Colorado Medicaid

By Dick Dorrough ~

In Colorado, Medicaid is called Health First Colorado and is administered by the Colorado Department of Health Care Policy & Financing.

Medicaid is a wide-ranging health care insurance program for low-income individuals of all ages.

Colorado Medicaid, called Health First Colorado, provides medical coverage to low-income individuals through various state-specific programs. It’s governed by Federal Medicaid law and regulations. There are a variety of programs and waivers, but this article will cover Medicaid for the disabled and blind, and people over 65 years of age.

Is Medicaid available for people with disabilities?

People under age 65 can qualify for Medicaid on the basis of blindness or a disability that they have had since birth and others who have disabling conditions acquired through illness, injury, or trauma.

Over one-third of Medicaid beneficiaries who qualify on the basis of a disability do so through receipt of Supplemental Security Income (SSI), the federal cash assistance program for the elderly and people with disabilities who have low levels of income and assets. In most states, SSI beneficiaries are automatically eligible for Medicaid. Adults in the Social Security Disability Insurance (SSDI) program may obtain Medicare after a 24-month waiting period.

What about seniors who need assistance with their care?

Colorado Long Term Care Medicaid’s services are primarily care and residence in nursing facilities and Home and Community Based Services (HCBS). 

Nursing home facilities provide 24/7 nursing and will typically take Medicaid as soon as a patient enters care and qualifies for the assistance.

HCBS take place in a variety of locations such as personal residence or a care community. HCBS may include assistance by a nurse, a home health aide, or other personal care provider and includes services such as house cleaning, meal preparation and assistance with bathing and dressing. 

Some assisted living and memory care communities will accept Medicaid, but almost all require a period of time the resident pays all the expenses associated with their care before they can transition to Medicaid. The period of time varies by community. This is known as a “spend down” period, and is sometimes confused with the same term used by Medicaid. Medicaid uses the term to apply to period when an applicant is spending down their financial assets to reach eligibility limits. 

What does it take to qualify for Colorado Long Term Care Medicaid?

• Individual Asset Cap of $2,000
• Funds in excess of the gap must be spent down to qualify for assistance.
• Individual Income Cap of $2,382

Qualified Income Trusts (QIT’s), also referred to as Miller Trusts, are for Medicaid applicants who are over the income limit, but still cannot afford to pay for their long-term care. Income over the Medicaid limit is directly deposited into a irreversible account. Cost of care is recovered by Medicaid from this account. Upon death of the Medicaid participant or in the event of Medicaid disenrollment, the remainder of the funds must be paid to the Colorado Department of Health Care.

Many seniors who aren’t currently eligible for Medicaid because of excess income or assets still cannot afford their cost of care.  Medicaid planning can help create strategies to become eligible as quickly as possible, sometimes while preserving assets and homes.

Dick Dorrough is a Certified Medicaid Planner and has been helping Colorado residents obtain Long Term Care Medicaid for six years.