Health Coverage Programs

CKF’s work focuses on three main health coverage programs: Health First Colorado, CHP+, and financial assistance through Connect for Health Colorado.

Health Coverage Programs

CKF’s work focuses on three main health coverage programs: Health First Colorado, CHP+, and financial assistance through Connect for Health Colorado.

Health First Colorado

What: Colorado’s Medicaid program, administered by the Colorado Department of Health Care Policy and Financing (HCPF), Colorado’s Medicaid Agency.
Eligibility: Low or no-cost health coverage for low income children, pregnant women, some adults, and people living with disabilities. To qualify for Health First Colorado, individuals need to meet certain income requirements, must be lawfully present in the U.S., be a resident of Colorado, and meet other qualifications specific to the program.
Cost: Low or no-cost, dependent on income.
Application: An individual can fill out the online PEAK application or get in-person help. In-person help is offered in several ways: by the county health and human services department, medical assistance sites, or community-based organizations.

Child Health Plan Plus (CHP+)

What: Colorado’s Children’s Health Insurance Program (CHIP).
Eligibility: Health coverage for children (ages 0-18) and pregnant women who make too much money to qualify for Medicaid. To qualify for CHP+, individuals must meet certain income requirements, be lawfully present in the U.S., be a resident of Colorado, and meet other qualifications.
Cost:  Dependent on income. There is an annual enrollment fee for children which must be paid within 30 days to complete enrollment.
Application: An individual can fill out the online PEAK application get in-person help. In-person help is offered in several ways: by the county health and human services department, medical assistance sites, or community-based organizations.

Connect for Health Colorado

What: Colorado’s state-based health insurance marketplace established under the Affordable Care Act.
Eligibility: Health coverage for individuals of all ages. To purchase health coverage on Connect for Health Colorado, individuals must be lawfully present in the U.S. Subsidies are available based on an individual’s income and eligibility for other coverage, including Health First Colorado, CHP+, and affordable employer-sponsored insurance. Low-income immigrants who are not eligible for Health First Colorado because of their immigration status are also allowed to purchase on Connect for Health Colorado.
Cost: Dependent on plan purchased. Financial Assistance is available through Advanced Premium Tax Credits (APTCs) and Cost Sharing Reductions. APTCs are available for individuals with incomes up with 400 percent of the Federal Poverty Line and help lower the cost of the monthly premium. CSRs are automatically applied for individuals with income below 250 percent of the FPL who purchase a silver level plan and help lower the cost of out of pocket costs, such as deductibles and copays.
Application: An individual can fill out an online PEAK application, through the Connect for Health Colorado website, or get in person help. In-person help is offered by an insurance broker or enrollment assister at community-based organizations.

Health First Colorado

What: Colorado’s Medicaid program, administered by the Colorado Department of Health Care Policy and Financing (HCPF), Colorado’s Medicaid Agency.
Eligibility: Low or no-cost health coverage for low income children, pregnant women, some adults, and people living with disabilities. To qualify for Health First Colorado, individuals need to meet certain income requirements, must be lawfully present in the U.S., be a resident of Colorado, and meet other qualifications specific to the program.
Cost: Low or no-cost, dependent on income.
Application: An individual can fill out the online PEAK application or get in-person help. In-person help is offered in several ways: by the county health and human services department, medical assistance sites, or community-based organizations.

Child Health Plan Plus (CHP+)

What: Colorado’s Children’s Health Insurance Program (CHIP).
Eligibility: Health coverage for children (ages 0-18) and pregnant women who make too much money to qualify for Medicaid. To qualify for CHP+, individuals must meet certain income requirements, be lawfully present in the U.S., be a resident of Colorado, and meet other qualifications.
Cost:  Dependent on income. There is an annual enrollment fee for children which must be paid within 30 days to complete enrollment.
Application: An individual can fill out the online PEAK application get in-person help. In-person help is offered in several ways: by the county health and human services department, medical assistance sites, or community-based organizations.

Connect for Health Colorado

What: Colorado’s state-based health insurance marketplace established under the Affordable Care Act.
Eligibility: Health coverage for individuals of all ages. To purchase health coverage on Connect for Health Colorado, individuals must be lawfully present in the U.S. Subsidies are available based on an individual’s income and eligibility for other coverage, including Health First Colorado, CHP+, and affordable employer-sponsored insurance. Low-income immigrants who are not eligible for Health First Colorado because of their immigration status are also allowed to purchase on Connect for Health Colorado.
Cost: Dependent on plan purchased. Financial Assistance is available through Advanced Premium Tax Credits (APTCs) and Cost Sharing Reductions. APTCs are available for individuals with incomes up with 400 percent of the Federal Poverty Line and help lower the cost of the monthly premium. CSRs are automatically applied for individuals with income below 250 percent of the FPL who purchase a silver level plan and help lower the cost of out of pocket costs, such as deductibles and copays.
Application: An individual can fill out an online PEAK application, through the Connect for Health Colorado website, or get in person help. In-person help is offered by an insurance broker or enrollment assister at community-based organizations.

Health Coverage Systems

Health Coverage Systems

PEAK

PEAK is Colorado’s online application for public assistance programs. Individuals and families can use it to apply at home, or they may use it if they visit a community-based organization for help. PEAK interfaces with Colorado Benefits Management System (CBMS) (see description below): when a person enters their information in PEAK, their information is sent to CBMS, which makes the eligibility determination. In many cases, a person’s eligibility for Health First Colorado can be determined quickly, within a few minutes to 24 hours. This means that person can often receive a “real time” eligibility determination through PEAK.

Colorado Benefits Management System

Colorado Benefits Management System (CBMS) is the state’s technology system which determines if a person qualifies for Health First Colorado or CHP+, as well as many other public programs, such as the Supplemental Food Assistance Program (SNAP) and adult financial assistance programs. CBMS makes eligibility determinations by connecting to several electronic verification systems which can verify a person’s identity, income, and citizenship or lawful immigration status. Information is inputted into CBMS by eligibility technicians at county health and human services offices or automatically from PEAK. The Governor’s Office of Information Technology (OIT) administers CBMS, and partners with state agencies such as HCPF and the Colorado Department of Human Services (CDHS).

Connect for Health Colorado Eligibility System

The Connect for Health Colorado Eligibility System determines if a person is eligible for APTCs or CSRs. If a person is eligible for APTCs or CSRs, the Connect for Health Colorado Eligibility System will then connect the consumer with the opportunity to shop for a qualified health plan with APTC and CSR discounts. Connect for Health Colorado administers this eligibility system, working closely with state agencies.

PEAK

PEAK is Colorado’s online application for public assistance programs. Individuals and families can use it to apply at home, or they may use it if they visit a community-based organization for help. PEAK interfaces with Colorado Benefits Management System (CBMS) (see description below): when a person enters their information in PEAK, their information is sent to CBMS, which makes the eligibility determination. In many cases, a person’s eligibility for Health First Colorado can be determined quickly, within a few minutes to 24 hours. This means that person can often receive a “real time” eligibility determination through PEAK.

Colorado Benefits Management System

Colorado Benefits Management System (CBMS) is the state’s technology system which determines if a person qualifies for Health First Colorado or CHP+, as well as many other public programs, such as the Supplemental Food Assistance Program (SNAP) and adult financial assistance programs. CBMS makes eligibility determinations by connecting to several electronic verification systems which can verify a person’s identity, income, and citizenship or lawful immigration status. Information is inputted into CBMS by eligibility technicians at county health and human services offices or automatically from PEAK. The Governor’s Office of Information Technology (OIT) administers CBMS, and partners with state agencies such as HCPF and the Colorado Department of Human Services (CDHS).

Connect for Health Colorado Eligibility System

The Connect for Health Colorado Eligibility System determines if a person is eligible for APTCs or CSRs. If a person is eligible for APTCs or CSRs, the Connect for Health Colorado Eligibility System will then connect the consumer with the opportunity to shop for a qualified health plan with APTC and CSR discounts. Connect for Health Colorado administers this eligibility system, working closely with state agencies.