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Medicaid Rules & Regulations in Denver, Colorado

Medicaid rules and regulations in Denver, Colorado, ensure that families, children and pregnant women have access to public health insurance. The rules also pertain to people who are blind and those with disabilities. The state of Colorado and the federal government fund the program, but the state develops and implements the guidelines for eligibility and operates the program.

  1. Program Eligibility

    • Low income Denver residents who cannot afford medical care may apply for Medicaid. Generally, children and pregnant women may receive immediate Medicaid benefits while the county processes the application. The program is only open to United States citizens. The state looks at the household income, bank accounts, and other factors to determine income eligibility. Households may have a home and one vehicle exempt from asset calculations to determine qualification.

      The income limit for most cases is133 percent of the Federal Poverty Level (FPL) or $29 327 for a family of four as of 2010. Colorado sets the income limit for "low income adult" households below the Aid for Families with Dependent Children (AFDC) Need Standard. Disabled individuals and those 65 and older have an income limit of $502 per month with asset limits up to $3,000.

    Application Process

    • Applicants may apply for Medicaid at the Denver Human Services Office. Applicants may also go to the Denver Health Medical Center (DMHC) and its associated clinics. Single parents must apply for Child Support Services for children under the age of 19. In Colorado, when families apply Family Medicaid they automatically apply for the Child Health Plan Plus (CHC+). Applicants need to bring proof of citizenship such as a passport. Applicants also need to have various financial documents, including proof of income, bank statements, vehicles owned and real property ownership. The agency may require statements of health care expenses and insurance policies.

    Providers and Benefits

    • The Department of Health Care Policy and Financing maintains a list of primary care providers, specialists, managed care organizations and other service providers Medicaid recipients must go to for services. The benefits covered by Medicaid include in-patient and outpatient care, outpatient surgical services In addition, Medicaid recipients may receive laboratory services, X-rays and early screening diagnostic services. Other programs include preventative health care, children's preventative dental care, podiatrist services, prescription drugs, eyeglasses and dentures.

    Emergency Medicaid

    • In Denver, undocumented immigrants and non-citizens do not qualify for the standard Medicaid program. However, the law requires the Medicaid program to provide qualified individuals emergency medical care. The plan covers pregnant women, individuals 65 or older, disabled people, children under the age of 19 or a relative who is responsible for taking care of a minor child. In some instances, they may also receive immunizations and services for some infectious diseases.

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