Programs for Individuals with Physical or Developmental Disabilities

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 individuals with physical or developmental disabilities, please choose another category.

Programs For Children with Disabilities

Brain Injury Waiver (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.

Who Qualifies?

  • 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 $2,000 for a single person or $3,000 for a couple.

Benefits and Services(see program information page for full list)

  • Adult day services
  • Behavioral Management
  • Home Modifications
  • Respite Care
  • Supportive Living Services

What Does It Cost?

Co-pay costs vary. Learn more in the program information page

Children With Life Limiting Illness Waiver (CLLI)

The Waiver for Children with Life Limiting Illness provides a home or community-based alternative to children with a life limiting illness.

Eligibility Requirements:

Children who are:

Ages 18 and younger
Receiving hospital level of care
Determined by case manager to be safely served in the community
Receiving at least one CLLI waiver benefit per month while enrolled in the waiver
Meet the medical criteria:
Physician-certified diagnosis of a Life Limiting Illness
Disability determination by the Social Security Administration
Meet the financial criteria:
Income is less than 300% the Supplemental Security Income allowance per month
Countable resources less than $2,000

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

Counseling/Bereavement Services
Expressive therapy
Palliative/Supportive care
Respite Care Services

Co-pay Costs:

Children 18 and younger do not pay co-pays.

Children's Extensive Support Waiver (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)

  • Respite Care
  • Behavioral Services
  • Homemaker
  • Specialized Medical Equipment and Supplies
  • Assistive Technology

Co-pay Costs: There are no copays for Waiver Services.

Children's Habilitation Residential Program Waiver (CHRP)

This waiver provides services for children and youth who have an intellectual or developmental disability and extraordinary needs that put them at risk of, or in need of, out of home placement.

Who Qualifies?

In order to apply for this waiver you must:

  • be 20 years of age or younger
  • have an intellectual or developmental disability or developmental delay if under five (5) years of age, and extraordinary service needs
  • be at risk of, or in need of, out of home placement
  • be institutionalized or at be at risk for being institutionalized in an Intermediate Care Facility for individual with intellectual Disabilities (ICF-IID)

Top 5 Benefits:(see program information page)

  • Habilitative Services (24-hour residential out of home)
  • Respite Services
  • Community Connection Services
  • Intensive and Transition Support Services (wraparound)
  • Professional services (such as hippotherapy, massage, and movement therapy)

Co-pay Costs:

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

Children's Home and Community-Based Services Waiver (CHCBS)

The Children's Home and Community-Based Services Waiver(CHCBS)provides a home or community based alternative to children with significant medical needs who are at risk for acute hospital or skilled nursing facility placement.

Who Qualifies?

  • Medically fragile children ages 17 and younger who are in the home and at risk of nursing facility or hospital placement
  • Child must be institutionalized or at risk of being institutionalized in a nursing facility or hospital level of care
  • Children's income must be less than 300% (3 times) the Supplemental Security Income allowance per month and countable resources less than $2,000

Benefits and Services(see program information page for full list)

  • Case management
  • In-Home Support Services (IHSS) [Health Maintenance only]

What Does It Cost?

Children ages 18 and younger do not pay co-pays.
 

Family Support Services Program (FSSP)

The Family Support Services Program (FSSP) provides support for families who have children with developmental disabilities or delays with costs that are beyond those normally experienced by other families.

Eligibility Requirements:

The program is for families who have eligible children living at home or who are interested in having their child return from an out-of-home placement.

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

  • Medical and Dental Expenses
  • Additional Insurance Expenses
  • Respite Care and Sitter Services
  • Special Equipment, Clothing and Diets

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 aregional 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-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 Program for Children with Disabilities

The Health First Colorado Buy-In Program for Children with Disabilities allows families who make too much to qualify for Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+) to buy into Health First Colorado coverage for their child with a disability by paying a monthly premium based on the family's income.

Who Qualifies?

  • Children age 19 and under, with a qualifying disability per the Social Security Administration (SSA)
  • A determination of disability by the SSA is accepted as proof of disability
  • Children not certified through the SSA can still be determined disabled by the State by completing the Health First Colorado Disability application
  • Family income must be below 300% of Federal Poverty Level (FPL), after income disregards are calculated

Benefits and Services (see program information page for full list)

If your child is enrolled in the Children's Buy-In program, they will receive full Health First Colorado benefits. Benefits include:

  • Doctor visits
  • Prescriptions
  • Mental Health services
  • Dental
  • Lab work and x-rays
  • Much more (see program information page for additional benefits)

What Does It Cost?

Children ages 18 and younger do not pay co-pays.

Programs For Adults with Disabilities

Brain Injury Waiver (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.

Who Qualifies?

  • 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 $2,000 for a single person or $3,000 for a couple.

Benefits and Services(see program information page for full list)

  • Adult day services
  • Behavioral Management
  • Home Modifications
  • Respite Care
  • Supportive Living Services

What Does It Cost?

Co-pay costs vary. Learn more in the program information page

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+)

Benefits and Services (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

What Does It Cost?

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

Community Mental Health Supports Waiver (CMHS)

The Community Mental Health Supports Waiver (CMHS) provides a home or community-based alternative to nursing facility care for people with major mental illness.

Eligibility Requirements:

  • Must be age 18 or older
  • Must have a diagnosis of major mental illness from a medical or psychiatric professional
  • Must be institutionalized or at risk of being institutionalized in a nursing facility

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

  • Adult day services
  • Consumer Directed Attendant Support Services (CDASS)
  • Personal Emergency Response System
  • Non-medical transportation
  • Homemaker services

Co-pay Costs:

Health First Colorado (Colorado's Medicaid program) members who reside in a nursing facility do not pay co-pays.

Developmental Disabilities Waiver (DD)

The Waiver for Persons with Developmental Disabilities provides people with developmental disabilities services and supports that allow them to continue living in the community.

Who Qualifies? To qualify for the DD waiver, you or the person applying must:

  • Be 18 or older
  • Need extensive supports to live safely, including access to 24-hour supervision, and do not have other resources to meet those needs
  • Meet the medical criteria:
  • Residing in or at risk of residing in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
  • Determined to have a developmental disability
  • Meet the financial Criteria:
  • Income must be 300% the Supplemental Security Income allowance per month
  • 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)

  • Group and Individual Residential Services and Supports
  • Day Habilitation services
  • Supported Employment
  • Behavioral Services
  • Specialized medical equipment and supplies
  • Non-Medical Transportation

What Does It Cost?

There are no copays for Waiver Services.

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, as well as individuals living with HIV/AIDS.

Eligibility Requirements:

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

Family Support Services Program (FSSP)

The Family Support Services Program (FSSP) provides support for families who have children with developmental disabilities or delays with costs that are beyond those normally experienced by other families.

Eligibility Requirements:

The program is for families who have eligible children living at home or who are interested in having their child return from an out-of-home placement.

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

  • Medical and Dental Expenses
  • Additional Insurance Expenses
  • Respite Care and Sitter Services
  • Special Equipment, Clothing and Diets

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-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 Program for Working Adults with Disabilities

The Health First Colorado Buy-In Program for Working Adults with Disabilities allows adults who earn too much income to qualify for Health First Colorado (Colorado's Medicaid program) to buy into Health First Colorado coverage by paying a monthly premium based on their income.

Who Qualifies?

Adults who are 16 through at least 65 years of age, employed, and have a qualifying disability
Disability determination is based on:

  • If you are a current Social Security Disability beneficiary, or
  • If you have been determined disabled by the State after completing the Health First Colorado Disability application
  • Disability determination excludes individual Substantial Gainful Activity (SGA)
  • Income must be below 450% of Federal Poverty Level (FPL)
  • Some deductions to your income are applied
  • About half of earned income is disregarded
  • There is no resource limit

Benefits and Services (see program information page for full list)

If you are enrolled in the Working Adults Buy-In program, you will receive full Health First Colorado benefits. Benefits include:

  • Doctor visits
  • Prescriptions
  • Mental Health services
  • Lab work and x-rays
  • Much more (see program information page for additional benefits)

Also, if you meet the criteria for the Elderly, Blind and Disabled Waiver or the Community Mental Health Supports Waiver, you can receive Home and Community-Based Services through this program.

What Does It Cost?

Co-pay costs vary. Learn more in the program information page.
 

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) 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.

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

Benefits and Services (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.

What Does It Cost?

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 program information page for the list of co-pays per service.

Participant Directed Programs

Participant-directed services are home and community-based services that help people of all ages, across all types of disabilities, maintain their independence and determine for themselves what mix of personal assistance supports and services work best for them. Participant direction empowers each program participant to expand his or her degree of choice and control over decisions made about his or her long-term services and supports in a highly personalized manner.

Our Programs:

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, coinsurance, and co-pays

Who Qualifies?

In order to be enrolled in QMB you must meet monthly income and resource limits

Benefits and Services (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

What Does It Cost?

Health First Colorado will pay for your Medicare co-pays. You are still responsible for small Health First Colorado co-payments, unless you are living in a nursing facility. Health First Colorado co-pay costs vary. Learn more in the program information page.

Medicare Savings Program - Qualifying Individual (QI-1)

Medicare Savings Program - Qualifying Individual (QI-1) pays for your Part B premium

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 the previous year

Benefits and Services (see program information page for full list)

  • Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part A or Part B premiums and Medicare co-pays
  • 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)

What Does It Cost?

Health First Colorado will pay for your Medicare co-pays. 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. Learn more in the program information page.

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 be getting medical assistance from your state
  • Meet monthly income and resource limits

Benefits and Services (see program information page for full list)

  • Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part A or Part B premiums and Medicare co-pays
  • 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)

What Does It Cost?

Health First Colorado will pay for your Medicare co-pays. 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. Learn more in the program information page.

Medicare Savings Program - Specified Low-Income Medicare Beneficiary (SLMB)

Medicare Savings Program - Specified Low-Income Medicare Beneficiary (SLMB)pays for your Part B premiums

Who Qualifies?

In order to be enrolled in SLMB you must meet monthly income and resource limits

Benefits and Services (see program information page for full list)

  • Health First Colorado (Colorado's Medicaid program) pays for your Medicare Part B premiums

What Does It Cost?

Health First Colorado will pay for your Medicare Part B premiums only. You are still responsible for any deductibles, co-insurance and co-pays

Spinal Cord Injury Waiver (SCI)

The Waiver for Persons with Spinal Cord Injury (SCI) provides a home or community based alternative for people with a spinal cord injury.

Who Qualifies?

  • People ages 18 and older, with a medical diagnosis of spinal cord injury
  • Must reside in the Denver Metro Area:
    • Adams
    • Arapahoe
    • Denver
    • Douglas
    • Jefferson
  • Must be institutionalized or at risk of being institutionalized in a nursing facility
  • Income must be 300% (3 times) the Supplemental Security Income (SSI) allowance per month
  • Countable resources must be less than $2,000 for a single person or $3,000 for a couple

Benefits and Services (see program information page for full list)

  • Adult day services
  • Alternative therapies: acupuncture, chiropractic, massage therapy
  • Home modifications
  • Medication reminder
  • In-Home Support Services (IHSS)

What Does It Cost?

Health First Colorado (Colorado's Medicaid program) members who reside in a nursing facility do not pay co-pays.

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 Services
  • Day Habilitation Services
  • Personal Care Services
  • Respite Services
  • Supported Employment

What Does It Cost?

There are no copays for Waiver Services.

Transition Services

Transition Services is a program to help transition Health First Colorado (Colorado's Medicaid program) members out of nursing homes and long-term care facilities and into home and community-based settings. As a member of the CCT program you would also receive enhanced-services designed to promote independence.

Who Qualifies?

 

  • 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
Benefits and Services(see program information page for full list)

See Transition Services Members page

What Does It Cost?

Co-pay costs vary. Learn more in the program information page