Applying for and Maintaining Medicaid

You can use the below chart to figure out what Medicaid application(s) is/are needed, based on the LTC Medicaid applicant’s specific circumstance and if they get Social Security benefits. The chart is meant to be a guide and does NOT replace consulting with a Medicaid expert.

Yes, owning one home and using it as your primary residence is acceptable to Medicaid and does not count as an asset/resource. However, owning a home and using it for income purposes counts as an asset/resource.

Yes. Medicaid is always the payer of last resort.

Check out the Health Insurance Buy-In (HIBI) Program for more information about assistance with private health insurance premiums. You can also find more information about HIBI in the LTC Medicaid and SSA Guide on our Helpful Tools page.

Yes, Colorado Access – Access Medical Enrollment Services (AMES) can review the applications and let you know what pieces are missing, if any. They can also process the completed applications for you.

You can submit the application(s) to your county DHS (Department of Human Services) Medicaid office where you live or to an application assistance site or Eligibility Application Partner, like Colorado Access- Access Medical Enrollment Services (AMES), if working with one.

• Do not submit your Medicaid Disability application directly to Arbor/ARG. It must be submitted to Medicaid, and they will forward it to Arbor.
• There is also information about how to submit Medicaid application(s) in the linked application guides above.

If you want to enroll in an LTC Medicaid waiver and you don’t already have Medicaid, then you must apply for Medicaid. Medicaid pays for the waiver services and supports you will receive through the waiver.

You should not have to complete a new Medicaid application if you already have Foster Care or Adoption Medicaid. Your Medicaid is likely housed in a separate system called the Trails System. Trails is the child welfare database used in Colorado. Only select people in each county have access to the database to confirm a person’s coverage. Call your assigned child welfare contact at Medicaid to let them know you are working to enroll (or helping someone) onto an LTC Medicaid waiver.

Yes, you must reapply in Colorado. Medicaid is a state-run program and does not transfer from state to state.

• You will need to contact Medicaid in your previous state to inform them of the date of your move to Colorado, so they can close your Medicaid coverage in that state. You must then apply for Medicaid in Colorado.
• The exception is if you are receiving SSI, as a new Medicaid application should not be needed for people getting SSI. Contact the county DHS office where you live and ask for SSI Mandatory Medicaid. They will require the following information — proof of your SSI, the full names of everyone in your household, phone number, address, email, authorized representative information, and other pertinent information they require.
• Make sure both Social Security and Medicaid have your updated address and other contact information.
• If you are getting SSDI and not SSI, you will need to complete a Medicaid application.

There are a few ways to find this out:

• Create an account and log into your mysocialsecurityaccount to look up your benefits
• Call Social Security to ask them what type of benefit you get
• Look at your most recent award letter from Social Security. If it says “Supplemental Security Income” at the top of the page, then it is SSI. If it says “Social Security Disability Insurance” at the top, then it is SSDI. Keep in mind that not all SSDI comes with a disability determination.

Yes! The two processes are separate. You must complete your Renewal packet, sign it, and submit it back to Medicaid with current financial documents. Failure to do so, may result in a loss of Medicaid, which would impact your enrollment and ability to start waiver services. 

See the LTC Medicaid and SSA Guide on our Helpful Tools page for more information about your annual Medicaid Renewal.

• App: You can find your renewal date in the Health First Colorado app. After you sign in, go to the “Quick Links” section to find your renewal date. If you need to take action on your renewal, you will see a notice. You can be notified about your renewal through a notification from the Health First Colorado app if you’ve opted in.
• Online: You can find your renewal due date on CO.gov/PEAK at any time. Sign in to PEAK. On the main navigation, choose “Manage my benefits” then “Overview of health coverage benefits.” Find renewal due dates for each household member under “Summary of health coverage benefits.”
• Chatbot: You can use the chatbot on CO.gov/PEAK or Health First Colorado to find your renewal date. Start the chat and choose “Check my benefits.” After confirming your identity, you can access your renewal date.

See these sites/links for Medicaid Renewal information.

• Renewals: What you need to know – Health First Colorado
• The Renewal section of the LTC Medicaid and SSA Guide and the Medicaid Renewal Support document linked on our Helpful Tools page.

You can find a how-to document on our Helpful Tools page for creating a Colorado PEAK account.

• Scroll to the Medicaid Information section and click on Creating a Colorado PEAK Account (Managing Medicaid Benefits).

The disability determination completed with Intake is different from the one through Medicaid.  The disability determination that comes from completing a Medicaid Disability application, or from being approved for SSI and some types of SSDI, requires the person meet Social Security’s definition of a disability. The one Intake completes with you looks at the State of Colorado’s definition of a disability.

That is up to you. You can wait for the decision from Social Security and then if approved for SSI, you can move forward with an enrollment. The SSI application review process can be lengthy. There is also the risk that you will get denied. If services are needed urgently, we suggest you apply for Medicaid and complete a Medicaid Disability application while you wait for the decision from Social Security.

We are not able to help with the application(s), but we created helpful application guides (which you will find under our Other Helpful Resources section below) that you can use while you fill out the application(s).  

• For one-to-one assistance, you can call and schedule an appointment with Colorado Access-AMES.
• See the Health First Colorado Medicaid Application Guide for more information about application assistance as well as the Other Helpful Resources section below.
• Whether you contact Medicaid, Colorado Access-Access Medical Enrollment Services (AMES) or another application assistance provider, you are strongly encouraged to fill out as much of the application(s) on your own, using the guide(s), for a more efficient application assistance appointment.

You can find that information in our application guides under Our Helpful Resources section below.

No, they do not need to re-apply for Medicaid. You must complete the yearly Renewal/Redetermination, but a new application isn’t needed.

Yes, but all trusts a Medicaid recipient is connected to must be reviewed by Health Care Policy and Financing (HCPF) and Medicaid. Until the trust is reviewed, it may count as an asset/resource. Unfunded trusts must also be reviewed. See the LTC Medicaid and SSA Guide on our Helpful tools page for more information on trusts.

It can take up to a year for the entire Social Security application process. We suggest submitting strong supporting documents with your application to lessen the review time. See more tips and tricks in the Applying for Social Security Guide. 

The LTC Medicaid and SSA Guide on our Helpful Tools page has a Trust section with information about how to submit a trust for review.

Arbor/ARG (Action Review Group) is contracted by the State of Colorado to review Medicaid Disability applications. It can take up to 90 days for the review process. Submitting strong supporting documents and making sure you signed the application correctly in all places may help shorten the review process time. See the Medicaid Disability Application guide for more tips and tricks for a successful application process.

If you wish to move forward in the enrollment process, a 100.2 assessment will be scheduled.

Reminders:

• Be responsive if Medicaid reaches out for more information, to avoid a delay with your enrollment. You must report all income and assets, including Trusts, to Medicaid.
• You will not be fully approved for a waiver until Medicaid confirms your financial eligibility, including trust approval (as applicable), disability eligibility (as applicable), and functional eligibility (from the 100.2 assessment). This can take several months.
• For more information about LTC Medicaid, see the LTC Medicaid and Social Security Guide on our Helpful Tools page.
• Contact Medicaid directly with questions. Medicaid contact information is in the LTC Medicaid and Social Security Guide.

Yes. Working adults with a disability may qualify for Health First Colorado Buy-in Program for Working Adults (WAwD) and a waiver.  Adults who also qualify for a waiver can be on both at the same time. You can find more information about WAwD in the LTC Medicaid and SSA Guide and our Helpful Tools page as well as on the Dept. of Health Care Policy and Financing website. DB101 is also a fantastic resource!