Health First Colorado (Medicaid) Adult Buy-In

Pitfalls

Not getting health coverage because you think it will be too expensive

In the past, some people found it impossible to find health coverage that was affordable and met their needs. Now, there should be an option for almost everybody, regardless of whether you have a disability. The exact health coverage that will be right for you will depend on things like your family’s income, whether you have access to employer-sponsored coverage, your age, where you live, and if you have a disability.

If you do not have the option of employer-sponsored coverage, you may be able to get government help to pay for an individual plan on Connect for Health Colorado. If you cannot afford private individual coverage, your best options will be public programs, like Health First Colorado (Medicaid) or Medicare, if you qualify.

Note: It is very important to have health coverage, but since 2019, there is no tax penalty if you don't have coverage.

Not enrolling in the Medicaid Adult Buy-In because you have private coverage

The Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In) covers some services that private health care plans do not cover.

If you’re in that situation and your private premium is higher than what your Medicaid Adult Buy-In premium would be, you should enroll in the Medicaid Adult Buy-In. You’ll get more comprehensive coverage at a lower price.

Not enrolling in Medicare

If you are eligible for both the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In) and Medicare, you should enroll in both.

The Medicaid Adult Buy-In will help pay for things that Medicare doesn't pay for. And, 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.

Not going back to work because you fear losing your Health First Colorado (Medicaid) coverage

If you lose one health coverage option, there will be another one you can get. If you lose your Health First Colorado (Medicaid) coverage, you will either become eligible for employer-sponsored coverage or private individual coverage. And, if you can’t afford the individual coverage, the government may help you pay for it.

The bottom line: There is a coverage option for everybody. Do not worry that getting a job will leave you without health coverage.

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