Glossary: CO

Social Security benefits for adults who:

• Became disabled before turning 22, and
• Have a parent who died or who gets retirement or SSDI benefits.

Formerly known as "Disabled Adult Child" (DAC) benefits.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program (sometimes called "welfare-to-work"). It provides cash assistance to low income families with children, and also helps with job training and finding employment.

Get more details in DB101's Colorado Works article.

The Health First Colorado (Medicaid) Buy-In Program for Children with Disabilities (called the "Children's Buy-In" for short) is a public health coverage program for children with disabilities under the age of 19 whose families have too much in income or resources to otherwise qualify for Health First Colorado (Medicaid).

Families may have to pay a monthly premium for the Children's Buy-In, with the amount based on the family's income. The most a family might pay is $120 per month.

Get more information about the Children's Buy-In.

Note: The Children's Buy-In is different than Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In). For the Medicaid Adult Buy-In, you must have paid work and be 16 or older.

The Medicaid Adult Buy-In program (sometimes called WAwD for short) provides health coverage to working people with disabilities in Colorado ages 16 or older who are not otherwise eligible for Health First Colorado (Medicaid). It has a much higher income limit than Health First Colorado (Medicaid) usually has, has no resource limit, and lets you get the same coverage as regular Health First Colorado (Medicaid). Depending on your income, you may have to pay a premium of up to $200 per month.

For Medicaid Adult Buy-In, you must have countable income at or below $5,648 per month for individuals. Almost all of your unearned income is counted, but less than half of your earned income is counted. That means, you could earn as much as $11,380 per month and still qualify!

Get more details in DB101's Medicaid Adult Buy-In article.

Home and Community-Based Services (HCBS) Waiver programs offer extra services beyond what's usually covered by Health First Colorado (Medicaid). They are for people who get Health First Colorado (Medicaid) and need those extra services so that they can live in the community.

Not all people with disabilities qualify for an HCBS Waiver program; each program serves a different target population and has its own eligibility rules. Some Waivers also have waiting lists to get benefits.

These are the HCBS Waiver programs for adults with disabilities in Colorado:

• The Brain Injury (BI) Waiver provides services to people with brain injuries.
• The Community Mental Health Supports Waiver (CMHS) provides services to people with mental illness.
• The Complimentary and Integrative Health Waiver (CIH, previously called the Spinal Cord Injury Waiver or SCI) provides services to adults with a spinal cord injury (traumatic or nontraumatic), multiple sclerosis, brain injury, spina bifida, muscular dystrophy, or cerebral palsy who can't walk independently.
• The Developmental Disabilities (DD) Waiver provides services to people with developmental disabilities or related conditions.
• The Elderly, Blind and Disabled Waiver (EBD) provides services to people who are 65 and older, or who are 18-64 and have disabilities that mean they need long-term supports and services to live in the community.
• The Supported Living Services Waiver (SLS) provides services to people with intellectual or developmental disabilities who need the level of care offered in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID).

Get more details about adult and children's waivers in DB101's HCBS Waiver Programs article.

Medicare Savings Programs are programs that help people with low income and low resources pay for their Medicare expenses, such as Medicare Part A and Medicare Part B premiums, coinsurance, and deductibles. There are four Medicare Savings Programs:

• The Qualified Medicare Beneficiary (QMB) program helps people with countable income that’s 100% of the Federal Poverty Guidelines (FPG) or less ($1,255 per month or less if you live alone). QMB helps pay for your Part B premium, copayments, and deductibles. Note: If you have disability-based or SSI-linked Health First Colorado (Medicaid) coverage, you automatically qualify for QMB.
• The Specified Low-Income Beneficiary (SLMB) program helps people with countable income that’s more than 100% of FPG, but at or below 120% of FPG ($1,506 per month or less if you live alone). SLMB helps pay for the Part B premium, but does not help with anything else.
• The Qualified Individual-1 program, also called QI-1, helps people with countable income that’s more than 120% of FPG, but at or below 135% of FPG ($1,695 per month or less if you live alone). QI-1 helps pay for the Part B premium, but does not help with anything else.

• The Qualified Disabled Working Individual (QDWI) program helps people who have lost their SSDI benefits because they earn more than the Substantial Gainful Activity (SGA) level ($1,550 per month), but have countable income that’s 200% of FPG or less ($2,510 per month or less if you live alone). It lets you stay on Medicare Part A even though you don’t get SSDI anymore and it will pay for the Part A premium that would otherwise apply.

For MSPs, less than half of your earned income is counted. That means you might qualify even if you think your income is over the limits.

The resource limit for QMB, SLMB, and QI-1 is $10,930 if you live alone and $17,130 if you live with someone else. For QDWI, it’s $4,000 if you live alone and $6,000 if you live with another person.

Learn more about MSPs.

A Medicare supplement (also called Medigap) is a policy sold by a private insurance company that helps pay some of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles.

You have to pay a premium for a Medicare supplement policy to a private insurance company. This is in addition to any other premiums you pay for Medicare Part B or Part D. For any health care costs covered by Medicare Part A and Part B, Medicare pays its share first and then your Medicare Supplement pays its share.

Medicare supplement plans do not cover prescription drugs, and most do not include long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.

Note: It is illegal for anyone to sell you a Medicare supplement policy if you have a Medicare Medical Savings Account (MSA) plan or if you do not have Original Medicare.

Learn more about Medigap policies.