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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 pregnant women, 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 Colorado Medicaid 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 Colorado Medicaid.
Co-pay costs vary, learn more in the program information page
A Behavioral Health Organization provides Colorado Medicaid 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 Medicaid 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 regular Colorado Medicaid, 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.
Co-payment costs vary. Learn more in the program information page.
Child Health Plan Plus (CHP+) is a public health insurance program for low-income children ages 18 and younger and pregnant women who earn too much to qualify for Medicaid, but cannot afford private health insurance. Note: Medicaid and Child Health Plan Plus (CHP+) are both public health insurance programs for Coloradans who qualify. When you apply for Medicaid, you are applying for both Medicaid and CHP+. You do not need to turn in more than one application for you or your family.
Co-payments and enrollment fees vary. Learn more in the program information page.
Child Health Plan Plus (CHP+)State Managed Care covers CHP+ members before they are enrolled in a CHP+ health plan. It also covers CHP+ members in counties where CHP+ health plans do not offer coverage.
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.
You must be 18 and older You must be at or below 250% of the Federal Poverty Level (FPL) You must be lawfully present in the United States and a legal resident of Colorado You cannot be eligible for Medicaid or CHP+
Discounted health care services provided by participating Colorado hospitals and clinics No premium costs You are allowed to have primary health insurance or have Medicare CICP ratings are good for a full year; see program information page for exceptions
Co-payments are based on your ability to pay. This is determined by the CICP facility.
Colorado Medicaid 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: Medicaid and Child Health Plan Plus (CHP+) are both public health insurance programs for Coloradans who qualify. When you apply for Medicaid, you are applying for both Medicaid and 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 Medicaid 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 Colorado Medicaid Benefits & Services Overview for the list of co-pays per service.
The dental benefit provides Medicaid members up to $1,000 in dental services per year.
Dental services are a program benefit for Colorado Medicaid members of all ages.
None. See the Colorado Medicaid 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 Medicaid coverable, medically necessary services must be provided even if the service is not available under the state plan to other people who qualify for Medicaid. 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 Medicaid.
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.
The Health Insurance Buy-In Program (HIBI) is a premium assistance program for Medicaid clients 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.
HIBI participants receive monthly payments for a portion of the cost of their commercial health insurance premiums. Program participants receive benefits from both the HIBI program and Medicaid at the same time. Program participants may also receive reimbursements for payments made toward deductibles, coinsurance and co-pays, whether visiting a Medicaid enrolled provider or a provider within the network. In some cases, COBRA continuation health insurance is offered to recently terminated employees for up to 18 months. For more information, contact your benefits coordinator.
Medicaid 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 program information page for the list of co-pays per service.
Healthy Communities is a program that works to make sure your kids are getting all the care they need, including preventive services. Family Health Coordinators will help you find providers for your kids, keep track of immunization schedules, and find other resources in your community.
If you are age 18 and younger, pregnant, or living in a nursing facility, you don’t pay co-pays. If you are 19 and older, and not pregnant or residing in a nursing facility, you are responsible for small Medicaid co-pays. Co-pays vary depending on the service. See the program information page 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 these requirements:
Colorado Medicaid will pay for your Medicare deductibles and co-insurance. You are still responsible for small Colorado Medicaid co-payments, unless you are living in a nursing facility. Medicaid co-pay costs vary depending on the service. Learn more in the Colorado Medicaid 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 these requirements:
Pediatric Personal Care services help Medicaid members with physical, maintenance and supportive needs such as bathing, dressing, meal preparation and medication reminders.
There are no costs, pregnant woman & children are not charged Medicaid co-pays.
The Prenatal Plus program is a special program for at-risk pregnant women. If you are enrolled in the Prenatal Plus program, you will be provided with case management, nutrition counseling, and psycho-social services. The services are meant to lower risk for negative maternal & infant health outcomes due to lifestyle, behavioral, and other non-medical parts of a woman's life that could affect her pregnancy
In order to be enrolled in Prenatal Plus you must be:
There are no costs, pregnant woman are not charged Medicaid co-pays
Presumptive Eligibility (PE) is a program that gives temporary medical coverage right away. The coverage starts the same day you apply and lasts for at least 45 days while we process your Medical Assistance application.
There are no costs, pregnant woman & children are not charged Medicaid co-pays
Special Connections is a program for pregnant women on Medicaid who have alcohol and/or drug abuse problems. Special Connections helps women have healthier pregnancies and healthier babies by providing case management, counseling, and health education during pregnancy and up to one year after delivery. Special Connections services are in addition to any prenatal care you receive from her doctor or nurse-midwife.
Women who are:
If you pregnant and receive Medicaid, you don’t pay co-pays.
