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Programs for Individuals Needing Behavioral Health Services

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 behavioral health services, please choose another category.

Do you have physical or intellectual/developmental disabilities?Are you an American Indian or Alaska Native?Are you a veteran?

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:

Co-pay costs vary depending on the service. View the co-pay amounts per service in the Health First Colorado Benefits & Services Overview.

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.

Eligibility Requirements:

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 or Child Health Plan Plus (CHP+)

Top Benefits: (see Fact Sheet 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-payment Costs:

Co-payments are based on your ability to pay. This is determined by the CICP facility.

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 133% 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 services
  • Dental
  • Lab work and x-rays
  • Much more (see program information page for additional benefits)

Co-payment Costs:

You might have to pay a small co-payment. 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 & Services Overview for the list of co-pays per service.

Health Insurance Buy-In Program (HIBI)

The Health Insurance Buy-In Program (HIBI) is a premium assistance program for Health First Colorado members 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.

Eligibility Requirements:

  • 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 Fact Sheet 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-payment Costs:

Health First Colorado co-payments 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 program information page for the list of co-pays per service.

Home and Community-Based Services Children's Extensive Support Waiver (HCBS-CES)

The Children's Extensive Support Waiver (CES) provides supports and services to children with developmental disabilities or delays who have a complex behavioral or medical condition and who require near constant line of sight supervision.

Eligibility Requirements:

  • Children 18 years of age and younger with intensive behavioral or medical needs who are at risk of out-of-home placement and have been determined to have a developmental delay/disability through a Community Centered Board
  • Child must be institutionalized or at risk of being institutionalized in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
  • Children's income must be less than 300% (3 times) the Supplemental Security Income allowance per month and countable resources less than $2000

Top Benefits: (see program information page for full list)

  • Adaptive Therapeutic Recreational Equipment and Fees
  • Home Accessibility Adaptations
  • Personal Care Services
  • Specialized Medical Equipment and Supplies
  • Vehicle Adaptations

Co-payment Costs: Children ages 18 and younger do not pay co-pays.

Home and Community-Based Services For Persons With Brain Injury Waiver (HCBS-BI)

The BI waiver is a program to provide a home or community based alternative to hospital or specialized nursing facility care, for persons with a brain injury.

Eligibility Requirements:

  • must be 16 years of age and older (brain injury must have occurred prior to age 65)
  • must have a brain injury as defined in the Colorado Code of Regulations with specific diagnostic codes
  • 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
  • Behavioral Management
  • Home Modifications
  • Respite Care
  • Supportive Living Services

Co-pay Costs:

Co-pay costs vary, learn more in the program information page

Prenatal Plus

The Prenatal Plus program is a special program for at-risk pregnant women. If you are enrolled in the Prenatal Plus program, you will be provided with case management, nutrition counseling, and psycho-social services. The services are meant to lower risk for negative maternal and infant health outcomes due to lifestyle, behavioral, and other non-medical parts of a woman's life that could affect her pregnancy

Eligibility Requirements:

In order to be enrolled in Prenatal Plus you must be:

  • eligible for Health First Colorado
  • pregnant
  • at-risk (as determined by a Prenatal Plus provider)

Top 5 Benefits:(see Fact Sheet for full list)

  • Case Management services
  • Help from a registered dietitian
  • Help from a mental health professional
  • Service coordination
  • Job and education assistance

Co-pay Costs:

There are no costs, pregnant woman are not charged Health First Colorado co-pays

Special Connections

Special Connections is a program for pregnant women on Health First Colorado who have alcohol and/or drug abuse problems. Special Connections helps women have healthier pregnancies and healthier babies by providing case management, counseling, and health education during pregnancy and up to one year after delivery. Special Connections services are in addition to any prenatal care you receive from her doctor or nurse-midwife.

Eligibility Requirements:

Women who are:

  • Eligible for Health First Colorado
  • Pregnant or within one year after delivery
  • You must be eligible for Special Connections before giving birth to be eligible for Special Connections services after your baby is born, and
  • At risk of having an unhealthy pregnancy and unhealthy baby because of alcohol and/or drug abuse problems
  • Risk screening is done by a Special Connections provider to see if you qualify

Top 5 Benefits:(see Fact Sheet for full list)

Services can be outpatient or residential depending on your level of risk. Services include:

  • Individual substance abuse counseling
  • Group substance abuse counseling with other pregnant women
  • Group health education with other pregnant women
  • Urine screening and monitoring
  • Referral to appropriate aftercare and ongoing support

Co-pay Costs:

There are no costs, pregnant woman are not charged Health First Colorado co-pays

Special Connections 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