How to Apply for Medicaid If You Live in Colorado
Key takeaways:
Colorado’s Medicaid program is called Health First Colorado. It provides free or low-cost health insurance to people with low income.
You can apply for Health First Colorado online, on the phone, or in person.
If you make too much money to qualify for Medicaid and you have children, you may still qualify for the Children’s Health Insurance Program and other benefits.
Colorado provides coverage for a variety of health care services through Medicaid and the Children’s Health Insurance Program (CHIP).
The state’s Medicaid program, Health First Colorado, helps individuals and families with low income gain access to healthcare at low or no cost. You can also apply for Colorado CHIP, which is designed for people who have children and need low-cost health insurance but don’t qualify for Medicaid. There are more than 1.6 million people enrolled in these programs.
If you live in Colorado and your income is low, you may be eligible for health insurance benefits. You can apply online, in person, and over the phone.
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How Does Medicaid Work in Colorado?
Medicaid is a program run by the federal government and the states. It provides free or low-cost health insurance to people whose income is below a certain level. Colorado’s Medicaid program, Health First Colorado, is administered through Colorado’s Department of Health Care Policy and Financing.
Health First Colorado provides medical, dental, and behavioral health benefits.
Medicaid in Colorado covers:
Dental services
Emergency medical services and transportation
Family planning
Healthcare provider visits
Lab services
Maternity and newborn care
Pharmacy and durable medical equipment
Physical, occupational, and speech therapy
Preventive and wellness services
How much does Medicaid in Colorado cost?
Medicaid services are typically free or low-cost. There are no deductibles for services covered by Health First Colorado.
You may have to pay your healthcare provider a predetermined dollar amount (a copay) for some services. This amount can be as much as $10, depending on the service. Once you have paid the monthly copay maximum, you won't be required to pay any additional copays for that month.
How do I apply for Medicaid in Colorado?
You can apply for Medicaid in Colorado in three easy steps.
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Step 1: Determine how you want to apply
You can submit an application online, in person, or on the phone.
The quickest way to apply is to create an online account with Colorado PEAK. The online application system has a chat bot you can use to ask questions through the process.
If you don’t have access to a computer, you can apply over the phone by calling the Health First Colorado Member Contact Center at 800-221-3943 during regular business hours.
If you want to apply in person, visit the Department of Health Care Policy and Financing website to get a list of sites where you can apply.
Step 2: Gather important documents and information.
Some of the documents you may need include:
Proof of identity and citizenship, such as a driver’s license, passport, or visa
Social security numbers for all applicants, if available
Pay stubs or benefit check stubs for household members
Health insurance policies or cards for household members, if available
Proof of pregnancy, if applicable, in the form of a letter from your healthcare provider
Step 3: Complete the online application or a paper application.
It usually takes 30 to 60 minutes to complete the application. Once your online or paper application is complete, the local office will process and review it. You may need to speak with an application reviewer in person or on the phone if additional information is needed.
Once you get a case number (which will start with “1B”), you can check on the status of your application online — even if you completed an application in person or over the phone or sent it in by mail. It can take up to 45 days to receive a case number. If you need to get a disability determination, however, it can take as long as 90 days.
Who is eligible for Medicaid in Colorado?
Generally, your eligibility for Medicaid and CHIP is based on your household size and how your income compares to the federal poverty level (FPL). Colorado has an easy-to-use FPL calculator that will help you determine where you fall on the income scale.
In addition to meeting the annual income requirements, you must also meet citizenship requirements and not have other ways to get affordable health insurance.
If you don’t qualify for Health First Colorado, you can look into the following coverage options and discounts:
Connect for Health Colorado Marketplace: You may be eligible for financial assistance for health insurance through Colorado’s health insurance marketplace.
Colorado Indigent Care Program (CICP): This program provides discounted healthcare services to individuals and families who meet certain income requirements.
Prescription Drug Discount Resources: This resource offers information on ways to get prescription drugs for free or at a reduced price.
Are you eligible for CHIP in Colorado?
Colorado’s Children’s Health Insurance Program (CHIP) is called Child Health Plan Plus (CHP+). It provides affordable health insurance to children and pregnant women. It is designed for people who make too much money to be eligible for Medicaid but not enough to pay for private insurance.
To qualify, you must be a resident of Colorado and not have other insurance. Children age 18 and under and pregnant women age 19 and over qualify if their household income is below a certain level.
There are no copays for checkups, prenatal care, or preventive care visits under CHP+, but you may have a copay up to $50 for other services, depending on your income and family size. Some individuals may also have to pay a one-time enrollment fee, which can range from $25 to $105 and is based on income and household size.
Are you eligible for WIC benefits?
If you qualify for Medicaid, you likely meet the income eligibility requirements to qualify for WIC. WIC is a supplemental nutrition program that provides food for women, infants, and children. The WIC application is not part of your Medicaid application and must be completed separately.
Find a local WIC office to get help applying for these benefits.
Emergency Medicaid
Emergency Medicaid, also called Emergency Medical Services, provides short-term health insurance coverage for certain individuals facing life-threatening medical emergencies, such as severe COVID-19 symptoms and heart attack. If you don’t meet citizenship or immigration requirements but meet the other eligibility requirements for Health First Colorado, you may qualify for Emergency Medicaid. There are no copays associated with this coverage.
You can apply for EMS when you go in for treatment or within three months of receiving care. EMS also covers expenses related to giving birth for qualified people.
You can apply online at CO.gov/PEAK or through county human services departments. You can also apply over the phone by calling (800) 221-3943.
Do I need to renew Colorado Medicaid?
Yes. A renewal packet will be sent to you in the mail annually. Log into your ColoradoPEAK account to update your information and submit it.
Who do I contact if I have questions?
You can contact your local Department of Human Services for more help.
Call Health First Colorado Enrollment at 888-367-6557 during normal business hours to find a location near you.
If you need medical information or assistance, you can call Health First Colorado’s free nurse advice line at 800-283-3221.
The bottom line
Applying for Medicaid in Colorado can be done online, on the telephone, or in person. Because eligibility is income-based, be ready to answer questions about your income, assets, and debts. You also need to have information about anyone who lives in your household.
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References
Ammula, M., et al. (2022). As 2022 legislative sessions end, most states are adopting new option to extend Medicaid postpartum coverage. Kaiser Family Foundation.
Colorado Department of Health Care Policy & Financing. (n.d.). Application assistance mapping tool.
Colorado Department of Health Care Policy & Financing. (n.d.). Application for health insurance & help paying costs.
Colorado Department of Health Care Policy & Financing. (n.d.). Child health plan plus (CHP+).
Colorado Department of Health Care Policy & Financing. (n.d.). Contact your county human services department.
Colorado Department of Health Care Policy & Financing. (n.d.). Colorado Indigent Care Program (CICP).
Colorado Department of Health Care Policy & Financing. (n.d.). Colorado WIC families — referral form.
Colorado Department of Health Care Policy & Financing. (n.d.). Disability determination services.
Colorado Department of Health Care Policy & Financing. (n.d.). Federal poverty level calculator.
Colorado Department of Health Care Policy & Financing. (n.d.). Getting health care coverage through Health First Colorado and Child Health Plan Plus.
Colorado Department of Health Care Policy & Financing. (n.d.). Home.
Colorado Department of Health Care Policy & Financing. (n.d.). Prescription drug discount resources.
Colorado PEAK. (n.d.). Apply for benefits overview.
Colorado PEAK. (n.d.). Create an account.
ColoradoWIC.gov. (n.d.). Find a WIC clinic.
Connect for Health Colorado. (n.d.). Home.
HealthCare.gov. (n.d.). Federal poverty level (FPL).
Health First Colorado. (n.d.). Benefits & services.
Health First Colorado. (n.d.). Emergency Medicaid.
Health First Colorado. (n.d.). Get help.
Health First Colorado. (n.d.). Health First Colorado co-pays.
Health First Colorado. (2016). What is my case number and where do I find it?
Kaiser Family Foundation. (2022). Medicaid in Colorado.
Medicaid.gov. (n.d.). Medicaid & CHIP in Colorado.
