You are here

Medicaid Waiver Information

Medicaid is a health care program for low income Coloradoans. Applicants must meet eligibility criteria for one of the Medicaid Program categories in order to qualify for benefits.

Major program categories include Aid to Families with Dependent Children/Medicaid Only, Colorado Works/TANF (Temporary Assistance for Needy Families), Baby Care/Kids Care, Aid to the Needy Disabled, Aid to the Blind, and Old Age Pension.

To apply for Medicaid, contact your local County Department of Social/Human Services. Waiver programs provide additional Medicaid benefits to specific populations who meet special eligibility criteria. For some people, a waiver is the only way to qualify for Medicaid.

Clients must meet financial, medical, and program criteria to access services under a waiver. The applicant's income must be less than $1,986.00 (300%, or three times, the Supplemental Security Income allowance) per month and countable resources less than $2,000 for a single person or $3,000 for a couple. The applicant must also be at risk of placement in a nursing facility, hospital, or ICF/MR (intermediate care facility for the mentally retarded). To utilize waiver benefits, clients must be willing to receive services in their homes or communities. A client who receives services through a waiver is also eligible for all basic Medicaid covered services except nursing facility and long-term hospital care. When a client chooses to receive services under a waiver, the services must be provided by certified Medicaid providers or by a Medicaid contracting managed care organization. The cost of waiver services cannot be more than the cost of placement in a nursing facility, hospital, or ICF/MR.

Each waiver has an enrollment limit. There may be a waiting list for any particular waiver. Applicants may apply for more than one waiver, but may only receive services through one waiver at a time. Anyone who is denied Medicaid eligibility for any reason has a right to appeal. Talk to your County Department of Social/Human Services if you wish to exercise your right to appeal. For more information, go to: http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1223894303509 .