How to Get Medical Assistance in Colorado

How to Get Medical Assistance in Colorado provides information and links to help low-income adults, children, pregnant women, seniors, and people with disabilities get the health care they need.

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Introduction

In Colorado, there are many ways to get medical assistance. You can go to a community health center, a hospital, or a doctor’s office. You can also get medical assistance through the state’s Medicaid program. If you have private insurance, you can use that to get medical assistance as well.

Community health centers provide primary care, dental care, and mental health services. They also have staff who can help you apply for Medicaid or other programs that can help you pay for your care. To find a community health center near you, visit the Colorado Community Health Alliance website.

If you need to go to the hospital, there are many in Colorado that accept Medicaid. To find a hospital near you that accepts Medicaid, visit the Medicaid website.

If you have private insurance, you can use that to get medical assistance at any doctor’s office or hospital that accepts your insurance plan. To find a doctor or hospital near you that accepts your insurance plan, visit your insurance company’s website or call the customer service number on your insurance card.

What is medical assistance?

Medical assistance in Colorado is a state and federally funded program that provides health insurance to low-income adults, families with children, pregnant women, seniors, and people with disabilities.

The program is also known as Medicaid. In Colorado, it is called Peak Health Solutions. If you qualify, you will be enrolled in one of four managed care plans. These plans provide coverage for doctor visits, hospital stays, mental health care, prescriptions, and much more.

You can apply for medical assistance through the Colorado Department of Health Care Policy and Financing. You can also get help from your local Department of Human Services office or one of the many community organizations that assist with the application process.

If you are a low-income adult without children, you may be eligible for Medicaid if you meet the following criteria:
-You are a U.S. citizen or legal permanent resident
-You are a Colorado resident
-Your household income is at or below 138% of the federal poverty level ($16,643 for an individual or $22,412 for a family of two in 2018)
-You do not have access to private health insurance

Who is eligible for medical assistance?

Anyone who is a resident of Colorado and is a U.S. citizen or legal immigrant, with limited income and resources, may be eligible for medical assistance. You may also be eligible if you are under the age of 19, pregnant, have a disability, or are blind.

If you have Medicare, you may still be eligible for medical assistance. If you are over the age of 65 and do not have Medicare, you may still be eligible for medical assistance.

How to apply for medical assistance?

You can apply in several ways:
-Online through PEAK
-In person at a county office or Customer Service Center
-By phone by calling the Customer Contact Center
To start an online application, visit https://colorado.gov/pacific/hcpf/peaks. From the main menu, choose “Apply for Health First Colorado or Child Health Plan Plus.”

What are the income requirements for medical assistance?

In order to be eligible for medical assistance, an individual’s income must be at or below 133% of the federal poverty level. This level is set annually and is adjusted for inflation. For 2019, the income limit for a single person is $16,754. For a family of four, the income limit is $34,638.

What assets are considered when determining medical assistance eligibility?

In order to be eligible for medical assistance in Colorado, you must have assets that are considered “countable” by the state. These countable assets can include money in the bank, property, vehicles, and more. The exact assets that are considered countable will vary depending on your individual circumstances.

How is medical assistance funded?

Medical assistance in Colorado is funded by both the state and federal government. The federal government provides funding through the Medicaid program, while the state of Colorado provides funding through the Children’s health insurance Program (CHIP).

What services does medical assistance cover?

In general, medical assistance in Colorado covers a wide range of medical and health services. These services are designed to help low-income and vulnerable residents get the care they need to stay healthy and avoid serious medical complications.

Some of the specific services that medical assistance can cover include doctor’s visits, prescription medication, mental health services, hospitalizations, and more. In some cases, medical assistance can also help cover the cost of long-term care for those who need it.

If you are unsure whether or not your particular situation would qualify for medical assistance, you can always contact your local county human services office or the Colorado Department of Health Care Policy and Financing for more information.

What are the co-pays and premiums for medical assistance?

There are four types of Medicaid in Colorado: Child Health Plan Plus (CHP+), Colorado’s Medicaid Program, Elderly, Blind, or Disabled Federal Poverty Level (EB-FPL), and Refugee Medical Assistance (RMA).

The following table shows the co-pays and premiums for each type of Medicaid.

Service Co-Pay
Emergency Services $3 per visit
Physician Services* $2 per visit
Inpatient Hospital Services* $5 per day, not to exceed $50 per stay
Outpatient Surgery* 20% of the bill, not to exceed $200
durable medical equipment $2 per item
*After meeting the yearly deductible

Annual Premiums for Adults
name of program Entire Family’s Income must be below this amount Single Person’s Income must be below this amount

Child Health Plan Plus (CHP+) 208% FPL 133% FPL
Colorado’s Medicaid Program 208% FPL 133% FPL
Elderly, Blind, or Disabled Federal Poverty Level (EB-FPL) 100% FPL NA
Refugee Medical Assistance (RMA) Must be a refugee Must be a refugee

Medicaid is a program that helps low-income people pay for medical care. In order to qualify for Medicaid in Colorado, you must meet certain income requirements. The table below shows the income requirements for each type of Medicaid.

How can I get more information about medical assistance?

There are many ways to get more information about medical assistance. You can visit the Colorado Department of Health Care Policy and Financing website or the Medicaid website. You can also contact your local health department or social service agency. If you have questions about your specific situation, you can contact the Medicaid hotline at 1-800-633-4227.