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.
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.
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
- 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
- Home health care
- Durable Medical Equipment and supplies
- Home and Community-Based Services
- Mental health and substance abuse services
- 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.
HCPF contact: 303-866-2993
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