18 and younger do not pay co-pays.
The Children’s Extensive Support Waiver (CES) provides supports and services to children with developmental disabilities or delays who have a complex behavioral or medical condition and who require near constant line of sight supervision.
Co-pay Costs: There are no copays for Waiver Services.
This waiver provides services for children and youth who have an intellectual or developmental disability and extraordinary needs that put them at risk of, or in need of, out of home placement.
In order to apply for this waiver you must:
Co-pay costs vary, learn more in the program information page
The Children’s Home and Community-Based Services Waiver (CHCBS) provides a home or community based alternative to children with significant medical needs who are at risk for acute hospital or skilled nursing facility placement.
The Family Support Services Program (FSSP) provides support for families who have children with developmental disabilities or delays with costs that are beyond those normally experienced by other families.
The program is for families who have eligible children living at home or who are interested in having their child return from an out-of-home placement.
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.
Every Health First Colorado member has a primary care provider. Members and primary care providers belong to a regional organization that helps make sure Health First Colorado members get the health care and services they need. Regional organizations can also help members understand and manage physical and behavioral health benefits, find specialists or other providers, and connect members with transportation, food assistance or other social services, if needed.
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-pay. 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 Children with Disabilities allows families who make too much to qualify for Health First Colorado (Colorado's Medicaid Program) and Child Health Plan Plus (CHP+) to “buy into” Health First Colorado coverage for their child with a disability by paying a monthly premium based on the family’s income.
If your child is enrolled in the Children’s Buy-In program, they will receive full Health First Colorado benefits. Benefits include:
Colorado Choice Transitions (CCT) is a program to help transition Health First Colorado (Colorado's Medicaid Program) members 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 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-pays are based on your ability to pay. This is determined by the CICP facility.
The Community Mental Health Supports Waiver (CMHS) provides a home or community-based alternative to nursing facility care for people with major mental illness.
Health First Colorado (Colorado's Medicaid Program) members who reside in a nursing facility do not pay co-pays.
The Waiver for Persons with Developmental Disabilities provides people with developmental disabilities services and supports that allow them to continue living in the community.
There are no copays for Waiver Services.
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, as well as individuals living with HIV/AIDS.
In order to be enrolled in EBD you must:
Full Benefit Medicare/Medicaid Enrollees, also sometimes called “Duals” or “Dual Eligibles” are people who have both Medicare and regular Health First Colorado (Colorado's Medicaid Program) coverage. If you are a Full Benefit Medicare/Medicaid Enrollee, you’re automatically a part of the State’s Demonstration to integrate and coordinate your physical, behavioral, and social health care needs.
If you are a Full Benefit Medicare/Medicaid Enrollee, you receive Medicare benefits plus full Health First Colorado benefits (except for prescriptions; Health First Colorado can only cover some prescriptions for you once you are eligible for Medicare Part D). Health First Colorado will pay its share after Medicare pays theirs. Go to Medicare’s website for more information on what benefits they offer.Health First Colorado benefits include:
The Health First Colorado Buy-In Program for Working Adults with Disabilities allows adults who earn too much income to qualify for Health First Colorado (Colorado's Medicaid Program) to “buy into” Health First Colorado coverage by paying a monthly premium based on their income.
Adults who are 16 through at least 65 years of age, employed, and have a qualifying disability Disability determination is based on:
If you are enrolled in the Working Adults Buy-In program, you will receive full Health First Colorado benefits. Benefits include:
Also, if you meet the criteria for the Elderly, Blind and Disabled Waiver or the Community Mental Health Supports Waiver, you can receive Home and Community-Based Services through this program.
The Health Insurance Buy-In Program (HIBI) is a premium assistance program for Health First Colorado (Colorado's Medicaid Program) members 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-pays 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 program information page for the list of co-pays per service.
Participant-directed services are home and community-based services that help people of all ages, across all types of disabilities, maintain their independence and determine for themselves what mix of personal assistance supports and services work best for them. Participant direction empowers each program participant to expand his or her degree of choice and control over decisions made about his or her long-term services and supports in a highly personalized manner.
Our Programs:
How do I know which program is right for me?
How can I participate with other stakeholders on policy issues related to Participant Directed Programs?
Medicare Savings Program - Qualified Medicare Beneficiary (QMB): pays for your Part A and B premiums, and your Medicare deductibles, coinsurance, and co-pays
In order to be enrolled in QMB you must meet monthly income and resource limits
Health First Colorado will pay for your Medicare co-pays. 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. Learn more in the program information page.
Medicare Savings Program - Qualifying Individual (QI-1) pays for your Part B premium
In order to be enrolled in QI-1 you must meet these requirements:
Health First Colorado will pay for your Medicare co-pays. You are still responsible for small Health First Colorado co-pays, unless you are living in a nursing facility. Health First Colorado co-pay costs vary. Learn more in the program information page.
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 - Specified Low-Income Medicare Beneficiary (SLMB) pays for your Part B premiums
In order to be enrolled in SLMB you must meet monthly income and resource limits
Health First Colorado will pay for your Medicare Part B premiums only. You are still responsible for any deductibles, co-insurance and co-pays
The Waiver for Persons with Spinal Cord Injury (SCI) provides a home or community based alternative for people with a spinal cord injury.
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:
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.
