Disability-Based Health First Colorado (Medicaid)

Is It Right for You?

Health First Colorado (Medicaid) is government-funded health coverage for people in certain situations. You may qualify if you:

• Have low to moderate income, no matter how much you have in resources or whether you have a disability. Learn more about income-based Health First Colorado (Medicaid).
• Get Supplemental Security Income (SSI) benefits or qualify for SSI’s 1619(b) rule, which helps people who used to get SSI. In either case, you automatically get Health First Colorado (Medicaid) coverage and don’t need to worry about the rules discussed here. Learn more in DB101’s SSI article.
• Have low income, low resources, and a disability, but don't get SSI. Disability-based Health First Colorado (Medicaid) is explained on this page.
  
• Have a disability and work, even if your income is higher and you have lots of resources. Learn more about the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In).

Answer the questions on this page to see if you might qualify for disability-based Health First Colorado (Medicaid). If you do, it’s probably your best health coverage option because:

• It doesn’t usually have a premium and copayments are low
• It covers more services than most private insurance, and may help you qualify to get Home and Community-Based Services (HCBS) Waivers
• If you qualify for Health First Colorado (Medicaid), you cannot get government help paying for an individual plan on Connect for Health Colorado, and
• If you also have Medicare coverage, it may help pay your Part B premium.

Note: This page talks about disability-based Health First Colorado (Medicaid) rules for adults. If you are 18 or under, learn about the rules for Medicaid, the Children's Buy-In, and Child Health Plan Plus (CHP+) in DB101's Benefits for Young People article.

Do You Get Supplemental Security Income (SSI)?

If you get SSI benefits, or qualify for SSI’s 1619(b) rule, which helps people who used to get SSI, you automatically get Health First Colorado (Medicaid) coverage and don’t need to worry about the other rules discussed here. Learn more in DB101’s SSI article.

If you get SSI or qualify for 1619(b), you have Health First Colorado (Medicaid) coverage!

If not, keep reading this page to see if disability-based Health First Colorado (Medicaid) might be right for you.

If You Don't Get SSI, Do You Have Low Income and Low Resources?

If you don't get SSI, you need to apply for Health First Colorado (Medicaid) separately. If you meet most of SSI's eligibility rules, even though you don't get SSI, you may qualify for disability-based Health First Colorado (Medicaid) if you:

• Have a disability that meets Social Security’s adult definition of disability.
• Have countable income below the SSI program's limit ($943 per month or less for individuals).
  • The way your income is counted for disability-based Health First Colorado (Medicaid) is very similar to SSI’s countable income calculation: most of your unearned income is counted, while less than half of your earned income is counted.
• Have countable resources below the SSI program's limit ($2,000 for individuals).
  • Some resources don’t count towards these limits, like the home you live in, one car, and any money you have in an ABLE account.
• Meet all other Health First Colorado (Medicaid) program rules, such as being a citizen or meeting noncitizen requirements.

If you have a disability, have income and resources below the limits, and meet all other program rules, disability-based Health First Colorado (Medicaid) might be right for you.

Tip: If you have a disability, but you have higher income or resources, you may qualify for the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), which has a much higher income limit and no resource limit! Learn more about the Medicaid Adult Buy-In.

Health First Colorado (Medicaid) Rules for Immigrants:

• Undocumented immigrants do not qualify for full Health First Colorado (Medicaid) coverage, but they may qualify for Emergency Health First Colorado (Medicaid).
• Most immigrants who have been lawfully present for less than five years do not qualify for full Health First Colorado (Medicaid) coverage. However, they may qualify for private coverage subsidized by the government.
• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get.

How to Sign Up

You can apply for the Health First Colorado (Medicaid), the Medicaid Adult Buy-In, and other Colorado programs:

• Online on the Colorado PEAK website
• With a paper application (available in English, Spanish, or large print). Fill it out and return it by mail, fax, or in person at your county human services department, or
• By phone at 1-800-221-3943.

Colorado PEAK lists the details you may need to fill out an application.

Staying on Health First Colorado (Medicaid)

Usually, once approved for Health First Colorado (Medicaid), you continue to qualify as long as your situation doesn’t change. If your income, immigration status, residency, or household size changes, let your county human services department know within 10 days of the change. You can do this in person, by phone, or by email. When you report your changes, the county tells you whether you continue to get Health First Colorado (Medicaid) or if you have new health coverage options, like individual coverage with subsidies or the Medicaid Adult Buy-In.