Colorado Medicaid Eligibility and Enrollment
- Colorado Medicaid provides crucial healthcare for qualified residents. Find out how Colorado Medicaid works and whether you might be eligible in this article.
Medicaid is a federally funded and state managed program designed to provide healthcare services for low-income individuals who have limited resources to pay for it. Health First in Colorado is the state’s Medicaid program and public health insurance for residents who qualify. The program is administered by the Department of Health Care Policy and Financing.
Colorado provides medically necessary healthcare for an estimated 1.73 million state residents with disabilities, individuals who are 65 years and older, children and their caretakers, and pregnant women who meet the program’s financial requirements. Most of the applicants who qualify for Medicaid in Colorado are:
- Children ages 0-18 with a household income under 260% of the federal poverty level
- Pregnant women over the age of 19 whose household income is under 260% of the federal poverty level
- Parents and Caretaker Relatives with a dependent child whose income does not exceed 133% of the federal poverty level
- Adults without dependent children whose household income does not exceed 133% of the federal poverty level
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What Benefits Does Colorado Medicaid Cover?
The federal government is responsible for establishing guidelines for access, coverage and care for all state Medicaid programs.
Health First Colorado coverage includes emergency visits, doctor appointments, preventative care — including screenings and immunizations — and other routine treatments.
Other services include:
- Behavioral health
- Dental services
- Family planning services
- Maternity care
- Newborn care
- Outpatient care
Many Medicaid participants in Colorado receive healthcare for free or for a nominal co-payment fee, which is often set to the beneficiaries’ ability to pay. Participants with exceptionally low or no income often have no payment due at time of service.
Who Is Eligible for Medicaid in Colorado?
Colorado residents can access Medicaid as long as they meet the guidelines for eligibility. There are a few financial criteria that individuals must meet to be eligible for Medicaid benefits in Colorado. The maximum an applicant can earn is $19,392 for an individual household, $26,228 for a two-person household and $39,900 for a four-person household.
Program eligibility depends on your family size and Medicaid category for which you apply for. Income limits and asset restrictions are established annually by the federal Department of Health and Human Services and vary for different family sizes and needs. Colorado’s Health First Medicaid program will determine the income limit for you and your family when you apply.
How Much Does Colorado Medicaid Cost?
Applicants receive healthcare for free or reduced costs in Colorado. Residents with significantly low or no income typically do not pay for medical service.
Applicant fees and charges will depend on the healthcare service you receive and whether your fall into one of these categories:
- If you are age 18 and younger, pregnant or an American Indian or Alaska Native, you are will not pay any co-pays
- If you are a foster care youth, you will only pay co-pays for prescription drugs
- If you live in a nursing facility, you typically are not charged a co-pay for service
How Do I Enroll in Medicaid in Colorado?
There are several ways to apply for Medicaid in Colorado. Applications for traditional Medicaid are available online at the Colorado PEAK website, through the mail or by calling a local office at (800) 221-3943. In-person assistance is available at Colorado Medicaid offices, which can set an appointment for faster and safer service.
PEAK is an online portal for Colorado residents to screen and apply for medical, food and early childhood assistance programs. The website allows users to explore benefits and find out if you qualify for services.
Contact Information for Colorado Medicaid
The public can reach the Health First Colorado office by calling (800) 221-3943 (state relay: 711). Telephone inquiries about specific Medicaid services, billing process, application categories, non-citizen status and emergency matters can be made daily Monday through Friday between 8:00a.m. and 4:30p.m., except on state holidays, and every Friday between 2:00p.m. and 3:30p.m.
You can also chat online with an agent by signing into your PEAK account and selecting “Live chat about health benefits” under Online Assistance in the top menu. The live chat option is available Monday through Friday from 12:30p.m. to 4:30p.m.
Applications and general correspondence may be sent to the state Medicaid office at:
1570 Grant Street
Denver, CO 80203