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Learn About Medicaid Costs and Coverage in Colorado

Medicaid coverage in Colorado can span a variety of services depending on the eligibility of an applicant. Knowing how much does Medicaid cost an approved claimant is also contingent on his or her qualifications. Conditional to the types of Medicaid insurance Colorado petitioners are enrolled, some health care services may be completely covered while others will have a nominal fee. Medicaid costs and coverage can fluctuate greatly, since there are many different moving parts involved in the Medicaid program. In fact, Medicaid cost estimates usually detail if there are any deductibles, copayments or premiums attached to services. Learning what services are covered by Medicaid can help beneficiaries prepare for medical expenses. To find out how much is Medicaid in Colorado and what health care services are covered under the program, continue reading the outlined information below.

What services are covered by Medicaid in Colorado?

Understanding the services covered by Medicaid in Colorado can directly influence whether an applicant wishes to apply for the Medicaid program. Every state has its own types of Medicaid insurance coverage available. While the program has federal mandates on which services and treatments must be included for applicant, the state has additional coverage to enrollees. These mandatory health care services include transportation to medical care, laboratory tests, inpatient and outpatient care as well as:

  • Dialysis treatment.
  • Family planning.
  • General radiography.
  • Home health services.
  • Immunizations.

Colorado has a comprehensive list of services covered by Medicaid that the state has approved for eligible candidates. It is worth understanding the Medicaid coverage services can vary based on the age of the enrollee. For instance, dental care and hearing aids may be extended to children but not to adult participants in the Medicaid program.

Discover more information regarding Medicaid coverage by downloading our free guide today.

What services are not covered by Medicaid in Colorado?

What does Medicaid not cover? Medicaid coverage in Colorado generally includes a very broad level of health insurance benefits. While learning the types of services covered by Medicaid in Colorado is important, it is equally important to understand the services Medicaid does not cover. Services not covered by Medicaid are also considered optional services. Colorado offers optional benefits, which depending on the level of eligibility, may carry premiums, deductibles and heavier copayments for applicants. A few of the Medicaid coverage benefits that are optional include but are not limited to:

  • Hospice services and respiratory care
  • Cosmetic services or surgeries
  • Chiropractic and occupational therapy
  • Private nursing services
  • Prosthetic devices, eyeglasses and orthotic appliances

It is important to understand that the type of Medicaid insurance coverage available will vary depending on the applicant. Age, services, income requirements and level of qualification will all greatly affect the benefit options available per applicant.

How much does Medicaid cost in Colorado?

Colorado Medicaid coverage may be entirely free for many applicants, depending on their level of eligibility. However, Medicaid cost estimates in CO for higher earners may include copayments and deductibles. Small copayments may be required for select Medicaid services, but these are usually just a few dollars. While exact costs for coverage for Medicaid cannot be detailed due to eligibility factors as well as the numerous health care services available, estimated costs for Medicaid are very low as the program is specifically for those in financial need.

It is important for new applicants to understand the types of Medicaid costs like premiums, deductibles and copayments that may be involved in common services. For instance, knowing what to expect to pay for at emergency care versus scheduling a doctor’s appointment, can make a difference in chosen services. Out-of-pocket expenses should be understood for all Medicaid coverage services in order to avoid any financial headaches or burdens down the road.

While applicants may have some sort of Medicaid coverage copayment to receive particular services and treatments, applicants who falls under certain categories will not have to pay any copayment fees. For example, if an applicant is 18 years of age and younger, an American Indian or Alaska Native or if she is pregnant, copayments are not needed. If a Medicaid applicant is a qualifying former foster care youth, then he or she will only need to pay copayments for prescription drugs. Those Medicaid applicants living in a nursing facility typically do not have to pay any copayments. For an applicant to understand their level of eligibility for Medicaid coverages better, he or she will need to submit an application and receive further information.

Beyond copayments, Medicaid coverage costs can also include premiums and deductibles for treatments and services. Depending on the type of Medicaid insurance options available, an applicant may need to pay a deductible in order to receive particular service. While rare, premiums are still in effect for different levels of enrollment and eligibility, usually for applicant with a higher income. There is also the possibility that instead of a deductible or premium, an applicant is required to pay an annual enrollment fee.

Download our free guide for specific details about Medicaid and receiving health care coverage.