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 pregnant women, please choose another category.
Do you have physical or intellectual/developmental disabilities?Do you need behavioral health services?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: (see program information page for full list)
- Mental health services
- Substance abuse services
Co-pay Costs:
Pregnant women do not pay co-pays. Learn more in the program information page.
| Behavioral Health Program Information Page |
Child Health Plan Plus (CHP+)
Child Health Plan Plus (CHP+) is a public health insurance program for children ages 18 and younger and pregnant women who earn too much to qualify for Health First Colorado (Colorado's Medicaid program), but cannot afford private health insurance. Note: Health First Colorado and Child Health Plan Plus (CHP+) are both public health insurance programs for Coloradans who qualify. When you apply for Health First Colorado, you are applying for both Health First Colorado and CHP+. You do not need to turn in more than one application for you or your family.
Who Qualifies?
- Children ages 18 and younger
- Pregnant women
- All who qualify must meet certain income level requirements (see the CHP+ Program Information page for income levels)
Top Benefits: (see program information page for full list)
- Regular checkups
- Immunizations (shots)
- Prescription medicine
- Eye glasses
- Dental care (for children)
- Mental health and substance use disorder services
Co-pays and Enrollment Fees:
Co-pays and enrollment fees vary. Learn more in the program information page.
| Child Health Plan Plus 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+)
Top Benefits: (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
Co-pay Costs:
Co-pays are based on your ability to pay. This is determined by the CICP facility.
| CICP Program Information Page |
Dental Benefits
The dental benefit provides Health First Colorado (Colorado's Medicaid program) members.
Who Qualifies?
Dental services are a program benefit for Health First Colorado members of all ages.
Top 5 Benefits: (see program information page for full list)
- Basic preventive dental exams
- Diagnostic and restorative dental services (such as x-rays and fillings)
- Extractions (tooth pulling)
- Root canals
- Crowns
- Much more (see program information page for additional benefits)
Co-pay Costs:
None. See the Health First Colorado Benefits & Services Overview for the list of co-pays per service.
| Dental Benefits Program Information Page |
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services. EPSDT is key to ensuring that children and youth receive appropriate preventive, dental, mental health, developmental and specialty services.
All Health First Colorado (Colorado's Medicaid program) coverable, medically necessary services must be provided even if the service is not available under the state plan to other people who qualify for Health First Colorado. Benefits not listed are not considered to be a state plan benefit and are therefore outside of EPSDT coverage and exceptions. No arbitrary limitations on services are allowed, e.g., one pair of eyeglasses or 10 physical therapy visits per year.
Who Qualifies?
Children and Youth ages 20 and younger who are enrolled in Health First Colorado.
Top Benefits: (see program information page for full list)
- Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
- Arrange (through referral) for corrective treatment as determined by child health screenings
- Lead Screening
Co-pay Costs:
Children under the age of 19 do not have co-pays. Co-pay costs for youth ages 19 and 20 vary, see program information page.
| EPSDT Program Information Page |
Emergency Medicaid Services (EMS)
The Emergency Medical Services (EMS) benefit covers family planning and emergency services for people who qualify for Health First Colorado, but do not meet immigration or citizenship requirements. EMS is a limited benefit that does not cover all medical services. It is also known as “Emergency Medicaid” or “Emergency Services Only.”
Who Qualifies?
In order to be eligible for EMS you must:
- Meet the Health First Colorado (Colorado’s Medicaid program) eligibility requirements, except for immigration or citizenship requirements.
- Learn which immigration and citizenship statuses qualify for EMS.
Top Benefits: (see program information page for full list)
Health First Colorado provides benefits for Emergency Medicaid to treat life- or limb- threatening medical emergencies such as:
- Life-threatening health emergencies (such as chest pain, heart attack, appendicitis, etc.)
- Labor and delivery (not including prenatal or postpartum care)
- Dialysis for End-Stage Renal Disease at a freestanding dialysis center
Emergency Medicaid also covers family planning services for non-pregnant members which includes birth control, sterilization services and contraceptive counseling.
Co-pay Costs:
There are no co-pays.
| Emergency Medicaid Program Information Page - English | Emergency Medicaid Program Information Page - Spanish |
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.
Eligible individuals will now have Health First Colorado coverage during their pregnancy and for one year after their pregnancy ends.
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 68% 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
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 & Services Overview for the list of co-pays per service.
| Health First Colorado 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
Top Benefits: (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.
Co-pay Costs:
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.
| HIBI Program Information Page |
Pediatric Personal Care Services
Pediatric Personal Care services help Health First Colorado (Colorado's Medicaid program) members with physical, maintenance and supportive needs such as bathing, dressing, meal preparation and medication reminders.
Who Qualifies?
- You must be 20 years or age and younger
- Meet the requirements in the Department defined in the assessment tool (PCAT)
- Require moderate to total assistance in at least three of the 18 Personal Care Tasks
Top Benefits: (see program information page for full list)
- Assistance with Pediatric Personal Care Services
Co-pay Costs:
There are no costs, pregnant woman, and children are not charged co-pays.
| Pediatric Personal Care 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
Who Qualifies?
In order to be enrolled in Prenatal Plus you must be:
- eligible for Health First Colorado (Colorado's Medicaid program)
- pregnant
- at-risk (as determined by a Prenatal Plus provider)
Top 5 Benefits:(see program information page 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 co-pays.
| Prenatal Plus Program Information Page |
Presumptive Eligibility (PE)
Presumptive Eligibility (PE) is a program that gives temporary medical coverage right away. The coverage starts the same day you apply and lasts for at least 45 days while we process your Medical Assistance application.
Who Qualifies?
- You must be a child under 19 or a pregnant woman,
- You must appear to qualify for Health First Colorado (Colorado's Medicaid program) or Child Health Plan Plus (CHP+) and
- You must complete an application for Medical Assistance.
Top Benefits: (see program information page for full list)
- Same day coverage
Co-pay Costs:
There are no costs. Pregnant woman and children are not charged co-pays.
| Presumptive Eligibility Program Information Page |
Special Connections
Special Connections is a program for pregnant and postpartum people who have substance use disorders and are covered by Health First Colorado (Colorado's Medicaid program). Special Connections helps members have healthier pregnancies and healthier babies by providing case management, counseling, and health education during pregnancy and up to one year postpartum. Special Connections services are in addition to any prenatal care provided by other care providers, such as doctors or nurse-midwifes. Special Connections providers offer pregnancy risk assessments, care coordination services, group counseling sessions, individual counseling sessions, health education groups, and residential substance use disorder treatment in a women-only setting. Special Connections providers will perform risk screenings to see if a member qualifies for Special Connections.
Who Qualifies?
Pregnant and Postpartum people who are:
- A Health First Colorado member
- Pregnant or within one year postpartum
- At risk of having an unhealthy pregnancy and unhealthy baby because of a substance use disorder
Top 5 Benefits: (see program information page for full list)
Services can be outpatient or residential depending on a member's level of risk. Services include:
- Case management
- 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 and postpartum people and children are not charged co-pays.
| Special Connections Program Information Page |