Colorado Medicaid - A Guide to Health First Colorado

Applying for Health First Colorado

Knowing how to apply for Health First Colorado is the first step to getting the coverage you need. You can register in one of four ways:

1. Apply in person by downloading the Health First Colorado coverage application. You can access this 20-page document in English or Spanish. Fill out the application, submit it to a nearby county human services department, and await your approval by mail or phone.
2. If you don’t want to submit your application in person, mail it to the department. This option is practical if you don’t have reliable transportation. However, be cautious when writing the address to ensure that the postal service does not lose your information.
3. You can call 1-800-221-3943 to apply to Health First Colorado with a representative. They will give you clear instructions on how to proceed with your application.
4. Online forms provide the fastest way to submit your information. Visit the Colorado PEAK website to start your application. It will walk you through the process step-by-step, so you don’t miss any details.

You must have Colorado Medicaid-accepted documentation nearby when filling out your application. Driver’s licenses, passports, marriage certificates, pay stubs, and SSN cards are all valid forms of identification.

Eligibility Requirements

As an adult, you can qualify for Health First Colorado coverage if:

You may also qualify for these programs if you fall within the maximum Colorado Medicaid income limit. For example, you cannot earn over $22k to qualify if you have two people in your household.

However, Colorado may still allow you to apply if your regular medical expenses cause you to fall below the monthly income limit.

Getting a Health First Colorado Card

You have four ways to access your insurance card:

1. After enrollment, you can visit Colorado.gov/PEAK to print out a copy of your insurance card directly from your account.
2. You can download the Health First Colorado app on your smart device to access a digital copy of your information. You can also use this resource to update your contact information, input pay stubs, and pay your premiums.
3. You can contact the County Department of Human Services and ask them to send a physical copy via snail mail.
4. You can order a copy from the Member Contact Center portal. Cards will typically arrive within 14 days of your request.

Renewing or Replacing Your Health First Colorado Card

The State of Colorado will audit your household once a year to ensure that you still meet the coverage requirements. This process will require you to fill out renewal documents they mail to your house. The State will typically provide these forms two months before your renewal date.

Your benefits will still be active during this assessment period.

If you need to replace a lost or damaged insurance card, contact the Health First Colorado service line and speak to a representative. They may ask you to confirm your information or fill out a short form before sending you a new copy.

Colorado Medicaid Coverage

Here is a list of what Health First Colorado covers when you become a member:

Dental

You won’t need to worry about co-pays at the dentist with Colorado Medicaid. You can access a $1,500 benefit for teeth cleanings and restorations. This benefit cap does not apply to emergency procedures or artificial teeth treatment. For those who have more serious dental issues and anticipate requiring more visits to the dentists, investing in private dental plans in Colorado is advisable.

Prescription Drugs

You should expect to pay about $3 for every prescription or refill you need under the Colorado Medicaid plan. You are not subject to these co-pays if you are pregnant or under 18.

The Colorado Department of Health Care Policy & Financing website lets you explore the preferred drug list for covered medication.

Extended Health Care

You receive extra benefits and services if you are below the age of 20. Additionally, you may qualify for extended health care benefits if you manage a long-term or escalating disability.

Travel and Out-of-State Coverage

1. You experience a medical emergency and need to seek help immediately.
2. Your condition could escalate or compromise your long-term health if you travel back to Colorado for help.
3. Your out-of-state healthcare provider enrolls in the Colorado Medicaid program.

You can view which doctors are in the network by exploring the Health First Colorado find a doctor tool. If you are traveling outside of Colorado for leisure, invest in proper travelers insurance.

Students and Seniors

You can keep your health insurance benefits if you receive grant money, scholarships, or other forms of academic assistance as a student.

After you turn 65, you can designate Colorado Medicaid as your primary healthcare insurance. Coverages will typically include routine doctor visits and emergencies. You may also qualify for home care, and community assisted living, but these options are not available for all seniors.

Suppose you do not work enough under Social Security to receive hospital insurance (Medicaid A). In that case, you may still qualify for a cost-savings program.

Coverage for Subgroups

In an effort to provide inclusive access to care, Health First Colorado offers specific subgroups additional benefits. Here is what you can expect:

Indigenous Americans and Native Alaskans

You do not need to pay an enrollment fee or office visit co-pay if you are an Indigenous American or a Native Alaskan. Speak to a Department of Health Care Policy & Financing representative if you have more questions about coverage for indigenous individuals.

Military

You may qualify for both Veterans Affairs health care insurance and Health First Colorado if you are a current or former member of the United States Armed Forces. Neither insurance plan will cancel out the other. It’s important to note that Health First Colorado may not provide enough coverage in an instance where someone becomes temporarily or permanently disabled. Investing in quality disability insurance is an excellent way to assist with some of the costs incurred with not being able to work, and to help with the cost of medical needs.