Health First Colorado Medicaid or CHP+
HCPF | Colorado Department of Health Care Policy & Financing
You may qualify for Health First Colorado or CHP+ if you fall under one of the following categories:
- Individuals and families who meet income limits
- Children under 19
- Children with a disability
- Pregnant women
- Adults ages 19–64
- People ages 16–64 who are working and have a disability
- Health First Colorado Buy-In Program for Working Adults with Disabilities (Adult Buy-In) allows adults with disabilities who earn too much income or have too many resources to purchase Health First Colorado benefits. Clients pay a monthly premium based on income. For more information, visit
HCPF: Adult Buy-In.
- People who are eligible for Supplemental Security Income (SSI)
- If you receive SSI, you will automatically be enrolled in Health First Colorado.
- If you have not yet applied for SSI, you should apply at a Social Security Administration (SSA) office.
How to ApplyIncome GuidelinesOther Information
Step 1: Get an application
Online:
PDF Download:
Print and complete the paper application. Be sure to sign the application—unsigned applications cannot be processed.
In-person:
Visit any of our offices Monday–Friday, 8:30 AM – 4:30 PM to pick up an application:
- Montezuma County Department of Social Services
109 West Main Street
Courthouse — Room #170
Cortez, CO 81321
Step 2: Complete the application
Please fill out as much of the application as you can. The application must be signed; we cannot process an unsigned application. If you need help or do not understand a question, call 970-565-3769 for assistance.
Step 3: Return the application
You may return the application to the office listed above, fax it to 970-565-8526, or mail it to the address listed above. To start the process we need your name, home street address, and signature. Providing as much information as possible helps speed processing.
What I Should Know — My Rights and Responsibilities
- I understand I or another applicant may be enrolled in Health First Colorado (Colorado’s Medicaid Program) or Child Health Plan Plus (CHP+) if eligible. I will notify the State of any medical claim or lawsuit and cooperate in collecting medical bills the State paid. I assign to the State rights to payment for medical expenses and the right to appeal denials by other payers when the State paid the bills. If an absent parent exists and I am applying for Health First Colorado, I must seek medical support from that parent and may contact Child Support Enforcement for help.
- Federal and Colorado law require the Department of Health Care Policy and Financing to recover medical assistance benefits from the estates of deceased clients who were permanently institutionalized when required by law. For clients over 55, recovery may include nursing facility, home and community-based services, and related hospital and prescription services. Some exemptions apply; request the “Medical Assistance Estate Recovery Program” brochure for details.
- If I am eligible for Advance Premium Tax Credit (APTC), those payments are made directly to my chosen insurance carrier(s). Accepting APTC may affect my annual tax liability. I will be offered the option to apply all, some, or none of the APTC to my monthly premium.
- If I receive financial assistance, I must report changes. I must report any changes to the organization providing assistance. If enrolled in Health First Colorado or CHP+, I have 10 calendar days to report changes to my local county office or CHP+. If receiving APTC, reduced co-pays/deductibles, or enrolled in a Qualified Health Plan, I have 30 calendar days to report changes to Connect for Health Colorado. If enrolled in multiple programs, I must report to each program within its required time frame. Changes may affect eligibility for me and household members.
- I understand my answers, supplements, and attachments form the basis for any issued health insurance or financial assistance policy. Coverage is effective only on the date specified by the insurer or program. I may request a copy of my application; photographic copies and legible copied signatures are valid.
- To help determine future eligibility, if I enroll in a Qualified Health Plan I agree that Connect for Health Colorado may use income data, including tax return information, for the next coverage year. Connect for Health Colorado will notify me, let me make changes, and I may opt out at any time.
- The Department of Health Care Policy and Financing and Connect for Health Colorado do not discriminate on protected bases. To request free disability or language aids, or to file a discrimination complaint, contact the HCPF 504/ADA Coordinator (1570 Grant St, Denver, CO 80203; phone: 303-866-6010; fax: 303-866-2828; State Relay: 711; email: [email protected]). For Connect for Health Colorado, contact General Counsel (3773 Cherry Creek N. Dr., Suite 1005; phone: 303-590-9640; fax: 303-322-4217). Complaints may also be filed with the U.S. HHS Office for Civil Rights.
- I certify under penalty of perjury that the information I provide is true and correct, including citizenship and immigration status. I understand it is unlawful to receive APTC and CSR from two Marketplaces at the same time. Providing false information may result in penalties, fines, denial of benefits, or criminal prosecution. Insurance carriers or agents who knowingly provide false or misleading information will be reported to the Colorado Division of Insurance.
- If I disagree with a decision, I may appeal. Contact Health First Colorado or CHP+ for appeal instructions, or contact the Marketplace for Marketplace decisions. I may be represented by someone else in the appeal process.
Additional information acknowledgement (checkbox)
Domestic violence information and services are available. If I am in immediate danger I will call 911. For safety services in Colorado or information about the Address Confidentiality Program, I will contact the appropriate statewide resources and inform my department worker if I need or receive these services.
To save time and help the process go faster, please be prepared to supply the following documents and information:
- Your identification, such as a driver’s license, tribal ID, or other photo ID
- Social Security numbers (or proof of application) for everyone requesting benefits
- Proof of household income, such as pay stubs, Social Security award letters, or child support documentation
- Proof of U.S. status for everyone you are applying for, such as a Visa, Legal Permanent Resident Card, Passport, or Employment Authorization Card
- If someone is pregnant, proof of the expected due date (a letter or statement from a doctor or health care provider)
- If on Medicare and applying for the Medicare Savings Program (MSP):
- Proof of other resources or assets, such as checking or savings account statements, vehicle information, retirement accounts, stocks, or life insurance policies
Do I Qualify?
The best way to find out if you qualify is to apply online.
Apply Now
You may qualify for Health First Colorado if you meet the income guidelines below:
Approximate Monthly Income to Qualify for Health First Colorado
| Family Size | Adults 19–65 | Children 0–18 | Pregnant Women |
|---|
| Family of 1 | up to $1,507 | up to $1,609 | up to $2,209 |
| Family of 2 | up to $2,030 | up to $2,167 | up to $2,976 |
| Family of 3 | up to $2,553 | up to $2,726 | up to $3,743 |
| Family of 4 | up to $3,076 | up to $3,284 | up to $4,510 |
| You may still qualify if your income is higher. Apply to find out more. |
HCPF | Colorado Department of Health Care Policy & Financing
How can I get help with my medical bills and visits to the doctor and dentist?
- Health First Colorado (Colorado’s Medicaid Program) is free or low-cost public health insurance for Coloradans who qualify. It can cover doctor visits, emergency care, preventive care (such as screenings and immunizations), and other procedures and treatments. You may also qualify for Long-Term Care, which includes nursing facility care and Home and Community-Based Services delivered in your home.
- Child Health Plan Plus (CHP+) is low-cost public health insurance for Colorado’s uninsured children and pregnant women who earn too much to qualify for Health First Colorado but cannot afford private insurance.
- Colorado Indigent Care Program (CICP) provides discounted health services through qualified providers to Colorado residents, migrant workers, and legal immigrants who are uninsured or underinsured. CICP is not a health insurance program. Services are limited to participating hospitals and clinics. Click here to learn how to apply.
- Connect for Health Colorado is the only place where Coloradans can access new financial assistance based on income and other factors to reduce the cost of health insurance. Visit their site for more information.
- Medicare is a medical insurance program for low-income individuals who have paid Social Security taxes and are at least 62 years of age, as well as their spouses and disabled children.
- The Medicare Savings Program (MSP) may help pay for Medicare Part A or Part B premiums. It can also help cover deductibles, coinsurance, and copayments for those who meet income and resource limits.
- Health First Colorado Dental Providers — Directory
- Eligible adults enrolled in Health First Colorado can receive up to $1,000 per year in preventive dental care.
OverviewMSP CategoriesHow to Apply
Medicare Savings Plan (MSP)
HCPF | Colorado Department of Health Care Policy & Financing
Medicare is a medical insurance program for low-income individuals who have paid Social Security taxes and are at least 62 years of age, as well as their spouses and disabled children. The Medicare Savings Program (MSP) may help pay for Medicare Part A or Part B premiums. It can also help cover deductibles, coinsurance, and copayments for people who have Medicare Part A, meet certain income limits, and have limited resources.
Note: Medicare provides coverage to people who are 65 and older or have a severe disability, regardless of income. Medicaid provides coverage to people with low incomes. When you apply for benefits with us, we can help determine which non-Medicare programs you qualify for and assist with the health insurance application process.
Visit www.medicare.gov for information on how and when to apply for Medicare. (We do not enroll or determine eligibility for Medicare.)
Medicare Savings Program Categories
The Medicare Savings Program includes several categories that assist with health care costs for eligible Medicare Part A patients.
Qualified Medicare Beneficiary (QMB)
- Pays for monthly Medicare premiums, deductibles, and coinsurance
- Eligibility begins the month after the application is approved
- Must currently be eligible for Medicare Part A
- Prescriptions are covered under Medicare Part D
- Income guideline: $1,153 individual / $1,546 couple
- Resource guideline: $9,900 individual / $15,600 couple
Supplementary Medical Insurance Benefits (SLMB)
- Pays Medicare Part B premium
- Must be currently eligible for Medicare Part A
- Income guideline: $1,379 individual / $1,851 couple
- Resource guideline: $9,900 individual / $15,600 couple
- Medicare Part B premiums are the only benefit available under Medicaid for SLMB
Qualified Individuals (QI-1)
- Pays Medicare Part B premium
- Must be currently eligible for Medicare Part A
- Income guideline: $1,549 individual / $2,080 couple
- Resource guideline: $9,900 individual / $15,600 couple
- Medicaid may pay for doctor visits, medical supplies, labs, x-rays, and ambulance services
Low-Income Subsidy (LIS) / Extra Help Part D
- Pays Medicare Part D premium only
- Must be currently eligible for Medicare Part A
- Income guideline: $1,699 individual / $2,289 couple
- Resource guideline: $14,790 individual / $29,520 couple
LIS helps pay for Part D monthly premiums, annual deductibles, coinsurance, and copayments.
Qualified Disabled and Working Individuals (QDWI)
QDWI pays for your Medicare Part A premiums only. You are still responsible for deductibles and coinsurance.
For more information, visit
Colorado HCPF Programs for Adults.
Online
Click to Apply Online Now – Colorado PEAK
PDF Download
Print and complete the PDF application. Be sure to sign it—unsigned applications cannot be processed.
In-Person
Visit any of our offices Monday–Friday, 8:30 AM – 4:30 PM to pick up an application:
Montezuma County Department of Social Services
109 West Main Street
Courthouse – Room #170
Cortez, CO 81321
OverviewEligibility & RequirementsHow to Apply
Long Term Care (LTC)
HCPF | Colorado Department of Health Care Policy & Financing
Long-Term Care Medicaid includes nursing facility care and Home and Community-Based Services, where medical providers come into the home to provide necessary services that help prevent institutionalization in a nursing facility or hospital.
Long Term Care (LTC) Requirements and Details
- Colorado HCPF Website
- Income guideline: $2,742 — Contact the county if your income exceeds this limit; assistance may still be available.
- Resource limit: $2,000 for an individual / $3,000 for a couple
- Applicants must receive long-term care services for 30 consecutive days before eligibility can be approved
- Applicants cannot transfer assets for less than fair market value within 5 years of applying; such transfers may result in temporary ineligibility
- Items commonly needed to process an application:
- Legal identification
- Alien Card or Naturalization Certificate (if applicable)
- Social Security and Medicare cards
- Verification of supplemental health coverage
- Birth or Baptismal certificate
- Marriage certificate / Divorce decree
- Spouse’s death certificate (if applicable)
- Address verification (rent receipts, utility bills)
- Mortgage verification and current property tax assessment
- Checking and savings account statements (last 3 months)
- Vehicle registrations and auto insurance ID/policy
- Life or burial insurance policies/contracts
- Power of Attorney documentation (if applicable)
- Employment check stubs (last 3 months for self/spouse)
- Income verification for Social Security, SSI, VA, annuities, dividends, royalties, etc. (net and gross from source)
Note: Providing copies of these documents at your interview will help speed processing. These items are not required to submit your application initially; you will be informed of what’s needed after review.
Online
Click to Apply Online Now – Colorado PEAK
PDF Download
Print and complete the paper application. Be sure to sign it—unsigned applications cannot be processed.
In-Person
Visit our office Monday–Friday, 8:30 AM – 4:30 PM to pick up an application:
Montezuma County Department of Social Services
109 West Main Street – Room #170
Cortez, CO 81321
Get Financial Help for Health Coverage
Visit the
Colorado Department of Health Care Policy & Financing (HCPF)
for official information and resources.
Get Financial Help
for your health coverage.
We can help you determine what kind of financial assistance you may qualify for. Members of the same household may be eligible for different programs.
This guide does not guarantee eligibility. To find out exactly what you qualify for, please complete the
application.
