Colorado Medicaid, also known as Health First Colorado, is a public health insurance program for individuals who meet specific eligibility criteria. Medicaid is funded by both the federal and Colorado state governments, and the Department of Health Care Policy & Financing manages it.

Every member of Health First Colorado is assigned a primary care provider. This organization helps connect you with the healthcare services you need. Your primary care provider is your first contact for health and wellness services. You and your primary care provider are members of a regional organization that ensures you receive the necessary healthcare and services.

Health First Colorado offers a comprehensive range of medical benefits and services. Here's a summary of the covered services:

Health Care Provider Visits

• Primary Care and Specialist Visits: Includes primary care and specialist (e.g., urologist, cardiologist) visits with a limit of one visit per issue per day.
• Home Health: Acute care home health services for up to 60 days without prior authorization.
• Telemedicine: Access to remote medical services.
• Vision Care: Includes necessary eye exams, glasses, and contact lenses post-surgery.

Dental Services

Comprehensive dental care, including cleanings, fillings, root canals, crowns, and dentures with no annual benefit limit.

Hospitalization, Emergency, and Other Services

Includes emergency room visits, ambulance services, non-emergent transportation, urgent care, outpatient and inpatient services, organ transplants, anesthesia, breast reconstruction, hospice care (up to 9 months), private duty nursing (up to 23 hours/day), radiation therapy, and chemotherapy with no limits on these services.

Maternity and Newborn Care

Covers prenatal and postpartum care, delivery, newborn child coverage for the first year, breast pumps, and specialty programs like Nurse Home Visitor and Prenatal Plus.

Mental Health, Substance Use Disorder, and Behavioral Health Services

Includes assessments, counseling, therapy, drug screening, medication-assisted treatment, inpatient and outpatient services, emergency/crisis services, and school-based services with no limits.

Pharmacy and Durable Medical Equipment

Prescription drugs as listed on the Pharmacy Benefits Page and durable medical equipment like wheelchairs and oxygen.

Physical, Occupational, or Speech Therapy

Covers acute and long-term home health therapies and outpatient and inpatient therapies with some daily limits for adults.

Laboratory Services

Lab and radiology tests such as X-rays and blood work with no limits.

Preventive and Wellness Services

Includes screenings, immunizations, audiology services, allergy testing, routine foot care, and cancer screenings with certain annual limits.

Family Planning Services

Offers office visits, counseling, surgical sterilization, contraceptives, long-acting reversible contraceptives (LARCs), emergency contraceptives, and fertility assessments with specific limits for certain services.

These benefits provide extensive coverage to ensure health care for Health First Colorado members.

Your income must fall within certain guidelines to be eligible for Health First Colorado, the state's Medicaid program. Here's a summary of the approximate monthly income limits based on family size:

Family Size and Income Limits:

Family of 1

• Adults 19-65: Up to $1,616
• Children 0-18: Up to $1,725
• Pregnant Women: Up to $2,369

Family of 2

• Adults 19-65: Up to $2,186
• Children 0-18: Up to $2,334
• Pregnant Women: Up to $3,205

Family of 3

• Adults 19-65: Up to $2,755
• Children 0-18: Up to $2,942
• Pregnant Women: Up to $4,040

Family of 4

• Adults 19-65: Up to $3,325
• Children 0-18: Up to $3,550
• Pregnant Women: Up to $4,875

Other Considerations

• Qualifying even with a higher income than the limits mentioned is possible.
• The best way to determine eligibility is to apply, as other factors may be considered.

Applying for Health First Colorado, the state's Medicaid program, can be done through various methods.

Apply online

Apply online at http://co.gov/peak. This is the fastest way to apply with most applicants finding out immediately if they qualify.

Apply by phone

Call 1-800-221-3943 / State Relay: 711. Phone applications are available Monday through Friday, from 8 a.m. to 4 p.m.

Apply by mail

Download and print a paper application from here.

Apply in person

Apply at your local county office in your county of residence (find your county office) or at a local application assistance site (find assistance sites).

Required information and documents

1. Social Security numbers for applicants who have them
2. Immigration document numbers for non-citizens
3. Name, address, contact information, and applicant birth date
4. Employer and income information (e.g., pay stubs, W2 forms)
5. Other income information like SSA or SSI payments
6. Health insurance information for household members, including Medicare
7. Additional information may be requested for verification purposes

The renewal process for Health First Colorado (Colorado's Medicaid program) or Child Health Plan Plus (CHP+) is designed to confirm continued eligibility.

Some members are automatically renewed based on existing information. If auto-renewed, you'll receive a letter confirming renewal and possibly another requesting income verification, which must be responded to for continued coverage.

If not auto-renewed, you must complete the renewal process. A renewal packet is sent 60-70 days before the deadline, either by mail or online at CO.gov/PEAK. Notifications are sent via mail, email, text, or the Health First Colorado app. The renewal packet must be completed, signed, and submitted by the deadline in person, by mail, or online.

Missing the deadline results in coverage loss at the end of the renewal period. A 90-day reconsideration period allows for late submission of renewal paperwork. Failure to renew within this period requires a new application.

Help is available through county eligibility workers, application assistance sites, or by contacting Health First Colorado directly.