Alyssa Lane
Health First Colorado is Colorado's Medicaid program, offering free or low-cost healthcare for children and adults who qualify. There is no premium, deductible, or copay, and Coloradans can sign up at any time during the year. To qualify for Health First Colorado, you must meet specific monthly income requirements. If you are already covered by an employer-provided health insurance plan, privately purchased insurance, Medicare, or military coverage, you may not be eligible for Medicaid as a secondary insurance. However, if your current insurance plan does not meet your needs, you can explore other options.
| Characteristics | Values |
|---|---|
| Name of Program | Health First Colorado |
| State | Colorado |
| Type of Program | Medicaid |
| Cost | Free or low-cost |
| Who is it for? | Colorado children and adults who qualify |
| Qualification Criteria | Meets monthly income requirements |
| Enrollment | Year-round |
| Application | Connect for Health Colorado or Colorado's Program Eligibility and Application Kit (PEAK) |
| Notification | Via mail, email, or PEAK account |
| Additional Benefits | Behavioral health services, including mental health and substance use disorder care |
| Other Options | Child Health Plan Plus (CHP+), Medicare Savings Program |
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What You'll Learn
Income requirements
Health First Colorado is Colorado's Medicaid program. It is free or low-cost health care for Colorado children and adults who qualify. There are no limits to how much money or other resources you can have for income-based Health First Colorado (Medicaid). However, if your income is low enough and you meet all other requirements, you should sign up for Health First Colorado (Medicaid) or Child Health Plan Plus (CHP+).
The income requirements for Health First Colorado are as follows:
- Children up to age 18: Up to 147% of FPL to qualify for Medicaid.
- Children up to age 18 who aren’t eligible for Medicaid can qualify for Child Health Plan Plus (CHP+; Colorado’s CHIP coverage) with household income up to 265% of FPL.
- Pregnant women: Up to 200% of FPL to qualify for Medicaid.
- Pregnant women who don’t qualify for Medicaid can qualify for CHP+ with family income up to 265% of FPL.
- Adults under the age of 65: Household income up to 138% of FPL.
If you are a US citizen or a non-citizen who qualifies, income-based Health First Colorado (Medicaid) might cover you. 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 non-citizens who meet specific non-citizen requirements qualify for the same programs that US citizens can get.
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Health First Colorado
To qualify for Health First Colorado, applicants must meet specific monthly income requirements. The Affordable Care Act has simplified the method for calculating income eligibility, using what is called Modified Adjusted Gross Income (MAGI). MAGI rules apply to eligibility determinations for most Health First Colorado programs, except for those for individuals over 65 or with a disability.
Some of the benefits of Health First Colorado include:
- No co-pays for those aged 18 and younger, pregnant women, or American Indians and Alaska Natives
- Co-pays only for prescription drugs for qualifying former foster care youth
- No co-pays for those residing in a nursing facility
If you are applying for Health First Colorado for individuals over 65 or with a disability, you may be asked to provide additional information, including:
- Whether you have a medical condition that has seriously limited your ability to do daily activities for at least a year
- Whether you need help with daily activities, such as dressing, eating, and bathing
- Any health care coverage received through Medicare
- Unearned income, such as Social Security Administration (SSA) or Supplemental Security Income (SSI) payments and pensions
Applications for Health First Colorado can be submitted through Connect for Health Colorado or Colorado's Program Eligibility and Application Kit (PEAK) eligibility system at any time during the year. There is no open enrollment period. You can apply online, in person, by phone, or by mail.
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Child Health Plan Plus
Each year, the maximum amount of money (referred to as an out-of-pocket limit) that CHP+ enrollees are required to spend on healthcare payments is 5% of their annual income. CHP+ members may also have to pay an annual enrollment fee, which is due within 30 days of approval. If the fee is not paid within this time, the application will be denied, and the family will need to re-apply.
If you make too much to qualify for Medicaid, your family might qualify for CHP+. If you have any problems or questions about your CHP+ eligibility or enrollment, you can call Health First Colorado Enrollment at 888-367-6557.
You can apply for CHP+ online, by phone, by mail, or in person. If you apply online, you will need to visit colorado.gov/PEAK and click on the "Apply for Benefits" box. This application may take 30 to 60 minutes. If you apply by phone, you can call 800-221-3943 or use State Relay 711, Monday through Friday from 8:00 a.m. to 4:00 p.m. To apply by mail, you can download and print a paper application and send it to your local county office or a local application assistance site. If you apply in person, you can visit your local county office or a local application assistance site.
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Application process
To apply for Medicaid in Colorado, you must be a resident of the state. You can apply for Colorado's Medicaid program, Health First Colorado, at any time during the year if you qualify. There is no open enrollment period.
You can apply through Connect for Health Colorado or Colorado's Program Eligibility and Application Kit (PEAK) eligibility system. You can also apply in person at your local county office or an Application Assistance Site. If you need help filling out your application packet, you can contact your county eligibility worker or make an appointment at an application assistance site.
If you are enrolled in Health First Colorado or Child Health Plan Plus (CHP+) and do not receive food assistance, cash assistance, or financial assistance to purchase private health insurance through Connect for Health Colorado, you can call the Member Contact Center at 1-800-221-3943 / State Relay: 711 to change your name.
If you are enrolled in Health First Colorado, you can manage your account and update your information through Colorado PEAK and the Health First Colorado mobile app.
If you are enrolled in Medicare, you can get help with questions about health insurance through Health First Colorado.
If you are enrolled in Health First Colorado and need mental health care and/or substance use disorder services, talk to your primary care provider or contact your regional organization. All Health First Colorado members can get behavioral health services. However, if you have other insurance, you must use that insurance first before using Health First Colorado benefits.
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Other insurance coverage
If you are a resident of Colorado and are enrolled in another insurance program, you may still qualify for Health First Colorado (Colorado's Medicaid program) or Child Health Plan Plus (CHP+). If you are enrolled in Medicare, you can contact the Colorado State Health Insurance Assistance Program (Colorado SHIP) for assistance. If you are an active or former member of the military, naval, or air service, you can also qualify for Health First Colorado and CHP+.
If you have employer-provided health insurance, you may still qualify for Health First Colorado as a secondary insurance. However, you must first use your employer-provided insurance before using Health First Colorado benefits. If you have private insurance, you can still purchase a separate Health First Colorado plan, but you will not qualify for financial aid to lower the cost of your insurance plan.
If you are enrolled in Health First Colorado and your circumstances change, you should begin researching other insurance coverage options to avoid becoming uninsured. For example, if you start a new job that puts you over the income limit for Medicaid, you may need to switch to a different insurance plan. You can use PEAK to manage your Health First Colorado benefits and make changes to your coverage if necessary.
If you do not qualify for Health First Colorado or CHP+, you may be able to receive financial assistance to lower the cost of private health insurance through Connect for Health Colorado. The amount of financial assistance you can receive depends on factors such as the cost of premiums in your area, the size of your household, and your estimated yearly income.
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Frequently asked questions
Health First Colorado is Colorado's Medicaid program. It provides free or low-cost health care for Colorado children and adults who qualify.
To qualify for Health First Colorado, you must be a resident of Colorado and meet specific monthly income requirements. You can apply through Connect for Health Colorado or Colorado's Program Eligibility and Application Kit (PEAK) eligibility system.
Yes, you can still purchase a private health insurance plan at full price if you qualify for Health First Colorado. However, you will not qualify for financial help to lower the cost of your health insurance plan through Connect for Health Colorado.
If you do not qualify for Health First Colorado, you may still be able to get financial help to lower the cost of private health insurance through Connect for Health Colorado. You can also look into other programs such as the Child Health Plan Plus (CHP+), which offers public low-cost health insurance for certain children and pregnant women.
