Medicaid & Waiver Information
Medicaid is a program, funded by the federal and state governments, which pays for medical care for low income people and those with special health care needs who are eligible for specific programs. Health First Colorado is the name of Colorado’s Medicaid program. Child Health Plan Plus is a low cost insurance program for children and pregnant women who do not qualify for Medicaid but cannot afford private insurance.
Medicaid waivers enable people (including children) who wouldn’t otherwise qualify for Medicaid due to income or assets to access Medicaid benefits even if the person already has private insurance. In the case of families, parental income is not considered for eligibility. Only a child’s assets or income is considered. Therefore, many children with extraordinary health care needs qualify for Medicaid waivers because they have few assets. A child must have institutional-level of care requirements to be eligible for these waivers.
For help in knowing how to see if your child might qualify for Medicaid or any of the waivers, you can start with Medicaid Eligibility Family and Children’s Programs or How to apply for Health First Colorado or Child Health Plan Plus
Health First Colorado Buy-In The Medicaid Buy-In Program for Children with Disabilities (Children’s Buy-In) is a medical assistance program that will provide Medicaid benefits for children who are under age 19, have a qualifying disability, and whose adjusted family income is at or below 300% of the Federal Poverty Level (FPL). There is also a program for Working Adults with Disabilities.
Colorado’s Medicaid Waivers are administered through the Department of Health Care, Policy and Financing. You can access specific information through the following links:
Adult Programs, including Medicaid Waiver Programs
Children’s Programs, including Medicaid Waiver Programs
Information for Parents and Caregivers
Physical and Developmental Disabilities (Children and Adults)
Behavioral Health Services and Providers (All children and adults covered by Health First Colorado are eligible for a behavioral health services)
You can find charts that compare the different Medicaid Waiver options for children and adults on the Long Term Services and Supports Training page. These charts are helpful to find out who to contact for eligibility and other questions about Medicaid waivers.
P2P Note: In July 2012, the governor appointed a Community Living Advisory Group to review long term supports and services in Colorado. Multiple recommendations for change from this group are being implemented and various committees have been formed to give stakeholder input into these changes. For more information and ways to get involved, see this page for Committees, Boards and Collaboration.
Colorado Financial Programs – a listing of different programs available in Colorado. Application for many programs, including medical, food, and financial assistance programs can be completed online at Colorado PEAK
Community Centered Boards (CCB) manage and deliver services, in partnership with private service providers, to individuals with developmental disabilities and their families throughout the state of Colorado. The CCB case manages specific Medicaid waiver programs for children and adults. Each CCB operates in a designated geographic area.
Consumer Directed Attendant Services (CDASS) Consumer Directed Attendant Support Services (CDASS) is a Medicaid benefit under the Home and Community Based Services that allow clients to manage their attendant services.
Early Periodic Screening, Diagnostic & Treatment (EPSDT) are services provided to youth who are Medicaid eligible.
Family Voices of Colorado – offers tools and resources for families online as well as individual navigation for families who may need help advocating for Medicaid equipment or services for their family member. Read a story about one family here!
In-Home Support Services – Available for people enrolled in the HCBS-EBD or Children’s HCBS Waiver program who want more choice and control in their home care.
Parents as Certified Nurse Assistant – family members can be trained and are allowed to provide Medicaid services under this program. Multiple home health care agencies provide this training. Check out our P2P sponsors on the HOME page for home health agencies that will also train you to be a CNA.
Program Approved Service Agencies are regulated through the Colorado Department of Public Health and Environment. You can find more information on facilities and provider agencies here. Some families seek to become their own PASA. This link will provide you with more information.
Single Entry Point (SEP) Agencies – provide case management, care planning, and make referrals to other resources for Health First Colorado (Colorado’s Medicaid Program) members with the following qualifying needs: elderly, blind and disabled, mental health, persons living with AIDS, brain injury, spinal cord injury, children with a life-limiting illness, children with a physical disability.
Transportation to Medicaid services appointments – may be provided if no other transportation resources are available.
Online Database of Medicaid Services provided by the Kaiser Family Foundation. This allows you to search for Medicaid services in a specific state. Very helpful if you are considering a move!
Understanding Medicaid Home and Community Services: A Primer – (P2P note – This is not a family friendly or easy to read summary. It is very detailed information.)