Health First Colorado (Medicaid) Adult Buy-In

Frequently Asked Questions

There are different ways to apply for the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In):

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

Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get Health First Colorado (Medicaid) coverage. You do not need to apply for Health First Colorado (Medicaid) and do not have to pay a premium.

Note: Due to COVID-19, there may be limits on in-person services. Contact your agency by phone to ask about this.

Health First Colorado (Medicaid) is a public health coverage program. There are different ways to qualify for Health First Colorado (Medicaid), depending on things like your age, income, resources, and whether you have a disability. One of those ways to qualify is through the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In).

If you qualify for regular Health First Colorado (Medicaid) coverage:

If you qualify for Medicaid Adult Buy-In coverage:

  • You pay small copayments and may pay a monthly premium based on your income.
  • You have to be working. At your work, you could earn as much as $10,278 per month ($123,330 per year!) and still qualify.
  • There is no resource limit.
  • You must have a disability that meets Social Security's disability rules (except for the rules related to work). If you aren't sure if your disability qualifies, you can apply and the state will review your disability.

To qualify for the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), you must:

At work, you can earn a lot and still qualify: your countable income must be 450% of the Federal Poverty Guidelines (FPG) or less. That's $5,096 per month or less. Only your income is counted, not the income of other household members.

The Medicaid Adult Buy-In counts your income the same way as SSI does: 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 $10,278 per month ($123,330 per year!) and still qualify.

You can use the Medicaid Adult Buy-In Estimator to see if you qualify and what your premium would be. Or, get a quick idea of your countable income by trying this tool:

Your Countable Income:

In most cases, no. The actual medical coverage you get from Health First Colorado (Medicaid) will be the same, no matter how you qualified. Generally speaking, the big difference is that people with disabilities get extra ways to qualify and if you have a disability and start working, you can earn more while still getting Health First Colorado (Medicaid) coverage.

DB101 has information about different ways to get Health First Colorado (Medicaid):

Note: The Medicaid Adult Buy-In will not help you qualify for the Developmental Disabilities (DD) Waiver, but can help you qualify for other Home and Community Based Services (HCBS) Waiver programs. If you need DD Waiver services and plan to switch to the Medicaid Adult Buy-In, talk to a benefits planner first.

You may have to pay a premium based on income for coverage through the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In). The maximum premium is $200 per month. For an estimate of what your Medicaid Adult Buy-In premium would be, use the Medicaid Adult Buy-In Estimator.

No, it is not the same as how much you make. When public programs look at your income to figure out if you should qualify, they don’t always count all of your income. What they do count is called “countable income.” This benefits you, because it means that you might have more income than the income limit for a program, but still qualify.

When the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In) reviews your income to see if you are eligible, only about half of your earned income (money you get from work you do) is counted. For example, if you make $4,000 per month at a job and have no other income, that’s only $1,957.50 in countable monthly income.

Try this tool to get an idea of how much countable income you have:

Your Countable Income:

Yes. The Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In) pays for the same services that standard Health First Colorado (Medicaid) pays for, including doctor visits, medical equipment, and In-Home Support Services (IHSS). For a listing of services covered under Medicaid Adult Buy-In, go to the Health First Colorado (Medicaid) website.

If you are eligible for both the Medicaid Adult Buy-In and Medicare, this can help because the Medicaid Adult Buy-In will help pay for things that Medicare doesn't pay for.

With the Medicaid Adult Buy-In, if your income is low enough, you may also qualify for a Medicare Savings Program to help pay your Part B premium (and your Part A premium, if you have one), and the Part D Low Income Subsidy, to help pay for your prescription drugs.

Contact the Colorado State Health Insurance Assistance Program (SHIP) if you have questions about how your Health First Colorado (Medicaid) and Medicare benefits work together. To learn more, read DB101’s How Health Benefits Work article, which has detailed information on Medicare Savings Programs and the Part D Low Income Subsidy.

The Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In) and the Health First Colorado (Medicaid) Buy-In Program for Children with Disabilities (or the "Children's Buy-In" for short) are different programs.

While both programs help people get Health First Colorado (Medicaid) benefits, they help different groups of people:

  • The Medicaid Adult Buy-In is for people who are 16 to 64 years old who are working and earning money at their jobs.
  • The Children's Buy-In is for people who are 18 years old or younger. For this program, the children do not need to be working. Learn about it in DB101's Benefits for Young People article.

You can also learn about both programs on the Health First Colorado Buy-In Programs website.

Learn more