Colorado
What Is Colorado Medicaid Long-Term Care?
Colorado Medicaid, known as Health First Colorado, is a joint federal and state health insurance program aimed at low-income residents, including seniors. This guide focuses specifically on long-term care benefits available to older Coloradans. In addition to covering care in nursing facilities, the program also offers services that help elderly individuals remain in their homes or assisted living environments.
What Types of Long-Term Care Medicaid Programs Are Available in Colorado?
There are three types of Medicaid long-term care programs seniors in Colorado might qualify for:
What Is Nursing Home Medicaid (Institutional Care)?
This program is an entitlement, meaning all eligible applicants are guaranteed services. It covers care provided exclusively in licensed nursing facilities.
What Are Home and Community Based Services (HCBS) Waivers?
These programs are not entitlements. There are enrollment caps, and waitlists may apply. HCBS aims to delay or avoid nursing home admission by providing support in home, assisted living, or adult day care settings.
What Is Regular Medicaid for the Aged, Blind, and Disabled (ABD)?
An entitlement program offering certain long-term care benefits—such as personal assistance or adult day care—for those who meet eligibility criteria.
Who Administers Health First Colorado?
Health First Colorado is overseen by the Colorado Department of Health Care Policy & Financing. Although federally funded, the state administers the program under federal guidelines.
What Are the 2025 Financial Eligibility Limits for Colorado Medicaid Long-Term Care?
Eligibility requirements vary by Medicaid program, marital status, and change annually. Here are simplified income and asset criteria for a single applicant seeking Nursing Home Medicaid in 2025:
- Monthly income limit: $2,901
- Asset limit: $2,000
- Medical need: Must require nursing home level care
A more detailed chart is typically available for different scenarios (e.g., married couples), but not meeting all listed requirements doesn’t automatically disqualify someone. Eligibility planning may help.
How Is Income Counted for Medicaid Eligibility in Colorado?
Most sources of income are included in eligibility calculations—wages, pensions, Social Security, IRA withdrawals, and more. Some exceptions include Holocaust restitution payments and VA Aid & Attendance benefits.
How Is Income Counted for Couples Applying?
- Nursing Home Medicaid or HCBS: Only the applicant’s income is considered. The non-applicant spouse may receive a Monthly Maintenance Needs Allowance (MMMNA) of up to $2,643.75/month in 2025, capped at $3,948/month.
- Regular Medicaid: Income from both spouses is counted. No MMMNA applies.
How Are Assets Evaluated for Medicaid in Colorado?
Assets are classified as either countable or exempt.
What Are Countable vs. Exempt Assets?
- Countable assets: Bank accounts, investments, and real estate (excluding primary residence)
- Exempt assets: One vehicle, personal possessions, household goods, irrevocable funeral trusts, and a primary residence (with conditions)
How Are Assets Treated for Married Applicants?
Assets are considered jointly owned. The non-applicant spouse can retain up to $157,920 in countable assets in 2025 under the Community Spouse Resource Allowance (CSRA). This allowance doesn’t apply to Regular Medicaid.
What Is the Medicaid Look-Back Period in Colorado?
Colorado applies a 60-month “look-back” rule for Nursing Home Medicaid and HCBS Waivers. Any asset transfers made within five years of applying will be reviewed. Gifts or transfers made for less than fair market value may trigger a penalty period—a temporary ineligibility for Medicaid.
Does the Gift Tax Exemption Protect Against Medicaid Penalties?
No. The federal gift tax exemption ($19,000 per person in 2025) does not prevent Medicaid penalties.
How Can a Home Be Exempt from Medicaid Asset Limits?
To exempt a home from asset calculations:
- The applicant or spouse must live in it, or the applicant must show intent to return.
- If no spouse resides there, home equity must be under $1,097,000 (2025 limit).
Is the Home Protected from Estate Recovery?
No. Exemption from eligibility limits does not protect the home from Medicaid estate recovery after death.
What Are the Medical Criteria for Medicaid Long-Term Care in Colorado?
A medical or functional need is required.
- Nursing Home Medicaid and HCBS Waivers: Must meet the Nursing Facility Level of Care (NFLOC).
- Regular Medicaid: Must require help with Activities of Daily Living (ADLs), but not necessarily meet NFLOC.
Can Someone Qualify for Medicaid If Over the Income or Asset Limits?
Yes, there are strategies to help individuals qualify even if they exceed the limits:
What Is a Qualified Income Trust (QIT)?
Also called an Income Trust in Colorado, this allows excess income to be placed in a trust that is excluded from eligibility calculations. The trust funds must be used for care-related expenses. Any remaining balance reverts to the state after the individual’s death.
What Is Asset Spend-Down?
Applicants can reduce countable assets by spending on exempt items like home modifications, vehicle replacement, funeral arrangements, or paying off debt. Documentation is essential to avoid penalties under the look-back rule.
How Can Medicaid Planning Help?
Professional Medicaid planners use legal tools to help applicants qualify while protecting assets, including shielding a family home from estate recovery.
What Specific Medicaid Programs for Seniors Are Available in Colorado?
Elderly, Blind, and Disabled (EBD) Waiver
This program provides home or assisted living care to delay or avoid nursing home admission. Services may include personal care, adult day care, home modifications, and emergency response systems. Self-directed care options (CDASS and IHSS) allow hiring of caregivers, including spouses.
Program of All-Inclusive Care for the Elderly (PACE)
PACE integrates Medicare and Medicaid services into one coordinated plan. Covered services may include long-term care, vision, and dental care.
What Is Money Follows the Person (MFP)?
This program supports individuals who wish to move out of nursing facilities and back into the community.
What Is the Community First Choice (CFC) Program?
Launching July 1, 2025, this program will offer an expanded range of long-term services and supports under Medicaid.
How Can You Apply for Colorado Medicaid?
Applications can be submitted through the following methods:
- Online: Colorado PEAK
- Phone: 1-800-221-3943
- In Person: Visit your local Department of Human Services or Application Assistance Site
