What is Health First Colorado (Medicaid)?
Health First Colorado, formerly known as 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. States are able to modify and tailor their Medicaid programs for their individuals states, so Medicaid in Colorado is known as Health First Colorado.
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 Health First Colorado (Medicaid)?
Recipients of Supplemental Security Income (SSI), and Temporary Assistance to Needy Families (TANF), automatically receive Health First Colorado. Childless adults between 19 and 64 can receive Health First Colorado if they have income of less than 133% of the Federal Poverty Level. After age 65, most individuals will be eligible for Medicare as their primary insurance. Individuals who have not worked enough under Social Security to receive Medicare Part A can apply for the Medicare Savings Program, and have the state pay the monthly premiums for both Medicare Parts A and B. Health First Colorado also has long-term care programs that have more permissive income and resource limitations for individuals of all ages who meet the functional requirements.
For 2017 the established income per month and total resource criteria are:
|Program||Single Income/Resource Limits***||Married Income/Resource Limits***|
|Childless Adults (age 19-64)||$1,317 / No resource limit||$1,776 / No resource limit|
|Supplemental Security Income (SSI)||$735 / $2,000||$1,470 / $3,000|
|Old Age Pension (OAP)||$771 / $2,000||$1,542 / $3,000|
|Qualified Medicare Benefit (QMB)||$1,010 / $9,060||$1,355 / $14,340|
|Special Low Income Medicare Benefit (SLIM-B)||$1,208 / $9,060||$1,62 / $14,340|
|Medicare Qualifying Individual 1 (QI-1)||$1,357 / $9,060||$1,823 / $14,340|
|Home and Community Based Services (HCBS)||$2,199* / $2000||$3,000** if both spouses apply / $120,900 if one spouse stays in the community|
|Nursing Home||$2,199* / $2000||$3,000** if both spouses apply / $120,900 if one spouse stays in the community|
|Program for All-Inclusive Care for the Elderly (PACE)||$2,199* / $2000||$3,000** if both spouses apply / $120,900 if one spouse stays in the community|
* Individuals can apply for a Medicaid Qualifying Trust if income is more than this amount.
** Couples applying together and living in the same room in the long-term care facility can have resources of up to $4,000.
*** Exempt resources include the following:
- The home (first $560,000 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 Health First Colorado
Individuals who are not currently receiving Medicaid may apply at any time. 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 U.S. citizenship (such as birth certificate or citizenship records);
- Proof of Colorado residency (such as self-written statement testifying that you are a resident of Colorado or photo ID with your 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 interest);
- 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 Health First Colorado applications, assistance in filing applications or counseling on Medicaid benefits, call 303-333-3482.
For more information on specific Medicaid programs, please select one of the pages below.