Colorado Medicaid Program

Colorado Medicaid offers health insurance coverage through state and federal funding for children, pregnant women, families, individuals, and those who are aged, blind, or disabled. During the course of health reform‘s implementation, Colorado gradually expanded its Medicaid program, adding three new programs since the beginning of 2012, including Medicaid Buy-in programs for persons with disabilities, as well as adults without dependent children. Now many more Coloradans in need of coverage can obtain it through Medicaid.

Colorado Medicaid Eligibility

Many groups of low-income and needy individuals and families qualify for Colorado Medicaid. In compliance with the Affordable Care Act, the program expanded to include low-income adults without children who earn up to 133% FPL. Other groups have higher income limits, including pregnant women and children, who are the top priority of the Medicaid program. In order to qualify for any category, you must be a U.S. citizen or legal immigrant, and also live in Colorado and intend to stay there. Below are the income thresholds for each eligible group according to the percentage of federal poverty, which changes each year. Note: pregnant women are considered two people when applying for Medicaid, so you would at least be a family of two if you live alone.

 

Income Guidelines

 

Pregnant Women 133% FPL

 

Children Ages 0-19  133% FPL

 

Parents (employed or unemployed) 133% FPL

 

Childless Adults 133% FPL

 

Single Aged, Blind, or Disabled 75% FPL

*$2,000 Asset Limit

Couple Aged, Blind, or Disabled 83% FPL

*$3,000 Asset Limit

 

Qualified Medicare Beneficiaries (QMB) 100% FPL

Medicaid covers your premiums, coinsurance, and deductibles.

 

Specified Low-Income Medicare Beneficiaries (SLMB) 120% FPL

Medicaid covers your premiums only.

 

Covered Benefits

Colorado Medicaid covers a broad range of services, from physician care to hospitalization. Your coverage will vary based on the program in which you are enrolled, but the main components are all very similar. Those who have special health needs, disabilities, or medical conditions will be able to obtain much needed services through Medicaid, as it covers everything deemed medically necessary. Below is a synopsis of services available through Medicaid.

  • Physician services
  • Prescription medications
  • Immunizations
  • Early and Periodic Screening, Diagnosis & Treatment (EPSDT) for children
  • Diagnostic services (lab tests, X-ray)
  • Hospital stays
  • Outpatient hospital care
  • Emergency care
  • Nurse practitioner services
  • Prenatal and maternity services
  • Nurse midwife services
  • Family planning
  • Vision care (exams and eyeglasses)
  • Physical, occupational, and speech therapy
  • Telemedicine
  • Podiatry
  • Home health care
  • Durable Medical Equipment and supplies
  • Home and Community-Based Services
  • Hospice
  • Mental health and substance abuse services
  • Psychotherapy
  • Medical transportation

 

How to Apply

If you feel you may be eligible for Medicaid, please apply as soon as possible to get yourself covered. There are different applications based on eligibility groups, which you can print, complete and send in to your local county health department. You can also apply in person at any County Department of Human/Social Services or MA Site. If you need help filling out your application for families and/or children’s Medicaid, you can locate an Application Assistance Site near you. Or, you can apply online using Colorado PEAK, which provides the most simple and instant application method.

Apply Online for Medicaid

Print an Application

 

 

Resources

Colorado PEAK: Apply for Benefits

Colorado Department of Health Care Policy & Financing (HCPF)

HCPF contact: 303-866-2993

Department of Human Services County Directory

 

 

References:

 

1. HCPF. “HCPF: Medicaid Eligibility.” http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1197969485591.

2. HCPF. “HCPF: Benefits.” http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1251567068368

3. HCPF. “HCPF: Applications.” http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1251567068887