The Basics
Benefits programs give you resources that help make your life better. For most young people with disabilities, the benefits that help the most offer health coverage and money.
This article discusses why benefits matter, what the most common benefits are, and how you can get them. It also explains how, if you get a job and save some money, you can still get good health coverage and may be able to keep getting cash benefits.
There's extra attention on how the rules change depending on your age, so that you can know your options as you get older.
Note: DB101 keeps track of changes to health coverage and related laws. DB101 has been and will continue to be updated to reflect any changes. Visit KFF for news related to health coverage.
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Why Benefits Matter
A lot of young people don’t know much about cash and health benefits. Sometimes parents take care of applying for benefits and managing money. Some people are embarrassed they get benefits. Others think that benefits are just too confusing to understand. Some don’t get benefits because they don’t know they qualify.
It is very important that you understand benefits, even if your parents do most of your benefits paperwork. You need to know how benefits can help you live independently and pursue your dreams, such as going to college and getting a job.
Benefits Lead to Independent Living
As a person with a disability you have more opportunities than you might think. People with disabilities are living in their own homes, graduating from college, working at good jobs, getting married, and having children. Getting jobs, studying, living on your own, making friends, and all of the other activities in life are all part of independent living!
One major reason that people with disabilities can live independently is the support that benefits offer. Benefits are keys that can give you needed support as you decide what to do in life and get started with adulthood.
The most important disability benefits offer money and health coverage. The money can help you pay your rent, have a social life, pay for college, and buy food and other things you need. The health coverage can keep you healthier and prevent health care expenses from putting you into debt. These benefits mean that you can think about your future and explore life, instead of constantly worrying about paying bills.
Benefits Help You Get a Job or Go to School
Benefits can help you get an education and a job. In fact, some benefits programs are designed to help you save money for an education or make money while you’re in school.
You may worry that if you get a job, you'll lose your cash benefits. But the reality is that when you get a job, your total income will almost always go up. While your cash benefits may go down as your work income goes up, your job income will more than make up for any drop in benefits. You may even keep getting the same amount of cash benefits after you get a job!
Benefits Give Access to Health Care
Did you know that the average cost of an emergency room visit is more than $1,000 and that medical expenses are the number one cause of personal bankruptcy in the United States? Make sure you have health coverage!
If you get a job and your income goes up, you can still get health coverage. You might keep the exact same coverage as you have now or you might have to sign up for a different program. Either way, you'll be covered.
Do You Qualify for Benefits?
Different benefits have different rules. For most benefits programs, you or your family must either have low income or have paid into an insurance program. Programs may also look at your age, whether your disability meets certain standards, and your family's resources.
Income-Based Benefits
Income-based benefits help you if your family doesn’t make a lot of money. Some programs also have a resource limit.
For most young people with disabilities, the income-based benefits programs that help the most are Supplemental Security Income (SSI), which gives some money each month, and Health First Colorado (Medicaid), which offers health coverage.
Insurance
Insurance is a type of program you pay into regularly. If something comes up and you need help, the insurance starts helping you.
For example, if you have private health insurance, you, your employer, or your parent pays money each month, and when you need to go to the doctor, the insurance pays most of the expenses.
Learn more about qualifying for SSI, Health First Colorado (Medicaid), and private health coverage.
When you work, a small part of the money you make is automatically paid into a federal program called Social Security Disability Insurance (SSDI). If your disability gets worse and you can’t work anymore, SSDI may help you with money each month. Learn more about SSDI.
Most young people don’t qualify for SSDI because they haven’t worked long enough. However, Social Security also has a program called Child’s Benefits that helps the children of people with disabilities and children with deceased parents. Another program called Childhood Disability Benefits (CDB) gives benefits to people with disabilities over the age of 18 if their parents are retired, disabled, or deceased.
Why You Should Take Charge of Your Benefits
You need to understand and manage your benefits, because your money and your health are your responsibilities during adulthood.
Managing Your Benefits Gives You More Options
What role does money play in your life? You might think of money as what you need to buy the things that you want. Yet money also pays your bills, buys your groceries, and takes care of your everyday concerns. You need money to carry out your day-to-day life.
However, you can use money for more than that. You can use it to pay for your education, for your own apartment, or for a car that you can drive to work. Money can also open the door to a future in which you have more options to choose from.
Taking control of your money will help you realize your dreams and achieve your goals, and learning how to deal with benefits is an important step. Cash benefits will help you during your transition to adulthood, while health coverage benefits will keep you healthy and let you save money to use for other purposes.
Managing your benefits means that you are the person who decides what you want to do with your life.
You Are Approaching or Have Already Arrived at Adulthood
You are an adult or soon will be an adult. You need to know how to manage your benefits, your health, and your money. Your parents or other family members have probably helped you with benefits in the past and they have made many choices about the direction of your life. As a young adult, it is important for you to set goals for yourself so that you can live an independent life. Your parents and family can still help you, but as an adult, it will be your responsibility to lead your life and make the big decisions on how to live it.
You might feel anxious or scared about taking more control over your life and that’s okay. It’s a lot of work, and handling your benefits is hard, but there is also a lot of information available and many people who can help you make informed decisions. Begin with Key Programs to get a brief introduction to the most important programs that can help you.
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Key Programs
This section introduces:
- Supplemental Security Income (SSI)
- Health First Colorado (Medicaid)
- The Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), and
- Private health coverage.
Supplemental Security Income (SSI)
SSI is the most important benefit that offers money for young people with disabilities. Even if you've never had a job, you may be able to get SSI. Even if you are under 18 and live with your parents, you may be able to get SSI.
Who it helps
If you have a disability, don’t have enough money for your basic needs, don’t have much income, and have limited resources, you may be able to get SSI. (If you are under 18, your parents also must have low income and limited resources for you to qualify for SSI.)
How it helps
If you qualify, SSI gives you money each month to help with your expenses, like food and rent. If you get SSI benefits, you also qualify automatically for Health First Colorado (Medicaid).
Learn more about SSI eligibility.
When you work, taxes are taken out of your paycheck. Some of those taxes are automatically paid into the SSDI program. If you work for long enough while paying into SSDI and then your disability limits how much you can work, you will get money each month from SSDI.
SSDI doesn't cover many young people, because they haven’t worked long enough to get benefits from it. However, if you get a job, your job could help you qualify for SSDI later. And, the more you work, the more SSDI will pay you if you need it!
Health First Colorado (Medicaid)
Health First Colorado (Medicaid) is the most important public health benefit for young people with disabilities.
Who it helps
Health First Colorado (Medicaid) is for people who cannot afford medical expenses. Generally, to get it, you or your family must have low income. If you get SSI benefits, you automatically qualify for Health First Colorado (Medicaid). If your family makes more money, you may be able to pay a premium to get covered by the Health First Colorado (Medicaid) Buy-In Program for Children with Disabilities.
How it helps
If you qualify, Health First Colorado (Medicaid) pays for your medical expenses, including visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. Health First Colorado (Medicaid) may also pay for Home and Community-Based Services (HCBS) waivers that help you live in the community.
Learn more about Health First Colorado (Medicaid) eligibility.
The Medicaid Adult Buy-In
The Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), sometimes called "WAwD" for short, lets you get a job and keep your Health First Colorado (Medicaid) health coverage.
Who it helps
The Medicaid Adult Buy-In is for people 16 or older with disabilities who have jobs. The income limit is much higher than with standard Health First Colorado (Medicaid), but you have to pay a monthly premium. The amount of your premium depends on your income.
How it helps
The Medicaid Adult Buy-In pays for the same services that standard Health First Colorado (Medicaid) covers, including visits to the doctor, hospital stays, medical equipment, and other medical services.
Learn more about Medicaid Adult Buy-In eligibility.
Private Health Coverage
Private health insurance is the most common way people get health coverage.
Who it helps
People get private health coverage in different ways. Some get it through their jobs, others get it from their parents’ employers, and some sign up for it on their own at Connect for Health Colorado. If you get an individual health plan, the government may help pay your monthly premium through tax subsidies. Note: There is no income limit for getting subsidies that help pay individual coverage premiums. (Before 2021, the limit was 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.
How it helps
Private health coverage pays for some of your medical costs when you see doctors, visit other health care providers, do lab tests, or get prescription medicines at a pharmacy. Depending on your private health plan, your coverage may pay for almost all of your medical expenses or for just a part of those expenses.
Learn more about private health coverage.
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SSI Eligibility for Young People
Supplemental Security Income (SSI) gives money each month to people who have disabilities, or are blind, and who have low income and low resources. If you qualify, you may get up to $967 in monthly SSI benefits and you also get Health First Colorado (Medicaid) coverage automatically.
To get SSI, you have to meet certain rules. Some rules are the same, regardless of your age. For example, you must be a U.S. citizen or qualified alien. However, other rules depend on your age. The biggest changes involve:
- How SSI decides whether you have a disability
- Whose income and resources SSI counts to decide if you can get benefits
These rules are explained in four parts:
- SSI if you are younger than 18
- If you get SSI and are turning 18 soon
- SSI if you are already 18 or older
- SSI rules that help you go to school, work, and save money
If you have questions after reading about the rules, talk to a benefits planner.
You can apply for SSI at your local Social Security office or by calling 1-800-772-1213 or 1-800-325-0778 (TTY).
SSI if You Are Younger than 18
If you are under 18, SSI says you are a child and have a disability if:
- You have a physical or mental impairment or combination of impairments
- Your impairments cause severe limitations in your daily life, and
- Your condition has lasted or is expected to last for at least 12 months.
Not everybody with a disability automatically gets benefits. You must also have no other way to pay for basic expenses, like food, rent, and utilities. If you are under 18, SSI decides whether you need help by looking at the money you and your parents earn and the resources you and your parents have, including savings accounts, stocks, and real estate.
If you or your parents make too much money or have too many resources, you will not get SSI. The exact limits depend on the size of your family. A complete table of income limits for families with a disabled child is listed near the bottom of Social Security’s SSI for Children page.
Note: You can open an ABLE account where over time you can save up to $100,000 in resources and not have them counted by SSI. Learn more about ABLE accounts.
Note: Almost all children under 18 who get SSI benefits have them sent to a parent or guardian. This person is called a representative payee. Occasionally, people who are 16 or older can be their own payees, but they must meet strict criteria.
Parent-to-Child Deeming
SSI counts both your income and resources and your parents’ income and resources when you are under 18 because they expect your parents to pay for your living expenses. This is called parent-to-child deeming.
SSI looks at your parents’ income and decides to lower your benefits amount by $250 due to parent-to-child deeming. Instead of giving you $967 per month, they give you $717.
Child Support
If you live with one parent and get child support from your other parent, SSI counts two-thirds of the child support as income. Child support can be shelter, not just a check. In that case, SSI figures out how much money that support is worth and counts two-thirds of it as income. Shelter can cause your benefits amount to be reduced by at most $322.33 per month.
Your parent gets $300 each month from child support. SSI counts two-thirds of that and lowers your monthly SSI benefits amount by $200. Instead of giving you a $967 monthly benefit, they give you $767.
If You Get SSI and Are Turning 18
If you get SSI, you stop being a child for the program when you turn 18. As an adult, when SSI decides whether you have a disability, they use their definition of disability for adults, not their definition for children. The adult definition looks at your ability to work, not just your physical or mental limitations. As a result, some people stop getting SSI benefits after they turn 18.
To check whether your disability meets their standards for adults, during the first year after you turn 18, SSI does a review called the SSI Age-18 Redetermination.
SSI will say you have a disability if:
- You have a physical or mental impairment or combination of impairments
- Your impairments limit your ability to work, and
- Your condition has lasted or is expected to last for at least 12 months.
SSI may also look at your work and school records to see if you are able to work and may even talk to your teachers, counselors, or employers.
If you got SSI benefits before turning 18 and are now going through the SSI Age-18 redetermination, Social Security may say you have a disability, even if you are working, regardless of how much you make.
Possible Results of the Age-18 Determination
If your disability does not meet Social Security's adult definition of disability, you keep getting SSI benefits for two more months before they end. In this situation, you have two options if you still want to get SSI:
- You can appeal. When SSI sends you the letter telling you that your benefits are ending, you have 10 days to request an appeal. During the appeal process, you can ask that SSI continue your benefits until they make a decision. Learn more about appeals in DB101's SSI article.
- If you are in an employment support program, like Vocational Rehabilitation (VR), an Individualized Education Program (IEP), a Plan to Achieve Self-Support (PASS), or any other program approved by SSI that helps you get a good job in the future, you can apply to continue benefits through a special rule called Section 301.
If SSI says that your disability does qualify and that you will continue to get benefits after turning 18, these factors could impact the amount you get each month:
- Parent-to-child deeming ends. SSI stops counting your parents’ income and resources when considering your eligibility for benefits, which may help you get a higher benefits amount than before you were 18.
- If you or your family gets child support for your living expenses, SSI now counts all of it as income. This may cause your benefits to go down.
- Your living situation: If you live alone or pay your fair share of expenses as a roommate with others, your benefits amount may be higher than if you live with others who help pay for your shelter.
- In-kind support and maintenance: If someone else helps pay for your food or rent, your benefits amount may be reduced by up to one-third ($322.33). This is called a Value of the One-Third Reduction (VTR).
Some people who get SSI before they are 18 lose it when they turn 18 because their disabilities don't meet Social Security's adult definition of disability. Other people who couldn’t get SSI before they were 18 due to parent-to-child deeming may now be able to get it.
SSI if You Are Already 18 or Older
If you are 18 or older and didn't get SSI before turning 18, SSI says you are an adult and have a disability if:
- You have a physical or mental impairment or combination of impairments
- Your impairments limit your ability to work, preventing you from earning Substantial Gainful Activity ($1,620 per month if you’re not blind), and
- Your condition has lasted or is expected to last for at least 12 months.
Note: If you are blind, you could be able to earn more than $1,620 per month.
Not everybody with a disability automatically gets benefits. You must also have no other way to pay for basic expenses like food, rent, and utilities. If you are 18 or older, SSI looks at your income and resources, including savings accounts, stocks, and real estate, to decide if you need help.
SSI's income limit depends on your living situation, including whether you are married, whether somebody helps pay for your housing, and other factors. Read about different income limits in DB101's SSI article.
SSI's resource limit is $2,000 for individuals. Some resources don’t count towards SSI’s resource limit, like the home you live in and one vehicle. Social Security has a complete list of excluded resources.
If you have a disability, your income is below the income limit, and your resources are below the resource limit, you qualify for SSI. The exact amount you get in SSI benefits depends on your living situation, your income, and whether you qualify for special SSI rules that can help you earn or save more money without reducing your benefits.
If you work, you may have to spend money on things, like transportation, medical expenses, or accommodations, to do your job. If you have a disability, SSI may consider some of your expenses to be Impairment Related Work Expenses (IRWEs) and may not count the money you spend on them as income. If you are blind, the rules are a bit different and the expenses are called Blind Work Expenses (BWEs). Be sure to keep all receipts for expenses you think qualify as IRWEs or BWEs.
The bottom line: If you have IRWEs or BWEs, you may qualify for SSI even if you think your income is too high to get it. Or, you might get higher SSI benefits than you otherwise would.
SSI Rules that Help You Go to School, Work, and Save
SSI and many other government benefits programs have limits on how much income and savings you can have. If you go over the limits, you can't get benefits. This can make working and saving seem scary, because you might be afraid you'll lose your benefits.
That's why there are special rules and programs, like the Student Earned Income Exclusion (SEIE), Plans to Achieve Self-Support (PASS), Individual Development Accounts (IDAs), and ABLE accounts that can help you earn and save money without losing your SSI benefits.
Student Earned Income Exclusion (SEIE)
SSI has rules called exclusions that let you make some money without having your SSI benefits go down or stop. The Student Earned Income Exclusion (SEIE) is a major exclusion: it lets students earn up to $2,350 per month, and up to $9,460 per year, without having those wages be part of their countable income!
To qualify for the SEIE, you must be under 22, working, and regularly attending school. That usually means you have to go to school more than:
- 8 hours a week for college students
- 12 hours a week for grades 7–12
- 12–15 hours a week for employment training
If you drop out of school, you will not qualify for the SEIE, and your SSI benefits will be smaller than they would be if you stayed in school. Stay in school! You get more money thanks to the SEIE, and when you graduate, you’ll get a higher paying job thanks to your degree.
You make $1,000 per month at a summer job and during the school year, you make $400 each month at a work-study job. Combined, you make a total of $6,600 for the year. Since the money you make doesn’t go over the monthly and annual limits for the SEIE, your SSI benefits don’t go down at all.
Plans to Achieve Self-Support (PASS)
Usually, if you have too many resources or too much income, you stop qualifying for SSI. A PASS is a way to go over these limits without losing your benefits.
To set up a PASS, you must qualify for SSI, have a specific work goal, and have expenses that you need to pay to reach your goal, such as school tuition, transportation, books, and services. You must also show that after you start putting money into your PASS, you’ll still have enough money left over to pay for your basic living expenses.
Once your PASS is set up, any money you put into it doesn't count as income or resources for SSI. In this way, a PASS lets you earn more and save more without having your SSI benefits go down. You can also put unearned income into your PASS, which means that you can start saving even if you don’t have a job yet. Note: You cannot put your SSI benefits into your PASS.
Learn more about PASS in DB101's Building Your Assets and Wealth article or contact a PASS specialist.
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Medicaid and Child Health Plan+ Eligibility
Health First Colorado (Medicaid) helps people with low to moderate income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services. Child Health Plan Plus (CHP+) offers health benefits to children and pregnant women who don't qualify for Health First Colorado (Medicaid).
If you get Supplemental Security Income (SSI) benefits or used to get SSI benefits and now qualify for SSI's 1619(b) status, you get Health First Colorado (Medicaid) coverage automatically and do not need to worry about the eligibility information discussed here.
If you don't get SSI benefits, Health First Colorado (Medicaid) and CHP+ rules depend on whether you are:
- 18 or younger (or pregnant for CHP+), or
- 19 or older.
Note: This page does not cover all ways you might qualify for Health First Colorado (Medicaid) or CHP+. The best way to check if you qualify is to apply.
You can apply for the Health First Colorado (Medicaid), Child Health Plan Plus (CHP+), 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.
Health First Colorado (Medicaid) and CHP+ if You Are 18 or Younger
If you are 18 or under (or pregnant for CHP+):
- You may qualify for income-based Health First Colorado (Medicaid) or Child Health Plan Plus (CHP+) if your family has low income, regardless of whether you have a disability.
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You may qualify for Health First Colorado (Medicaid) if you have a disability and...
- Your family has low income and low resources, or...
- You get Health First Colorado (Medicaid) through the Children's Buy-In because your family's income or resources are too high for regular Health First Colorado (Medicaid) or CHP+, or...
- You get Health First Colorado (Medicaid) through the Medicaid Adult Buy-In. For the Medicaid Adult Buy-In, you must also work, and be 16 or older. Learn more about the Medicaid Adult Buy-In.
1. Income-based Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+)
When you apply on Colorado PEAK, they first check to see if you qualify for health coverage based on your household's Modified Adjusted Gross Income (MAGI).
If your family's income is 138% of the Federal Poverty Guidelines (FPG) or less ($44,367 per year or less for a family of four), you may qualify for income-based Health First Colorado (Medicaid). It doesn't matter how much your family has in resources.
If you are 18 or younger and your family’s income is too high for income-based Health First Colorado (Medicaid), but is 260% of FPG or less ($83,590 per year or less for a family of four), you may qualify for Child Health Plan Plus (CHP+). It doesn't matter how much your family has in resources. Note: If you are pregnant, you may also qualify if you are over the age of 18.
Check if your family's income is low enough for you to get income-based Health First Colorado (Medicaid) or CHP+ coverage:
| Your family size: | |
Income limits for your family: | |
| Income-based Health First CO (Medicaid), adults (138% FPG) | |
| Child Health Plan Plus (CHP+) (260% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
2. Disability-Based Health First Colorado (Medicaid) and the Children's Buy-In
If you don't qualify for income-based Health First Colorado (Medicaid) and don't get SSI benefits, Health First Colorado (Medicaid) checks to see if you qualify for disability-based Health First Colorado (Medicaid) or the Medicaid Buy-In Program for Children with Disabilities (called the "Children's Buy-In" for short).
For either, you must have a disability that meets Social Security Administration (SSA) standards for children. The differences are in the income and resources rules:
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If you have very low income and very low resources, you may qualify for disability-based Health First Colorado (Medicaid) with no monthly premium:
- Your resources must be $2,000 or less.
- Your countable income must be $967 per month or less. It includes your unearned income, some of your earned income, and a portion of your parents' income, which is deemed to you. Most income rules that apply to SSI also apply to disability-based Health First Colorado (Medicaid).
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If your income or resources are higher and you are under the age of 19, you may qualify to get coverage through for the Medicaid Children's Buy-In.
- There is no resource limit.
- The income limit is a lot higher (the amount depends on your family size) and not all income is counted against the limit (only about two-thirds of income is counted). Learn more about the Children's Buy-In income limit.
- Depending on your income, you may need to pay a monthly premium to get coverage. The amount you pay for your monthly premium is based on your family's income. The most you might pay is $120 per month.
Note: The Children's Buy-In is different than the Adult Buy-In. For the Medicaid Adult Buy-In, you must have paid work and be 16 or older. Learn more about the Medicaid Adult Buy-In.
If you get SSI, but then stop getting SSI benefits because your earned income goes up, a rule called 1619(b) lets you keep your automatic disability-based Health First Colorado (Medicaid) coverage. With 1619(b), you can make up to $60,307 per year without losing your Health First Colorado (Medicaid) coverage.
1619(b) means that you can get Health First Colorado (Medicaid) while earning way more than the program’s normal income limit, but your resources have to stay below SSI’s $2,000 resource limit. If your resources go over that limit, look into Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), which has no resource limit and a much higher income limit. Learn more about the Medicaid Adult Buy-In.
Health First Colorado (Medicaid) if You Are 19 or Older
If you are 19 or older, you may qualify for Health First Colorado (Medicaid) if:
- You have low income, regardless of whether you have a disability, or
- You have a disability, low resources, and low income. Note: You automatically qualify for disability-based Health First Colorado (Medicaid) if you get SSI benefits, so you do not need to read this section.
If you have a disability, work, and 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) instead.
1. Income-Based Health First Colorado (Medicaid)
If you are 19 or older and your household's Modified Adjusted Gross Income (MAGI) is 138% of FPG or less ($21,597 per year or less if you are single), you may qualify for income-based Health First Colorado (Medicaid). It doesn't matter how much your family has in resources.
If you are pregnant, you can get Child Health Plan Plus (CHP+) coverage if your income is 260% FPG or less ($54,990 per year or less if you are single and pregnant with your first child; the baby counts as a family member for this program).
Check whether your income is low enough for you to get income-based Health First Colorado (Medicaid) or Child Health Plan Plus (CHP+) coverage:
| Your family size: | |
Income limits for your family: | |
| Income-based Health First CO (Medicaid), adults (138% FPG) | |
| Child Health Plan Plus (CHP+) (260% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
2. Disability-Based Health First Colorado (Medicaid) and the Medicaid Adult Buy-In
If you don't qualify for income-based Health First Colorado (Medicaid), Health First Colorado (Medicaid) checks to see if you qualify for disability-based Health First Colorado (Medicaid) or the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In).
People who get Supplemental Security Income (SSI) benefits get Health First Colorado (Medicaid) coverage automatically. If you have a disability and don't get SSI benefits, you may still 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 and resources below the SSI program's limits.
- Meet all other Health First Colorado (Medicaid) program rules, such as being a citizen or meeting noncitizen requirements.
If you have a disability, your resources or income are higher than SSI's limits, and you have paid work, you may instead qualify for the Medicaid Adult Buy-In. The Medicaid Adult Buy-In:
- Has no resource limit, and
- Has a much higher income limit; you could earn as much as $11,823 per month ($141,870 per year) and still qualify!
Learn more about the Medicaid Adult Buy-In.
If you don’t qualify for Health First Colorado (Medicaid) or the Medicaid Adult Buy-In, Connect for Health Colorado may offer other health coverage options. Learn more about private health insurance.
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Medicaid Adult Buy-In Eligibility
If you get a job and are either making too much money or have saved up too much money to get Health First Colorado (Medicaid), you might qualify for the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In).
The Medicaid Adult Buy-In offers the same coverage as regular Health First Colorado (Medicaid), but you may have to pay a monthly premium to keep your coverage. Sometimes, the Medicaid Adult Buy-In is called WAwD for short. Note: The Medicaid Adult Buy-In is different than the Children's Buy-In. For the Medicaid Adult Buy-In, you have to be 16 or older, working, and earning money.
To qualify for the Medicaid Adult Buy-In, you must:
- Be 16 years old or older
- Live in Colorado
- Be a U.S. citizen or a qualified immigrant
- Be working
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Have a disability that meets Social Security’s medical standards.
- Note: For the Medicaid Adult Buy-In, SSA’s disability rules related to income do not apply.
- Note: If you aren't sure if your disability qualifies, you can apply and the state will check.
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Have countable income at or below $5,869 per month for individuals.
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The Medicaid Adult Buy-In counts your money 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 $11,823 per month ($141,870 per year!) and still qualify.
- Only your income is counted, not the income of other household members.
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The Medicaid Adult Buy-In counts your money 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 $11,823 per month ($141,870 per year!) and still qualify.
If you have Medicaid Adult Buy-In coverage, you may have to pay a $0 to $200 premium each month (the higher your income, the higher your premium).
Freddy has no unearned income and makes $10,118 per month at his job. That's more than the regular Health First Colorado (Medicaid) income limit, but his county worker tells him to apply, because he should qualify for the Medicaid Adult Buy-In.
When the county reviews his application, it says Freddy only has $5,017 in countable income, so he easily qualifies for the Medicaid Adult Buy-In. He has to pay a $200 monthly premium, but it’s less than he’d have to pay for private insurance.
How to Apply for the Medicaid Adult Buy-In
You can apply for 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.
Learn more about the Medicaid Adult Buy-In in DB101’s How Health Benefits Work article.
For more information about the Medicaid Adult Buy-In:
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Private Health Coverage for Young People
To get private coverage, somebody — you, your employer, your parents, your parents’ employer — must pay for that coverage. This section introduces the basic ways you can get private health coverage and points out some of the health expenses you may encounter.
Coverage Through Work
Many, but not all, jobs offer health benefits. That’s why private health insurance through work is the most common way that Americans get their health coverage.
If you get your health coverage through your job, usually your employer pays hundreds of dollars each month for it. Depending on your job, you may also have to pay some money each month to keep coverage. The total monthly expense paid for the private health coverage is called the premium.
In addition to the premium you and your employer pay, you have to pay various other expenses out of your own pocket. The most common expenses are called copayments. A copayment means that every time you have a doctor’s appointment, have a test done, or get a prescription filled, you have to pay some money. With private coverage, copayments generally range from about $10 to $50.
Depending on your health plan, you may not have to pay anything for certain services, such as routine testing and vaccinations, but have to pay a lot for other services. Some plans, for example, may require you to pay for half of all your hospitalization expenses, which can add up to hundreds or even thousands of dollars each day. Other plans simply don't cover certain medical expenses, such as wheelchairs or other durable medical equipment.
All plans have an annual limit on the total amount you have to pay in addition to your monthly premium. This limit is called the out-of-pocket maximum. So, if you have a plan with a $2,000 out-of-pocket maximum, once you’ve paid a total of $2,000 in copayments and other medical expenses, you won’t have to pay any copayments or other expenses for the rest of the year. Note: The monthly premium isn't included in this maximum and will still have to be paid.
Coverage Through Parents
Federal law says that parents who get health coverage through their jobs are allowed to add any children under the age of 26 to their plans. Usually, a parent adding a child to their employer-based coverage has to pay some or all of the child's monthly premium.
Buying Individual Coverage
Some people pay a health coverage company directly instead of getting it through their jobs or parents. This is called individual coverage. As with employer-sponsored coverage, individual coverage requires you to pay a monthly premium, copayments, and perhaps a deductible, depending on your plan.
Connect for Health Colorado is the easiest place to sign up for individual coverage. It used to be that health insurance companies could deny you coverage or charge you more if you had a disability, but that's not true anymore. Now, anybody can get private insurance.
You should only think about getting an individual plan through Connect for Health Colorado if you cannot get health coverage from:
- Your job
- Your parent’s job
- Your spouse’s job
- Health First Colorado (Medicaid), or
- Medicare.
If you cannot get health coverage from any of the above options, the government may help you pay your monthly premium via a tax credit. If your family’s income is at or below 250% of the Federal Poverty Guidelines (FPG), ($37,650 for an individual or $78,000 for a family of four), the government also helps you get a silver plan that has lower copayments and other expenses.
Note: There is no income limit for getting subsidies that help pay individual coverage premiums. (Before 2021, the limit was 400% of FPG.) To get subsidies, you still must meet other eligibility rules and the premium amount you pay depends on your income and your plan.
| Your family size: | |
Income limits for your family: | |
| Income-based Health First CO (Medicaid), adults (138% FPG) | |
| Child Health Plan Plus (CHP+) (260% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
| |
Read more about how to sign up for individual coverage in DB101's How Health Benefits Work article.
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Other Programs
You may qualify for many other benefits programs. For example, if you get Supplemental Security Income (SSI) and are over 18, you can probably get help from the Supplemental Nutrition Assistance Program (SNAP) and may be able to get income support from Colorado Works.
Depending on your circumstances, two Social Security programs may give you benefits based on contributions your parents made during their careers: Child’s Benefits and Childhood Disability Benefits (CDB).
Asset-building programs, including ABLE accounts, Individual Development Accounts (IDAs), and the Earned Income Tax Credit (EITC) can help you save up money without losing benefits you get that have income and resource limits.
Supplemental Nutrition Assistance Program (SNAP)
The SNAP (formerly Food Stamps) program helps you pay for food by giving you a plastic card, called an Electronic Benefits Transfer (EBT) card, that looks and works like a debit card. Colorado puts money on the EBT card each month and you use it to buy food. To qualify for SNAP benefits, you must have low income.
Learn more in DB101's SNAP article.
Colorado Works
Colorado Works gives money to families with low income and low resources who don't have enough to pay for basic needs, like food, clothing, and rent. For Colorado Works, a family is one or two parents living with their child or children under 18. The age limit is 19 for children who are in school full-time. A family can include biological kids, step-kids, adopted kids, and children of relatives.
Learn more in DB101's Colorado Works article.
You can apply for Health First Colorado (Medicaid), the Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In), SNAP, Colorado Works, and other programs online on the Colorado PEAK website. Or, download 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.
Colorado PEAK lists the details you might need to fill out an application.
Child’s Benefits (only if you are under 19)
The most common way for adults to get Social Security benefits, like SSDI or retirement benefits, is to work and pay into Social Security’s trust fund.
For young people, however, another common way to get Social Security benefits is to qualify for Child’s Benefits. You don't need to have a disability to qualify for Child’s Benefits. To get them, you must:
- Be under the age of 18 (or 19 if you’re attending high school or other secondary education)
- Not be married, and
- Have a parent who gets Social Security retirement benefits or SSDI. If your parent is deceased, you may also qualify.
You get Child's Benefits in any month your parent gets a Social Security disability or retirement benefit, or if your parent is deceased and would have qualified for benefits. For example, if your parent is in SSDI's Trial Work Period, you keep getting Child's Benefits, but during the Extended Period of Eligibility, you only get a Child's Benefit in any month your parent gets SSDI benefits. Make sure to tell Social Security if your family is in this situation.
You can apply for Child’s Benefits at your local Social Security office or by calling 1-800-772-1213 or 1-800-325-0778 (TTY).
Learn more about Child's Benefits or talk to a benefits planner.
Childhood Disability Benefits (only if you are 18 or older)
If you have a disability, you may qualify to get money each month through the Childhood Disability Benefits (CDB) program. CDB is based on your parent’s work record.
To qualify, you must:
- Be 18 or older
- Have a disability since before you turned 22 that meets Social Security's adult definition of disability
- Not be married, unless your spouse also gets SSDI or CDB, and
- Have a parent who gets Social Security retirement benefits or SSDI. If your parent is deceased, you may also qualify.
You don’t automatically get CDB when you turn 18. You can apply for it at your local Social Security office or by telephone at 1-800-772-1213 or 1-800-325-0778 (TTY).
If you get CDB, you can also get health coverage through Medicare after a 24-month waiting period.
Learn more about CDB in DB101's SSDI article.
Asset-Building Programs
Instead of sending you money or paying for your health expenses, asset-building programs help you save up your own money so that you can afford to pay for future expenses, such as education, buying a car, or even retirement.
ABLE Accounts Help You Build More Assets
ABLE accounts let people who have disabilities that began before they turned 26 keep money in a special tax-advantaged account. The first $100,000 in an ABLE account doesn't count against the $2,000 SSI resource limit, and none of the money in an ABLE account counts for Health First Colorado (Medicaid).
Learn more in DB101's ABLE accounts article.
Individual Development Accounts (IDAs)
An IDA helps people save money for a specific goal, such as buying a home, starting a small business, or paying for education. The great thing about an IDA is that for every dollar you save, the bank or other financial institution where you have your account matches your money. For example, if you save $50 per month, the financial institution might contribute $100 per month. The amount they contribute depends on the institution, but sometimes they put more money into your account than you do!
To open an IDA:
- For most IDA programs, your annual income must be 200% of the Federal Poverty Guidelines (FPG) or less ($31,300 per year for individuals). Some programs have higher limits, and you may qualify if your income is 65-85% of the median income in your area.
- You must have earned income from a job or your own business
- You have to take financial literacy classes about things like money, debt reduction, developing a savings plan, credit, and investing; and
- Depending on the program, you may also need to be a U.S. citizen or permanent resident.
If you get SSI benefits, only enroll in an IDA that is federally funded through Colorado Works or the Assets for Independence Act (AFIA). SSI doesn't count money deposited into federally funded IDAs, so the money you save doesn't cause your SSI benefits to be reduced or stopped.
If you enroll in a nonfederally funded IDA (for example, one funded by a nonprofit or private company), money deposited and matched in your IDA could affect your benefits.
Read DB101’s Building Your Assets and Wealth article to learn more about IDAs.
Earned Income Tax Credit (EITC)
The federal and state Earned Income Tax Credits (EITC) give money to low- to moderate- income workers and families. Even people who don’t make enough to owe income taxes may qualify for this tax credit.
To qualify, you must have income from employment, self-employment, or employer-paid disability benefits and you must file your taxes!
The amount you get from your EITCs depends on your Adjusted Gross Income (AGI), whether you are married, and the number of children you have. For 2024 (filing taxes by April 2025), the federal EITC ranges from $2 to $7,830.
The Colorado EITC is 25% of the Federal EITC, or $1 to $1,958. For example, if your federal EITC is $4,000, your Colorado EITC is $1,000.
Note: If your income is too high, you don't qualify for the EITC credits.
To get the Earned Income Tax Credit, you need to file your federal and state taxes, even if you owe nothing. Make sure to complete the “Schedule EIC” as well. Lots of people don’t get the EITC because they don’t know they could.
If you need help filing your taxes, get in touch with a Volunteer Income Tax Assistance (VITA) center. With VITA, certified volunteers help prepare your taxes and make sure you get any credits you qualify for. Most sites also offer free electronic filing (e-filing). Find a local VITA center or call 1-800-906-9887.
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Next Steps
Learn More
To learn more about the programs discussed in this article, read DB101’s sections on:
- Supplemental Security Income (SSI)
- Social Security Disability Insurance (SSDI)
- Income-Based Health First Colorado (Medicaid)
- Disability-based Health First Colorado (Medicaid)
- Health First Colorado Buy-In Program For Working Adults With Disabilities (Medicaid Adult Buy-In)
- Employer-Sponsored Health Coverage
- Individual Coverage Through Connect for Health Colorado
- Building Your Assets and Wealth
- ABLE Accounts
- Plans to Achieve Self-Support (PASS)
- Individual Development Accounts (IDAs)
- Earned Income Tax Credit (EITC)
Apply for Benefits
You can apply for SSI, SSDI, CDB, and Child’s Benefits at your local Social Security office or by calling 1-800-772-1213 or 1-800-325-0778 (TTY).
To apply for a PASS, contact your local PASS specialist.
To apply for individual health coverage, use Connect for Health Colorado.
You can apply for Health First Colorado (Medicaid), the Medicaid Adult Buy-In, Child Health Plan Plus (CHP+), SNAP, Colorado Works, 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.
Ticket to Work
Social Security’s Ticket to Work Program helps people with disabilities who get Social Security benefits re-enter the workforce and become more independent. The Ticket to Work Program offers free access to employment-related services, such as training, transportation, and vocational rehabilitation. You can call the Ticket to Work Help Line at 1-866-968-7842 or 1-866-833-2967 (TTY).
Get Help with Your Benefits
A trained Benefits Planner can help you understand your benefits programs. Exactly who you need to contact depends on your situation and the benefits you get.
View DB101's full list of experts who can help you understand different benefits.