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Learn About Requirements for Medicaid in Colorado

“What are the requirements for Medicaid in Colorado?” is a frequent question applicants interested in receiving health care assistance ask before applying. Understanding how to qualify for Medicaid helps potential beneficiaries complete an application and increases their chances of acquiring medical insurance. Many variables go into figuring out who is eligible for Medicaid and knowing the qualifications before beginning an application helps applicants decide whether they should apply to the Medicaid program. However, all applicants are encouraged to apply for the Medicaid program in Colorado, otherwise known as Health First Colorado, if they meet the basic income and residency status requirements. Since Medicaid is a state and federally funded program, petitioners also ask, “What are the income requirements for Medicaid in CO?” because meeting income requirements is the largest determining factor in who receives Medicaid benefits. To understand who is eligible for Medicaid in CO, review the sections below.

Who qualifies for Medicaid in Colorado?

Determining who is eligible for Medicaid in Colorado begins with petitioners who meet income requirements. CO Medicaid benefits eligibility consider earnings as Medicaid is an assistance program designed to provide health care to low-income households. Medicaid eligibility requirements extend to pregnant women who are older than 19 years of age. Furthermore, children between the birth and 18 years of age can qualify for medical assistance through Health First Colorado’s CHIP program, Child Health Plan Plus. Parents and caretakers of minors may also be eligible for Health First Colorado as well as single adults who meet the income requirements.

Additionally, there are specific Medicaid restrictions all applicants must comply with in order to qualify for health care assistance. These Medicaid eligibility requirements are in place to protect the program from admitting fraudulent beneficiaries while also protecting qualified households from being denied Medicaid assistance . The specific requirements for Medicaid benefits eligibility all applicants must meet are as follows:

  • Applicants must be United States citizens or legal residents of the country with resident status for at least five years
  • Applicants must be a resident of Colorado
  • Applicants must meet the income limit

If an applicant meets the above eligibility requirements for Medicaid, then they can begin the application process to receive medical assistance.

While Medicaid benefits eligibility generally encompasses adults between the 18 and 64 years of age, there are specialized programs for adults who fall outside of this spectrum. These programs are worth noting for any adult who meets Medicaid income requirements seeking medical assistance through the government. For example, senior citizens are not considered eligible for the Medicaid program in Colorado if they older than 65 years of age. However, any senior citizen who is classified as low-income should look into Colorado’s Medicare program. Additionally, an employed adult who is eligible for Medicaid with a qualifying disability and between 16 and 64 years of age should look into the Health First Colorado Buy-In program. This program is an expansion of the Health First Colorado Medicaid program and can offer additional aid for working adults with disabilities.

Note: Veterans are also eligible to enroll in Medicaid assistance. Veterans who are enrolled in a veteran’s health care program may also be qualified for Medicaid assistance assuming they meet Medicaid’s income requirements.

What are the income requirements for Medicaid in Colorado?

The Medicaid income requirements in Colorado are consistent with the federal statute on income eligibility. While the Medicaid income requirement varies by a household’s specific circumstances, all eligible Medicaid applicants should have an adjusted gross income that is less than the threshold for their household size. The monetary amount a household can make and still qualify for Medicaid increases as the number of household members increase.

In order to qualify for Medicaid in CO, children between younger than 19 years of age as well as pregnant woman older than 19 years of age will qualify for Medicaid coverage with an income of less than 260 percent of the federal poverty level. In order to meet Medicaid eligibility requirements, parents, caretakers and adults without dependents should have a gross household income that does not exceed 133 percent of the federal poverty level.

Download our free guide for specific details about Medicaid income requirements.

What are the Medicaid application guidelines in Colorado?

The Medicaid application guidelines in Colorado begin with supplying supportive documentation that proves an applicant meets the basic eligibility requirements. If an applicant can prove he or she meets Medicaid eligibility requirements by providing supplemental documents such as a Social Security Number, proof of legal residency in the United States or a birth certificate, then he or she has met the first requirements for the Medicaid application guidelines.

What are common disqualifications for Medicaid in Colorado?

Medicaid benefits eligibility are highly dependent upon an applicant’s household income. Therefore, meeting the federal income limit for Medicaid is crucial for an applicant’s admittance into the program. Additional reasons petitioners are disqualified from receiving medical assistance include being unable to provide supplemental documents to verify their identity. For example, an individual may qualify for Medicaid according to his or her economic status, but may be unable to provide a Social Security Number. In order to prevent disqualification from Medicaid benefits, applicants should ensure they have met all of the eligibility requirements before submitting their applications.

Review our free guide today to get more information about the Medicaid application process.