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What is Medicaid?
Medicaid comprises a group of programs that provide health insurance to Colorado residents who meet the income and resource criteria for eligibility. Medicaid provides coverage for among others, physician services, prescription drugs (not covered by Medicare Part D), inpatient/outpatient hospitalization, durable medical equipment, laboratory and x-ray serves, medical supplies, medical transportation, podiatry, hospice, immunization and home health care.
How is Medicaid different than Medicare?
Medicaid goes to persons of all ages who meet low income and other guidelines. It provides a broader range of services than Medicare.
Medicare covers most people over age 65, regardless of income. The primary benefits are doctors' office visits and hospitalization. Home health and nursing home coverage are extremely limited.
Who Qualifies for Medicaid?
Recipients of Supplemental Security Income (SSI), and Temporary Assistance to Needy Families (TANF), automatically receive Medicaid. Individuals who receive Old Age Pension (OAP) also receive Medicaid if they receive SSI. OAP recipients who do not receive SSI are eligible for the Old Age Pension Health and Medical Fund. Individuals can also receive Medicaid when they or a loved one needs intensive in-home or nursing home care.
For 2013 the established income per month and total resource criteria are:
|Program||Single Income/Resource Limits**||Married Income/Resource Limits**|
|Supplemental Security Income (SSI)||$730 / $2000||$1086 / $3000|
|Old Age Pension (OAP)||$757 / $2000||$1514 / $3000|
|Qualified Medicare Benefit (QMB)||$931 / $8,580||$1261 / $13,620|
|Special Low Income Medicare Benefit (SLIM-B)||$1117 / $8,580||$1513 / $13,620|
|Medicare Qualifying Individual 1 (QI-1)||$1256 / $8,580||$1702 / $13,620|
|Home and Community Based Services (HCBS)||$2130* / $2000||NA / $115,920 for spouse only|
|Nursing Home||$2130* / $2000||NA / $115,920 for spouse only|
|Program for All-Inclusive Care for the Elderly (PACE)||$2130* / $2000||$1048* / $115,920 for spouse only|
* Individuals can apply for a Medicaid Qualifying Trust if income is more than this amount.
** Exempt resources include the following:
- The home (first $525,000 of assessed value)
- Term life insurance policy
- Irrevocable burial policy (any value)
- One automobile
- Any property that is owned in joint tenancy (although transfer with fair consideration rules may apply depending on when title was taken in joint tenancy)
Applying for Medicaid
Individuals who are not currently receiving Medicaid may apply. They will need to meet the financial qualifications to be eligible for Medicaid. To apply, complete the financial application and submit to the county department of human services . To determine if an individual is functionally eligible to receive HCBS including consumer directed attendant support services (CDASS), nursing home care, or PACE, the Single Entry Point case manager will conduct an interview using the ULTC 100.2 and other associated forms .
You will need to attach the following documents to the Medicaid application:
- Proof of age (such as birth certificate or baptismal certificate
- Proof of US Citicenship (such as birth certificate, citizenship records or Social Security card
- Proof of Colorado Residency (such as self-written statement testifying that you are a resident of Colorado or photo ID with you address or a copy of your telephone bill
- Proof of income and spouse's income (if appropriate) including two payroll stubs (if appropriate; verification of Social Security, pensions, or Supplemental Security Income; proof of other income such as interst
- Proof of Resources including bank statements, registration papers for motor vehicles, deeds and mortgages for real property including the house, life insurance policies, and burial funds or policies
For Medicaid applications, assistance in filing applications or counseling on Medicaid benefits, call 303-333-3482.
Click here for Medicaid rules.