Snapshots are informational only. You must apply to find out what programs or waivers you qualify for.
If you are not looking to find coverage for adults, please choose another category.
Behavioral Health
Health First Colorado (Colorado's Medicaid program) members are eligible for behavioral health services, including mental health and substance use disorder care. If you need mental health care and/or substance use disorder services, talk to your primary care provider or contact your regional organization.
Who Qualifies?
All Health First Colorado members can get behavioral health services.
Top Benefits:
- Mental health services
- Substance abuse services
Co-pay Costs:
There are no co-pays for Health First Colorado behavioral health services through a regional organization. However, if you have other insurance, you must use that insurance first before using Health First Colorado benefits.
Breast and Cervical Cancer Program (BCCP)
The Breast and Cervical Cancer Program (BCCP) is for uninsured or underinsured women who have been diagnosed with breast or cervical cancer. BCCP also covers breast and cervical conditions that may lead to cancer if not treated.
Who Qualifies?
In order to apply for this program you must:
- be diagnosed with breast or cervical cancer or conditions that may lead to cancer if left untreated
- be between the ages of 40 and 64
- have an income less than 250% of the Federal Poverty Level
- not have health insurance that covers breast or cervical cancer treatments
- not be currently enrolled in Health First Colorado and are not eligible for Medicare
- be a U.S. citizen or a qualified non-citizen
Top Benefits:(see program information page for full list)
- access to all Health First Colorado covered services
- breast reconstruction after breast cancer surgery
Co-pay Costs:
None. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Colorado Dental Health Care Program for Low-Income Seniors
The Colorado Dental Health Care Program for Low-Income Seniors (Senior Dental Program) provides discounted dental health care services to individuals 60 years of age or older whose income is insufficient to meet the costs of such care.
Who Qualifies?
- You must be 60 or older
- You must be at or below 250% of the Federal Poverty Level (FPL)
- You must be lawfully present in Colorado
- You cannot be eligible for dental services under Health First Colorado or the Old Age Pension Health and Medical Care Program
- You cannot have private dental insurance
Benefits:(see program information page for full list)
- Discounted dental health care services provided by participating Qualified Grantees and Providers
- Services include, but are not limited to: oral examinations, x-rays, partial and full dentures, repair of permanent teeth, removal of permanent teeth, root canals, crowns, and much more
Co-pay Costs:
There is a co-pay max and it is a set fee by procedure.
Colorado Indigent Care Program (CICP)
The Colorado Indigent Care Program (CICP) provides discounted health care services to low income people and families. CICP is not a health insurance program. Services vary by providers.
Who Qualifies?
- You must be 18 and older
- You must be at or below 250% of the Federal Poverty Level (FPL)
- You must be lawfully present in the United States and a legal resident of Colorado
- You cannot be eligible for Health First Colorado (Colorado's Medicaid program) or Child Health Plan Plus (CHP+)
Top Benefits: (see program information page for full list)
- Discounted health care services provided by participating Colorado hospitals and clinics
- No premium costs
- You are allowed to have primary health insurance or have Medicare
- CICP ratings are good for a full year, see program information page for exceptions
Co-pay Costs:
Co-pays are based on your ability to pay. This is determined by the CICP facility.
Dental Benefits
The dental benefit provides eligible Health First Colorado (Colorado's Medicaid program) members.
Who Qualifies?
Dental services are a program benefit for Health First Colorado members of all ages.
Top 5 Benefits: (see program information page for full list)
- Basic preventive dental exams
- Diagnostic and restorative dental services (such as x-rays and fillings)
- Extractions (tooth pulling)
- Root canals
- Crowns
- Much more (see program information page for additional benefits)
Co-pay Costs:
None. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services.
All Health First Colorado (Colorado's Medicaid program) coverable, medically necessary services must be provided even if the service is not available under the state plan to other people who qualify for Health First Colorado. Benefits not listed are not considered to be a state plan benefit and are therefore outside of EPSDT coverage and exceptions. No arbitrary limitations on services are allowed, e.g., one pair of eyeglasses or 10 physical therapy visits per year.
Who Qualifies?
Children and Youth ages 20 and younger who are enrolled in Health First Colorado.
Top Benefits: (see program information page for full list)
- Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
- Arrange (through referral) for corrective treatment as determined by child health screenings
- Lead Screening
Co-pay Costs:
Children under the age of 19 do not have co-pays. Co-pay costs for youth ages 19 and 20 vary, see program information page.
| EPSDT Program Information Page |
Elderly, Blind, and Disabled Waiver (EBD)
Waiver For Persons Who Are Elderly, Blind, or Disabled (EBD) is a program to provide an alternative to nursing facility care for elderly, blind, or physically disabled persons.
Who Qualifies?
In order to be enrolled in EBD you must:
- either be 65 years of age and older with a functional impairment,
- or be between the ages of 18 and 64 and be blind or physically disabled (including having a diagnosis of HIV or AIDS)
- be currently residing in, or be at risk of being institutionalized in a nursing facility or hospital
- have an income less than 300% (3 times) the Supplemental Security Income allowance per month
- have countable resources less than $2000 for a single person or $3000 for a couple.
Top 5 Benefits:(see program information page for full list)
- Adult day services
- Community Transition Services
- Consumer Directed Attendant Support Services (CDASS)
- Home Modification
- Supplies, equipment, and medication management
Co-pay Costs:
Co-pay costs vary, learn more in the program information page
| EBD Waiver Program Information Page |
Emergency Medicaid Services (EMS)
The Emergency Medical Services (EMS) benefit covers family planning and emergency services for people who qualify for Health First Colorado, but do not meet immigration or citizenship requirements. EMS is a limited benefit that does not cover all medical services. It is also known as “Emergency Medicaid” or “Emergency Services Only.”
Who Qualifies?
In order to be eligible for EMS you must:
- Meet the Health First Colorado (Colorado’s Medicaid program) eligibility requirements, except for immigration or citizenship requirements.
- Learn which immigration and citizenship statuses qualify for EMS.
Top Benefits:
Emergency Services
- Life-threatening health emergencies (such as chest pain, heart attack, appendicitis, etc.)
- Labor and delivery (does not include prenatal or postpartum care)
- Dialysis for End-Stage Renal Disease at a freestanding dialysis center
Learn more about Emergency Services.
Family Planning Services
- A 12-month supply of birth control
- Long-acting reversible contraception (LARC)
- Sterilization services
- Basic fertility services
- Birth control counseling
Family planning services don’t have to be emergencies.
Learn more about Family Planning Services.
Co-pay Costs:
There are no co-pays.
| EMS Program Information Page - English | EMS Program Information Page - Spanish |
Family Planning Limited (FAMPL) Benefit
The Family Planning Limited (FAMPL) benefit covers family planning and family planning-related services for people who qualify for Health First Colorado, but do not meet income requirements. FAMPL is a limited benefit that does not cover all medical services.
Who Qualifies?
In order to be eligible for FAMPL you must:
- Meet the Health First Colorado (Colorado’s Medicaid program) eligibility requirements, but have a household income between 133%-260% Federal Poverty Level (FPL).
Top Benefits:
Family Planning Services
- A 12-month supply of birth control
- Long-acting reversible contraception (LARC)
- Sterilization services
- Basic fertility services
- Birth control counseling
Learn more about Family Planning Services.
Family Planning-Related Services
- STI/STD screening and treatment
- Cervical cancer screening
- Related preventative services such as tobacco cessation and depression screenings
Co-pay Costs:
There are no co-pays.
| FAMPL Program Information Page - English | FAMPL Program Information Page - Spanish |
Health First Colorado (Colorado's Medicaid program)
Health First Colorado (Colorado's Medicaid program) is a public health assistance program for Coloradans who qualify. Children, pregnant women, parents and caretakers, people with developmental, intellectual, and physical disabilities, and adults can all potentially qualify.
Every Health First Colorado member has a primary care provider. Members and primary care providers belong to a regional organization that helps make sure Health First Colorado members get the health care and services they need. Regional organizations can also help members understand and manage physical and behavioral health benefits, find specialists or other providers, and connect members with transportation, food assistance or other social services, if needed.
Note: When you apply for Health First Colorado, you are applying for both Health First Colorado and Child Health Plan Plus (CHP+). You do not need to turn in more than one application for you or your family.
Who Qualifies?
You may be eligible if you meet one of these requirements:
- Children ages 0-18 whose household income does not exceed 142% Federal Poverty Level (FPL)
- Pregnant women whose household income does not exceed 195% FPL
- Parents and caretaker relatives (applicant must have a dependent child) whose household income does not exceed 68% FPL
- Adults without dependent children whose household income does not exceed 133% FPL
Eligibility requirements can be complex. See the program information page for more information or visit PEAK to see if you qualify.
Top 5 Benefits: (see program information page for full list)
- Doctor visits
- Prescriptions
- Mental health and substance use disorder services
- Dental
- Lab work and x-rays
- Much more (see program information page for additional benefits)
Co-pay Costs:
You might have to pay a small co-pay. If you are age 18 and younger, pregnant or are an American Indian or Alaska Native, you don't pay co-pays. If you are 19 and older and not pregnant, you are responsible for small co-pays. If you reside in a nursing facility you typically do not have to pay co-pays. Co-pays vary depending on the service. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Health First Colorado Buy-In for Working Adults with Disabilities (WAwD)
The Health First Colorado Buy-In Program for Working Adults with Disabilities lets adults with a disability who qualify to "buy-into" Health First Colorado (Colorado's Medicaid program). If you work and earn too much to qualify for Health First Colorado you may qualify. If you qualify, you pay a monthly premium. Your monthly premium is based on your income.
Who Qualifies?
- You must be between 16 or older,
- You must be employed,
- You must have a qualifying disability either through Social Security or the State Disability Determination vendor, even if you are 65 or older. The Social Security Administration (SSA) listings describes what disabilities qualify, and
- Your family income must be below 450% of the Federal Poverty Level (FPL).
If the Social Security Administration has not yet stated you are disabled, fill out the release form on the How To Apply page. We will see if you qualify using the Social Security Administration (SSA) listings.
Health Insurance Buy-In Program (HIBI)
The Health Insurance Buy-In Program (HIBI) is a premium assistance program for Health First Colorado (Colorado's Medicaid program) member who qualify. If you qualify, HIBI will send monthly payments to you for all or a portion of the cost of your commercial health insurance premiums, and in some cases also reimburses you for deductibles, coinsurance, and co-pays.
Who Qualifies?
- Being eligible for HIBI does not affect your Health First Colorado eligibility.
- You must be eligible for Health First Colorado and have access to commercial health insurance
- The annual cost of your commercial health insurance must be less than the estimated total cost of your annual medical expenses, out-of-pocket costs, and administrative costs
- Your employer must allow you to enroll in their group insurance within 60 days of when you are found eligible for HIBI, even if this occurs outside of the group insurance's usual open enrollment period
- You may choose to enroll in a health insurance policy after applying to the HIBI program
Top 5 Benefits: (see program information page for full list)
- HIBI participants receive monthly payments for a portion of the cost of their commercial health insurance premiums.
- Program participants receive benefits from both the HIBI program and Health First Colorado at the same time.
- Program participants may also receive reimbursements for payments made toward deductibles, coinsurance and co-pays, whether visiting a Health First Colorado enrolled provider or a provider within the network.
- In some cases, COBRA continuation health insurance is offered to recently terminated employees for up to 18 months. For more information, contact your benefits coordinator.
Co-pay Costs:
Health First Colorado co-pays vary depending on the service. If you are age 18 and younger, pregnant, or living in a nursing facility, you don't have to pay co-pays. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Medicare Savings Programs
Medicare Savings Programs (MSP) help people with limited income and resources pay for some or all of their Medicare premiums and may also pay their Medicare deductibles and coinsurance. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles and co-insurance. Medicare Savings Programs are a group of programs Colorado residents can apply for if they have Medicare. Medicare Buy-In is one of the benefits of the Medicare Savings Programs.
Medicare Savings Program - Qualified Disabled and Working Individual (QDWI)
Medicare Savings Program -Qualified Disabled and Working Individual (QDWI) pays for your Part A premium.
Who Qualifies?
In order to be enrolled in QDWI you must:
- be a working disabled person under age 65
- not receive medical assistance from your state
- meet monthly income and resource limits
Top Benefits:(see program information page for full list)
- Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part A premiums only
- You are responsible for any remaining amounts left over after Medicare pays their portion
- You may also be able to get extra help paying for your Medicare prescription drug coverage (Part D)
Medicare Savings Program - Qualified Medicare Beneficiary (QMB)
Medicare Savings Program - Qualified Medicare Beneficiary (QMB): pays for your Part A and B premiums, and your Medicare deductibles and co-insurance.
Who Qualifies?
In order to be enrolled in QMB you must meet monthly income and resource limits.
Top Benefits:(see program information page for full list)
- Health First Colorado (Colorado's Medicaid program) benefits for QMB include any service Medicare covers, except prescriptions.
- Health First Colorado will pay its share after Medicare pays theirs
Co-pay Costs:
Health First Colorado will pay for your Medicare deductibles and co-insurance. You are still responsible for small Health First Colorado co-pays, unless you are living in a nursing facility. Health First Colorado co-pay costs vary depending on the service. Learn more in the Health First Colorado Benefits and Services Overview.
Medicare Savings Program - Qualifying Individual (QI-1)
Medicare Savings Program - Qualifying Individual (QI-1) pays for your Part B premium only
Who Qualifies?
In order to be enrolled in QI-1 you must meet these requirements:
- You must meet monthly income and resource limits
- QI is granted on a first-come, first-served basis, with priority given to people who got QI-1 the previous year
Top Benefits:(see program information page for full list)
- Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part B premiums only
- You are responsible for any remaining amounts left over after Medicare pays their portion
- You may also be able to get extra help paying for your Medicare prescription drug coverage (Part D)
Medicare Savings Program - Specified Low-Income Medicare Beneficiary (SLMB)
Medicare Savings Program - Specified Low-Income Medicare Beneficiary (SLMB)pays for your Part B premiums only
Who Qualifies?
In order to be enrolled in SLMB you must meet monthly income and resource limits
Top Benefits:(see program information page for full list)
- Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part B premiums only
Old Age Pension Health and Medical Care Program (OAP)
The Old Age Pension (OAP) Health and Medical Care Program provides limited medical care for Coloradans getting Old Age Pension. If you (or your family or caretaker) get Old Age Pension and make too much to qualify for Health First Colorado (Colorado's Medicaid program), you may qualify.
The OAP Health and Medical Care Program is also known as the Modified Medical Plan, State Medical Program, Limited Medicaid and OAP State Only Program.
Who Qualifies?
- You must get Old Age Pension,
- You do not qualify for Health First Colorado (Colorado's Medicaid program), and
- You are not a patient in an institution for tuberculosis or mental disease.
If you do not qualify for the OAP Health and Medical Care Program you may have other coverage options.
Pediatric Personal Care Services
Pediatric Personal Care services help Health First Colorado (Colorado's Medicaid program) members with physical, maintenance and supportive needs such as bathing, dressing, meal preparation and medication reminders.
Who Qualifies?
- You must be 20 years or age and younger
- Meet the requirements in the Department defined assessment tool (PCAT)
- Require moderate to total assistance in at least three of the18 Personal Care Tasks
Top Benefits: (see program information page for full list)
- Assistance with Pediatric Personal Care Services
Co-pay Costs:
There are no co-pays.
Program For All-Inclusive Care For The Elderly (PACE)
The Program of All-Inclusive Care for the Elderly (PACE)PACE is a Medicare/Health First Colorado (Colorado's Medicaid program) managed care program that provides health care and support services to individuals 55 years of age and older. The goal of PACE is to assist frail individuals to live in their communities as independently as possible by providing comprehensive services based upon their needs.
Who Qualifies?
In order to be enrolled in PACE you must:
- be 55 years of age or older
- meet nursing-facility level of care requirements (determined by a single entry point agency)
- live in the area of the PACE organization (Adams, Arapahoe, Broomfield, Denver, Jefferson, Pueblo, El Paso, Delta, or Montrose county)
- be able to live in a community setting without jeopardizing your health or safety
Top 5 Benefits:(see program information page for full list)
- Dentistry services
- Optometry services
- Transportation to and from the day center and to medical appointments
- Respite care and caregiver education
- Durable medical equipment and supplies
Co-pay Costs:
Co-pays vary depending on the service. See the Health First Colorado Benefits and Services Overview for the list of co-pays per service.
Supported Living Services Waiver (SLS)
The Supported Living Services Waiver (SLS) is a program to provide supported living in the home or community to persons with developmental disabilities.
Who Qualifies?
In order to be enrolled in SLS you must:
- Be 18 years of age and older
- Be able to live independently with limited supports or, if you need extensive supports, are already receiving that high level of support from other sources, such as your family
- Be currently residing in, or be at risk of being institutionalized in an Intermediate care facility
- Have income less than 300% (3 times) the Supplemental Security Income allowance per month
- Have countable resources less than $2,000 for a single person or $3,000 for a couple.
Benefits and Services (see program information page for full list)
- Assistive Technology
- Behavioral Health Services
- Day Habilitation Services
- Personal Care Services
- Respite Services
- Supported Employment
What Does It Cost?
Co-pay costs vary, learn more in the program information page.
Transition Services
Transition Services were created as a result of success of the Colorado Choice Transitions (CCT) demonstration program. Transition Services help transition Health First Colorado members out of nursing homes and long-term care facilities and into home and community-based settings. Transition Services offer services designed to promote independence.
Eligibility Requirements:
In order to be receive Transition Services you must:
- You must be a Health First Colorado (Colorado's Medicaid Program) member
- You must be 18 years of age or older
- You must qualify for an HCBS waiver
- You must reside in a qualified institution, which is:
- a nursing home, or
- an intermediate care facility for people with intellectual disabilities
- You may also receive expanded HCBS services if you reside in the community and have a qualifying life event
Top Benefits: (see program information page for full list)
- Transition Coordination
Co-pay Costs:
Co-pay costs vary, learn more in the program information page
| Transition Services Program Information Page |
Waiting Lists and Enrollment
When funding limits the availability of services, waiting lists are established for individuals seeking services. Learn about the Department's efforts to ensure that all eligible individuals receive the services they need at the time they're needed, within the constraints of the state's limited financial resources.