Benefits for Young People

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 – 64 years old
  • Live in Colorado
  • Be a U.S. citizen or a qualified immigrant
  • Be working
  • 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.
  • Have countable income at or below $4,830 per month for individuals.
    • 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 $9,745 per month ($116,940 per year!) and still qualify.
    • Only your income is counted, not the income of other household members.

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).

Important: If you qualify for Home and Community Based Services (HCBS) Waivers through Health First Colorado (Medicaid), you can usually get them through the Medicaid Adult Buy-In too. However, the Medicaid Adult Buy-In will not help you qualify for the Developmental Disabilities (DD) Waiver. Instead, see if another waiver might help you, such as the Supported Living Services (SLS) Waiver. Learn more about waivers in DB101's Waiver Programs article.

Example

Freddy has no unearned income and makes $8,272 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 $4,093 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:

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

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

Learn more about the Medicaid Adult Buy-In in DB101’s How Health Benefits Work article.

State Medicaid Adult Buy-In resources

Learn more