Ten Things You Need to Know About Colorado Medicaid

Ten Things You Need to Know About Colorado Medicaid

Medicaid is a complicated system made of multiple programs serving a variety of incomes, ages, and abilities.  Here are some things to remember about Colorado’s Medicaid programs; be sure to talk to an experienced technician or case manager for more specifics on your situation:

  1. It’s not only for families on “welfare”.  Colorado provides Medicaid benefits to two groups: those with low-income and those with disabilities.  Income limits vary per program, from 10% to well over 400% of the Federal Poverty Guidelines.  Some programs have additional criteria, such as the need for care equal to that of a nursing facility or hospital, while others merely require your income to be below the income limit.
  2. You can apply online.  Colorado’s online application system launched about a year ago for certain family programs, and in March added the remaining programs.  Go to www.colorado.gov/PEAK and check it out.
  3. You dont need to have children.  If you are have very low income (less than about $91 per month), or if you have a disabling condition, you may qualify for one or for several Medicaid programs, including special “waiver” programs for those with  disabilities whose income is in excess of Social Security’s limits for Medicaid.
  4. It sometimes pays for more than medical bills.  If you qualify for low-income Medicaid or for the Medicaid Buy-In programs (where you purchase Medicaid coverage on a tiered scale), then Medicaid may pay your medical bills up to 90 days back from your date of application.  There are restrictions (as always), but this could definitely help.
  5. It might pay for your private insurance.  The Health Insurance Buy-In was designed to pay for your insurance as a way of saving the State on Medicaid costs.  It does have a limited number of slots every year, but it’s free to apply and doesn’t cost to particpate in.
  6. It doesnt penalize you for having money in the bank.  Most Medicaid programs, other than the waivers and SSI-based Medicaid, don’t consider your assets when determining your eligibility.  So, you can actually have that extra car for work or that retirement account and not lose your benefits. 
  7. It’s not available to those without proof of legal residency.  Unless you’re a pregnant woman who meets all the other income guidelines, you CANNOT get benefits if you are undocumented.  This has always been the case.  And the undocumented pregnant woman?  It’s really the baby who is the target of the care; the mother loses benefits pretty quickly after the birth.
  8. You dont have to be poor to access benefits.  Colorado has several programs for individuals with disabilities who work or whose income (or their family’s) is too high for other programs.  The Buy-In programs have a limit from 300-450% of the Federal Poverty Guidelines, while programs such as the waivers for children disregard parent income althogether.
  9. It’s available just about anywhere in the state.  You don’t have to be in Denver or the Front Range to access services.  Medicaid technically works just about everywhere in the State, and there are clinics, hospitals, and providers available just about everywhere too.  Medicaid even has programs to help defer the cost of non-emergency travel in some cases
  10. It doesn’t require you to “spend down” your savings to enter a nursing home.  Perhaps one of the biggest misunderstandings in Medicaid lore is the spend-down.  While there may be times to spend the remaining resources to below the limits (about $2000 for an individual), those with substantial resources must be very careful when allocating or moving resources to avoid disqualification for Medicaid.  One useful answer: the revocable Living Trust.  When done well–and in time–the Trust can protect much of your money, allowing you to access the services you need and the money you need pay for other things.