Applying for and Maintaining Medicaid

Applying for Medicaid for or as a person with a disability

To get onto a waiver, you must first apply for and be approved for Medicaid.
Waiver services are above and beyond what you can get with regular Medicaid.
Medicaid pays for the extra waiver services.

You will not be approved for Long-Term Care (LTC) Medicaid until you have gone through most of the enrollment process.

To start the process toward Long-Term Care (LTC) Medicaid, you need to fill out two Medicaid applications

  1. Health First Colorado (Medicaid) Application

  2. Disability (Medicaid) Application

When a person with a disability wants to enroll in an LTC Medicaid waiver, an extra Medicaid application might be needed if they are not getting Supplemental Security Income (SSI) or Social Security benefits that come with a disability determination.

Both applications can be found here:

When you click on the link above, you will see two different Medicaid applications. Choose which Medicaid application fits your needs.

  • The first one listed is for people who are only applying for Medicaid.

  • The second is for people who wish to apply for Medicaid AND another assistance program, such as food assistance.

There is only one option for the Disability application.

Fill out as much of the application(s) as possible before getting support; that way, you can focus on the parts you have questions about.

*Note

You can apply for Medicaid at any age. If you are under the age of 18 (or helping someone under 18 apply), Health First Colorado Medicaid will look at the income and resources/assets of all household members.

Application Support

We suggest you apply for LTC Medicaid in one of the following ways (we do NOT recommend applying for LTC Medicaid on Colorado PEAK):

  • With Colorado Access – AMES (Access Medical Enrollment Services), an Eligibility Application Partner
  • With your local Department of Human Services (DHS) by phone or in person
    Find the one in your county
    • They can answer some questions about the Medicaid application, but only offer partial application support. You can get more support if you go into your local DHS office. Wait times vary. If you need support in a language other than English or Spanish, it is recommended you go into the county office to ask for application support.
  • By calling the Member Contact Center for Colorado Medicaid at
    1-800-221-3943
Support icon with yellow background

When you apply:

  • Tell the person you speak with that you want to apply for LTC Medicaid, so that someone in your household (or whomever you are helping to apply) can get waiver supports. (This is only applicable if you want waiver supports.)
  • Tell them you are working with Developmental Pathways, if you’re working toward enrolling on a waiver.
  • Tell them that the person you are helping to apply (or if you are applying for yourself) has a disability.
Arrow icon point to the right

Another way to get Medicaid is to apply for Supplemental Security Income (SSI). People who are approved for SSI automatically get enrolled in Medicaid.

Things to keep in mind if applying for Supplemental Security Income (SSI):

  • If applying for a child, they will look at the household’s income and assets.
  • If applying for an adult, they will only look at the adult’s income and assets.
  • An option for a faster path to waiver services is to complete both a Medicaid and Medicaid Disability application and then apply for SSI (if you wish to apply for Social Security benefits).

See our Waiver Services page for more information on specific waivers offered through Developmental Pathways, or visit the Health Care Policy and Financing (HCPF) website for information on waivers available in the state of Colorado at https://hcpf.colorado.gov/hcbs-waivers.

FAQs

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.

Yes, AMES (Access Medical Enrollment Services) 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 to AMES (Access Medical Enrollment Services) or your county DHS (Department of Human Services) office where you live. 

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 is not needed for people getting SSI. You can contact Medicaid, provide them with proof of your SSI, and ask them to put you on SSI Mandatory Medicaid.
  • 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.
 

  • 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.

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).  

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.

What Medicaid applications do I need to complete?

(Based on the LTC Medicaid applicant’s specific circumstance)

KEY:

SSI: Supplemental Security Income
SSDI: Social Security Disability Insurance

Current Benefits

Applications Needed

I have Medicaid, but no Social Security benefits.

You will need to complete a Medicaid Disability application unless you completed one in the past and it has not expired.

The end date of an approved Disability application is called a diary date. If the diary date has expired or will be expiring soon, you will need to complete a new Disability application. You can ask Medicaid for this information.

I get SSI and have Medicaid.

No new Medicaid applications are needed.

I get SSI, but don’t have Medicaid.

Contact your county DHS office and show them proof of your SSI, so they can enroll you onto SSI Mandatory Medicaid. You should NOT have to fill out a new Medicaid application if you work with your local county DHS office.

I get SSDI, but don’t have Medicaid.

You will need to complete a Medicaid application. Contact your county DHS office or Colorado Access –  AMES to ask if a Medicaid Disability application is also needed. It will be needed if your type of SSDI does NOT come with a disability determination.

I don’t get any Social Security benefits or Medicaid.

You will need to complete both a Medicaid application and a Medicaid Disability application. You can also apply for Social Security if you think you will quality.

I recently applied for Social Security, but I haven’t received a determination yet. I do not have Medicaid.

*It can take between 4 and 8 months for the Social Security review process. The review time is subject to change.

*The Disability application review process can take up to 90 days. The review time is subject to change.

OPTION 1: Pause enrollment and wait for the decision from Social Security. Review the Applying for Social Security Guide to make sure you followed all the recommended steps, tips, and tricks. You will also find this guide on our Helpful Tools page.

If/when you receive an approval from Social Security, notify the Intake Team to let them know you are ready to restart the process.

OPTION 2: Complete both a Medicaid (Application for Public Assistance) and Medicaid Disability application, while you wait for the decision from Social Security.  This is potentially a faster track to waiver services.

I recently applied for Social Security, but I haven’t received a determination yet. I have active Medicaid.

Same options as above with one difference for option 2: no Medicaid application would be necessary, only the Medicaid Disability application would be required.

I have Medicare and Social Security benefits.

You probably get SSDI, as people are signed up for Medicare once they have been receiving SSDI for two years. You will need to complete a Medicaid application. Contact your county DHS office or Colorado Access –  AMES to ask if a Medicaid Disability application is also needed. It will be needed if your type of SSDI does NOT come with a disability determination.

I am not sure what benefits I already have.

Contact Colorado Access – AMES or your county DHS office and ask them to help you to figure out what benefits you have and if any applications are needed.

For Social Security, you can log into your mysocialsecurity account (or create one). You can also look at your bank deposit registry.

Other Helpful Resources

Application guides (or see our Helpful Tools page):
Health First Colorado Medicaid Application Guide and Medicaid Disability Application Guide

Health First Colorado Medicaid information:
https://www.healthfirstcolorado.com/

Health First Colorado FAQs:
https://www.healthfirstcolorado.com/frequently-asked-questions/

Medicaid Applications:
https://hcpf.colorado.gov/how-to-apply#by-mail

Colorado PEAK:
https://peak–coloradopeak.force.com/peak/s/peak-landing-page?language=en_US

HIBI program:
https://www.mycohibi.com/index.html

El Grupo VIDA
https://elgrupovida.org/en/about/
303-335-9875
They may be able to provide support to Spanish speaking individuals who only need to complete a Medicaid Disability application.
Ellos deberian proveer apoyo a individuos de habla hispana que solo necesitan completer una aplicación de Discapacidad de Medicaid.

Atlantis Community, Inc.
https://atlantiscommunity.org/about-us/
303-733-9324
They may be able to provide support to adults who only need to complete a Medicaid Disability application.

Applying For & Maintaining
Long-Term Care Medicaid