Renewal Guidance
February 4, 2022
Outlined updated renewal process for Medical Assistance programs, including the ex-parte process, verification, reasonable compatibility, and new signature policy.Health First Colorado Buy-In Programs Income Guidelines
March 1, 2022
Updated income guidelines for Health First Colorado Children with Disabilities and Working Adults with Disabilities programs.Health First Colorado Children with Disabilities Buy-In
Health First Colorado Buy-In for Working Adults with Disabilities
Health First Colorado CHP+ Income Guidelines
March 10, 2022
Adjusted income guidelines for MAGI programs.2022 Health First Colorado Income Chart
PHE Unwind and Member Communications
May 19, 2022
Instructed Regional Accountable Entities (RAEs) and Managed Care Organizations (MCOs) to assist in outreach to Health First Colorado and CHP+ members during the renewal process, including sending text and email communications to members regarding the renewal process.CHP+ July 2022 Updated Federal Poverty Level Guidelines
July 19, 2022
Updated CBMS to reflect the elimination of the CHP+ enrollment fees for all applications received on or after July 1, 2022.Implementation of Health First Colorado Buy-in Program for Working Adults with Disabilities: Age 65 and Older Population
May 13, 2022
Updated that as of July 1, 2022, there is no maximum age limit for WAwD.PM 22-002 Health First Colorado Buy-In Programs
Working Adults with Disabilities 65 and Older FAQ
Working Adults with Disabilities 65+Training
Postpartum Expansion to 12 Months
June 6, 2022
Expanded Health First Colorado and CHP+ postpartum coverage to 12 months, regardless of any changes in circumstances.Medical Assistance New Limited Family Planning Services Income Expansion
June 6, 2022
Implemented limited family planning services to Coloradans of any age or gender, including individuals who are not pregnant or incarcerated, and not eligible for a Medical Assistance eligibility category that provides full coverage, up to 260% of the federal poverty level.Reproductive Health Services for Undocumented Individuals
June 2, 2022
Implemented reproductive health care services for Coloradans who are not otherwise eligible for coverage under any other Medicaid program due to their citizenship or immigration status. There are no restrictions on this benefit related to sex or gender identity.Emergency Medicaid Extended to 12 Months
June 2, 2022
Extended Emergency Medicaid coverage to 12 months.Colorado Cash Back Taxpayer Bill of Rights (TABOR) Refund
August 22, 2022
The Taxpayer Bill of Rights (TABOR) requires the State to refund excess State tax revenue back to taxpayers. The TABOR refunds issued by the Department of Revenue for 2021 will send eligible taxpayers a direct refund through Colorado Cash Back, providing a tax rebate of $750 for individual filers and $1,500 for joint filers.Public Benefits Theft – Amendments to Colorado Revised Statuses Section 18-4-401
August 22, 2022
Amendments to Section 18-4-401 of the Colorado Revised Statutes (C.R.S.) create specific elements for public benefits theft within the existing theft statute. These amendments state how Health First Colorado overpayments can be criminally prosecuted.Remote Application Assistance During the COVID-19 Public Health Emergency
January 6, 2021
During the COVID-19 Public Health Emergency (PHE), enrollment professionals at County Human/Social Services, Medical Assistance Sites, Eligibility Application Partner Sites, Presumptive Eligibility Sites, and Certified Application Assistance Sites can help applicants apply for Medical Assistance remotely. Assisters should complete an Acknowledgement of Receipt of Verbal Consent form and attach it to the application This form states that the assister has authorization to apply on the client’s behalf.Acknowledgement of Verbal Consent
Acknowledgement of Verbal Consent (Spanish)
Connect for Health Colorado Re-Opens Enrollment Period
January 28, 2021
Connect for Health Colorado re-opened enrollment for a special enrollment period (SEP) for Coloradans without health insurance. The SEP is scheduled for February 8 – May 15, 2021.Connect for Health Colorado Statement
Changes to Fraud Investigations during the COVID-19 PHE
February 2, 2021 (going back to March 18, 2020)
Instructed that Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members cannot be terminated due to fraud during the lock-into coverage during the COVID-19 Public Health Emergency and other instructions for fraud investigations.Reduction to the Reasonable Opportunity Period
February 19, 2021
Reduced the Reasonable Opportunity Period (ROP) for income discrepancies from 90 to 30 days. The ROP is the period of time a Health First Colorado or CHP+ member has to submit verification of their income or an explanation if their income is not reasonably compatible with the electronic information. This became effective February 13, 2021.Health First Colorado Buy-In Programs Income Guidelines
March 5, 2021
Updated income guidelines for Health First Colorado Children with Disabilities and Working Adults with Disabilities programs.Health First Colorado Children with Disabilities with Buy-In
Health First Colorado Buy-In for Working Adults with Disabilities
Updated Disability Determination Application
March 12, 2021
Updated the Disability Determination Application to align with Social Security Administration Disability Determination and automated processing within the Colorado Benefits Management System.Connect for Health Colorado Enrollment Period Extended
March 24, 2021
Connect for Health Colorado extended the existing enrollment period through at least August 15, 2021, for all Coloradans regardless of insurance status, following a federal decision to extend the federal open enrollment period.Connect for Health Colorado Statement
Health First Colorado and CHP+ Income Guidelines
April 1, 2021
Adjusted income guidelines for MAGI programs.Health First Colorado Income Chart
Health First Colorado Buy-In Programs Income and Premiums
April 1, 2021
Updated income chart and premium guide for Children with Disabilities Buy-in and Working Adults with Disabilities programs.Codify COVID-19 Federal Regulations
April 11, 2021
Aligned state regulations with the Coronavirus Aid, Relief and Economic Security Act and the Families First Coronavirus Response Act and Maintenance of Effort provisions. Changes included allowing for self-attestation for verifiable information and maintaining eligibility for all members.Expanded Care Locations for Emergency Medical Transportation and Non-Emergent Medical Transportation
April 11, 2021
Allowed for transports to a wider range of locations for Medicaid Emergency Medical Transportation and Non-Emergent Medical Transportation.Enhanced Tax Credits from Connect for Health Colorado
April 15, 2021
Expanded Connect for Health Colorado tax credits due to the changes from the American Rescue Plan Act, including decreasing the cap for costs for all income group and opening zero-dollar benchmark plans for people with unemployment benefits in 2021.Connect for Health Colorado news announcement
COVID-19 Stimulus Payments
April 28, 2021
Clarified that the economic stimulus checks from the American Rescue Plan Act are not considered countable income for MAGI Health First Colorado and CHP+ eligibility and non-MAGI Health First Colorado eligibility. Payments are not a countable resource for 12 months for Non-MAGI programs that include a resource test.CHP+ State Managed Care Network Transition
April 28, 2021
Beginning on July 1, 2021, all CHP+ members will be automatically enrolled into a CHP+ Managed Care Organization (MCO) upon enrolling. Members were previously enrolled in the State Managed Care Network. Members will be transitioned into a CHP+ MCO on July 1, 2021.Changes to MAGI Income Methodologies
June 4, 2021 (going back to March 1, 2021)
Informed about changes for how alimony or spousal support, moving expenses, tuition, student debt, and capital gains are considered for income and asset tests.Income Interfaces for Medical Assistance
June 16, 2021
Notified of two new income interfaces, the Federal Data Services Hub and Equifax The Work Number, to verify income for Health First Colorado and Child Health Plan Plus. The two interfaces will be used in addition to the Income Eligibility Verification System through the Colorado Department of Labor.Affordable Care Act Upheld
June 17, 2021
The U.S. Supreme Court upheld the Affordable Care Act (ACA) in California v. Texas., allowing Medicaid expansion and the ACA marketplaces, as well as all other current provisions from the ACA to stay in effect.Medical Assistance Denial Prior to CICP Benefits
July 15, 2021
Clarified that individuals must receive a denial for Health First Colorado or Child Health Plan Plus before receiving Colorado Indigent Care Program (CICP) benefits.Changes to Non-Emergent Medical Transportation
July 26, 2021
Informed that IntelliRide will reduce its service area to Non-Emergent Medical Transportation (NEMT) to nine counties (Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer, and Weld Counties) effective August 1, 2021. Local transportation providers will administer services to all other counties.Emergency Medicaid
July 29, 2021
Informed about Emergency Medicaid eligibility, benefits, and the application process as well as the removal of the requirement to submit physician statement, or life or limb threatening statement, to receive benefits.Compact of Free Association (COFA) Migrants
August 10, 2021
Informed about new Health First Colorado eligibility for Compact of Free Association (COFA) migrants, which includes people from the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. Eligibility is effective December 27, 2020.Advance Child Tax Credit
August 10, 2021
Clarified that the expanded Advance Child Tax Credit from the American Rescue Plan Act are not considered countable income for MAGI Health First Colorado and CHP+ eligibility and non-MAGI Health First Colorado eligibility. Payments are not a countable resource for 12 months for Non-MAGI programs that include a resource test.Afghan Humanitarian Parolee Medicaid Eligibility
December 8, 2021
Informed about expanded eligibility for Health First Colorado, CHP+, and Refugee Medical Assistance for Afghan Humanitarian Parolees.County Program Accuracy and Performance Compliance
Outlined new incentive eligibility quality assurance and performance compliance program for counties, including performance measures and incentive payments.Increased Resource Limits
Informed about increased resource limits for Qualified Medicare Beneficiaries (QMB), Specified Low Income Medicare Beneficiaries (SLMB), Qualified Individuals (QI-1), and Low-Income Subsidy (LIS).Public Charge
Final rule announced August 14, 2019. While it was set to go into effect on October 15, 2019, lawsuits blocked implementation until February 24, 2020.
The definition of public charge, and corresponding public charge test was announced by U.S. Citizenship and Immigration Services, part of the U.S. Department of Homeland Security.
Public charge information and resources.
Special Enrollment Period Created for COVID-19
March 19, 2020
Created a special enrollment period for uninsured Coloradans to enroll in health insurance through Connect for Health Colorado from March 20 – April 3, 2020.Health First Colorado and CHP+ Income Guidelines
April 1, 2020
Adjusted income guidelines for MAGI programs.
Health First Colorado Income Guidelines
Special Enrollment Period for COVID-19 Extended
April 3, 2020
The Colorado Division of Insurance extended the special enrollment period for uninsured Coloradans to enroll in health insurance through Connect for Health Colorado from April 4 – April 30.Codify COVID-19 Federal Rules for Health First Colorado and CHP+
May 8, 2020
Codified rules from the Coronavirus Aid, Relief, and Economic Security Act and the Families First Coronavirus Response Act, including maintaining continuous enrollment, for the duration of the COVID-19 Public Health Emergency.NEMT Services Expansion
June 10, 2020
Expanded the list of allowable non-emergency medical transportation destinations to include alternative care sites that are not covered places of service.Directives for COVID-19 Continuous Eligibility
June 15, 2020
Communicated Continuous Enrollment policies established by the Families First Coronavirus Response Act, effective March 18, 2020.Self-Attestation of Information During COVID-19
July 14, 2020
Individuals applying during the public health emergency can self-attest to income, Social Security Number, and resources, as well as previous aspects, such as age, state residency, and household composition. After the public health emergency, members will be required to submit documentation or verifications for self-attested items. Members who do not return redeterminations during the public health emergency will be force-passed until the end of the PHE period.Health First Colorado and CHP+ Income Guidelines
April 1, 2019 Adjusted income guidelines for MAGI programs.Health First Colorado Income Guidelines
Updates to CICP SSN Requirements
June 30, 2019
Waives the social security number (SSN) requirement for individuals who are not eligible to receive a SSN or refuse to obtain a SSN due to religious beliefs, allowing individuals who otherwise eligible for CICP to receive services.Increase to Adult Dental Annual Limit
July 1, 2019
Increased the Health First Colorado annual adult dental limit from $1,000 to $1,500.Public Charge
Final rule announced August 14, 2019. While it was set to go into effect on October 15, 2019, lawsuits blocked implementation until February 24, 2020.
The definition of public charge, and corresponding public charge test was announced by U.S. Citizenship and Immigration Services, part of the U.S. Department of Homeland Security.
CHIP Reauthorization
January 22, 2018 (retroactive to October 1, 2017), and February 9, 2018.
A six-year funding extension was passed on January 22, and an additional four years were added on February 9, 2018.
Health First Colorado and CHP + Income Guidelines
April 1, 2018
Adjusted income guidelines for MAGI programs.
Updates to Returned Mail Policy
April 13, 2018
Updated eligibility sites’ outreach process for returned mail. Actions must be taken after one piece of return mail, rather than the previous practice of three pieces of returned mail. This supersedes previous guidance from April 23, 2015.Updates to Citizenship and Identity Verification
May 31, 2018
Allows copies of citizenship and identity documents to be accepted for Medical Assistance applications, in addition to the original documents.Apply Reasonable Compatibility Standard to Non-MAGI Eligibility Verification
June 30, 2018
Updates were made to apply the reasonable compatibility methodology to eligibility verification for non-MAGI groups. This methodology permits a certain difference between self-attested income and what is available through electronic data sources. This practice was already applied to MAGI groups.Children with Autism Waiver sunset
June 30, 2018
The Children with Autism Waiver sunset; the therapies provided under the waiver are available through EPSDT.
Children with Autism Waiver website
Limited Medicaid Benefits Available for Incarcerated Persons
October 16, 2018 (going back to March 1, 2017)
Allows incarcerated individuals who are eligible for certain Medical Assistance categories to maintain limited benefits from Health First Colorado during incarceration.Clarification of Reasonable Opportunity Period for Health First Colorado and CHP+
October 30, 2018
Clarifies that members receiving continuous eligibility have a 90-day reasonable opportunity period to verify their income if their self-attested income is not reasonably compatible with electronic records during the first income check.Health First Colorado and CHP+ Income Guidelines
April 1, 2017
Adjusted income guidelines for MAGI programs.
2017 Health First Colorado Income Chart
Updates to citizenship eligibility
September 30, 2017
Updates were made to rule to include eligibility for children who have a pending Special Immigrant Juvenile status. Work quarters were also removed for CHP+ eligibility.
CHP+ enrollment date adjustment
October 30, 2017
Enrollment begin date in a CHP+ MCO changed from the first day of the month following eligibility determination that occurs on or before the 21st of the month, to a determination that happens on or before the 16th of the month.
Asset Verification Program
December 17, 2017
For non-MAGI categories, assets can now be verified electronically.
Retro closing and exceptions to 10-day noticing
March 20, 2016
Changes were made to the policy and logic in the Colorado Benefits Management System for retroactive, or retro-closing, and noticing for ongoing cases and redeterminations. Clients with the following circumstances will be terminated without 10-day noticing: not requesting assistance, not in the home, not a Colorado resident, or whereabouts unknown.
Income guidelines updated
April 1, 2016
Income guidelines for program eligibility were updated.
Medicaid coverage extended to people residing in Community Corrections facilities (half-way homes)
June 1, 2016
Medicaid-covered services became available to residents of Community Corrections facilities (half-way homes) who would otherwise be Medicaid eligible, including individuals who reside at the facility involuntarily.
Colorado’s Medicaid program name updated to Health First Colorado
June 27, 2016
Medicaid, Colorado’s public health insurance program for low-income Coloradans who qualify, is now called “Health First Colorado.”
Annualized Income
July 1, 2016
As of July 1, 2016, the Colorado Benefits Management System is programmed to use an applicant’s annualized income for Health First Colorado and Child Health Plan Plus (CHP+) eligibility determinations when the person has income from self-employment, commission-based employment, and/or seasonal employment, and is found financially ineligible for all Modified Adjusted Gross Income (MAGI) Medicaid Assistance programs based upon their current monthly income.
Additional updates to the removal of the five-year bar for children and pregnant women
July 1, 2016
The removal of the five-year bar was extended to all Health First Colorado children eligible for non-MAGI programs, and some immigration codes were added.
Health First Colorado and CHP+ eligibility appeal timeline extended to 60 days
September 1, 2016
Health First Colorado applicants and members now have 60 days, as opposed to the previous 30 days, after the eligibility determination date on the Notice of Action to file an eligibility appeal with the Office of Administrative Courts.
Connect for Health Colorado eligibility appeal timeline extended to 60 days
October 1, 2016
Connect for Health Colorado extended the time limit for a customer to file an appeal from 30 days to 60 days to align with the changes to HCPF’s appeals process (listed above).
Minimum Essential Coverage for Dependent Children of Parents and Caretaker Relatives
October 1, 2016
Parents and caretaker relatives who have incomes between 69 and 133 percent of the Federal Poverty Level are required to attest that any dependent children who live with them, under the age of 19, are enrolled in Minimum Essential Coverage in order to be eligible for the Health First Colorado MAGI-Adult category.
Eligibility for refugees and other immigrants
December 30, 2016 (going back to September 2015)
Under the revised policy, individuals who are refugees will no longer be found ineligible for Health First Colorado and CHP+ based upon individuals not changing their status after seven years. Although the rule is effective December 30, 2016, the policy will be applied to applicants who lost coverage going back to September 2015.
Medicaid eligibility income change for Parent and Caretaker Relatives
April 1, 2015
To align with federal requirements and to fully implement the Modified Adjusted Gross Income (MAGI) income conversion for this population, MAGI Parent/Caretaker income threshold was reduced from 107% of the Federal Poverty Level (FPL) to 68% FPL. Parents with incomes above 68% FPL were transitioned to the Adult MAGI Medicaid category.
Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (HCPF)
Elimination of the five year waiting for lawfully present children and pregnant women applying for Medicaid and Child Health Plan Plus (CHP+)
July 1, 2015
Colorado eliminated the five year waiting period for lawfully present children otherwise eligible for MAGI Medicaid and CHP+, and for lawfully present regnant women otherwise eligible for CHP+ in July 2015. State legislation authorizing the elimination of the five year bar was passed in 2009, and funding to fully implement the bill was provided in July 2014. Systems changes were implemented July 2015.
Did you know you might now qualify for Medicaid or CHP+? (CKF Fact Sheet for Clients – English)
¿Sabía que ahora podría calificar para el Medicaid o CHP+? (CKF Fact Sheet for Clients – Spanish)
1115 Demonstration Waiver Extension for Prenatal Medicaid Coverage
August 1, 2015 – July 31, 2020
Colorado requested to maintain its existing authority under a 1115 demonstration waiver to provide Medicaid coverage using title XXI funding for uninsured pregnant women with income above 141 percent through 195 percent of the Federal Poverty Level (FPL). The renewal period will be effective from August 1, 2015 until July 31, 2020.
Centers for Medicare & Medicaid Services Approval Letter
12-month Continuous Eligibility extended to children’s non-MAGI Medicaid programs
October 18, 2015
12-month continuous eligibility was expanded to children enrolled in non-MAGI programs including children eligible for Supplemental Security Income (SSI) mandatory, Pickle, Disabled Adult Child (DAC), Medicaid Buy-In Program for Children with Disabilities and children in Long-Term Care programs such as Children’s Home and Community Based Services (HCBS) waiver and the Children with Autism Waiver (CWA). Continuous eligibility also applies to children under the age of 19 who are no longer eligible for Foster Care Medicaid.
Continuous Eligibility: Frequently Asked Questions (HCPF)
Medicaid eligibility rule review and updates
November 1, 2015
Several updates were made to the Medicaid eligibility regulations set forth in section 8.100.4 to align rule with federal regulations. These updates were made as part of a five-year rule review process. Clarifications were made to rules concerning verifications, MAGI methodology for income calculation, income disregard, household composition, presumptive eligibility, needy newborns, and transitional Medicaid.
Medicaid expansion for adults
January 1, 2014
Medicaid eligibility threshold expanded to 133% of the Federal Poverty Level (FPL) for Adults without Dependent Children, and for Parents and Caretaker relatives.
Parent/Caretaker Relative Federal Poverty Level Changes Frequently Asked Questions (HCPF)
Implementation of 12-month continuous eligibility for kids in MAGI programs
March 1, 2014
Children ages 0-18 will remain eligible and enrolled in one program (either MAGI Medicaid or CHP+) for 12 continuous months regardless of changes to family size or income.
Adult dental Medicaid benefit added
April 1, 2014
Medicaid clients ages 21 and older (including pregnant women) gained access to limited dental benefits in April 2014. Full dental benefits, including restorative procedures and services requiring prior authorization, became available on July 1, 2014.
Extension of reasonable opportunity period to 90 Days
May 1, 2014
The state responded to federal guidance by defining and aligning the reasonable opportunity period for citizens and non-citizen applicants to 90 days.
CHP+ children’s dental benefit expanded
July 1, 2014
The state responded to federal guidance by expanding benefits to include periodontic care, orthodontic care, prosthodontic care, and an increased annual maximum per member from $600 to $1,000.
Removal of Medicaid “stair step” for kids
January 1, 2013
Children between six and 18 with family incomes at or below 133 percent FPL gained Medicaid eligibility.
Increase in Medicaid eligibility for pregnant women
January 1, 2013
Increased the Medicaid eligibility threshold for pregnant women to 185 percent FPL allowing them to access dental benefits and lower cost sharing.
CHP+ expanded to dependents of state employees
January 1, 2013
CHP+ became a health coverage option for dependents of state employees, making their dependents eligible for CHP+ benefits, lower enrollment fees, and fewer out-of-pocket costs.
Implementation of CHP+ health plan automatic enrollment
January 1, 2013
Health Maintenance Organization selection for new CHP+ enrollees is automated to streamline enrollment. CKF continues to recommend that further changes be made to protect family choice.
CHP+ “opt in” options for children of families who have submitted food stamps or a Colorado Works application.
April 30, 2013
Express lane eligibility for children who have submitted an Free/Reduced Lunch application will have the option to “opt-in” for Medical Assistance eligibility determination at participating school districts
March 3, 2013
Removal of CHP+ three-month waiting period
May 1, 2013
Eliminates the three-month waiting period that required children who were covered by health insurance to wait three months before applying for CHP+ if the insurance was through an employer who contributed at least 50% of the premium cost.
Funding Colorado Health Benefit Exchange
Eliminates the three-month waiting period that required children who were covered by health insurance to wait three months before applying for CHP+ if the insurance was through an employer who contributed at least 50% of the premium cost.
Transfer Developmental Disabilities to HCPF
CHP+ Enrollment Fee
January 1, 2012
CHP+ Enrollment Fee increased for families between 205-250% FPL.
CHP+ Co-pay increases
July 1, 2012
Medicaid Buy-In Program for Working Adults with Disabilities (Adult Buy-In)
March 1, 2012
Electronic Identity Verification
Feb. 27, 2012
Department of Motor Vehicles Electronic Interface with the Colorado Benefits Management System for Identity Verifications.
MSB 11-12-09-C
Adults without Dependent Children (AwDC)
April 1, 2012
Medicaid Expansion to Adults without Dependent Children under 10% of FPL.Medicaid Buy-In Program for Children with Disabilities (Children’s Buy-In)
July 1, 2012
Families earning up to 300 percent of the Federal Poverty Level (FPL) can “buy-in” to Medicaid benefits for disabled children via a monthly premium.