Old Age Pension Rate Information

The following provider payment rates are effective for dates of service on or after July 1, 2014, and will remain in effect until further notice:

• Inpatient Hospital services reimbursed at 10% of the Health First Colorado rate.
• Outpatient services (including services received in outpatient hospital settings, federal qualified health centers, rural health centers and dialysis centers) reimbursed at 100% of the Health First Colorado rate.
• Practitioner services reimbursed at 100% of the Health First Colorado rate.
• Emergency Transportation services reimbursed at 100% of the Health First Colorado rate.
• Home Health services (including Hospice services) and supplies reimbursed at 100% of the Health First Colorado rate.
• Dental services reimbursed at 100% of the Health First Colorado rate.
• Emergency Dental services reimbursed at 100% of the Health First Colorado rate.
• Laboratory and X-ray services reimbursed at 100% of the Health First Colorado rate.
• Medical supply services reimbursed at 100% of the Health First Colorado rate.
• Pharmacy services reimbursed at 100% of the Health First Colorado rate.

Eligibility Information

Members will have a Medical Identification Card. Please continue to verify member eligibility through the Web Portal. Members covered by the Old Age Pension (OAP) Health and Medical Care Program are identified by the following message:

This member is enrolled in the Old Age Pension Health and Medical Care Program. Not Health First Colorado eligible. Benefits may be limited and payments may be reduced.

As a reminder, the current rules for the OAP Health and Medical Care Program include:

• Maximum annual member co-pay of $300.00.
• Co-pay amounts for services are the same as the co-pay amounts under Health First Colorado.
• There are no retroactive benefits (member can only be eligible from date of application).
• If claim overpayments are made in error, recoveries will be made retroactively.