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If your child has been diagnosed with autism or another developmental condition, accessing Medicaid services can be a game-changer, especially when it comes to securing Applied Behavior Analysis (ABA) therapy. Medicaid, known as Health First Colorado in the state, covers ABA therapy for eligible children. But how do you know if your child qualifies? In this article, we’ll walk you through the steps on how to apply for Medicaid in Colorado.
What are Medicaid Colorado’s Eligibility Requirements?
First, it’s important to familiarize yourself with the basic eligibility criteria for Medicaid in Colorado. Health First Colorado covers low-income individuals, including children with special needs. Factors that determine eligibility include:
- Household income: Colorado Medicaid sets income limits based on the size of your family.
- Age of the child: Medicaid covers children up to age 19, and adults with disabilities.
- Disability status: Children with developmental disabilities, including autism, may qualify based on medical need, even if their household income is above the normal threshold.
Below is a table that outlines the income limits for Colorado Medicaid in 2024. These limits are based on a percentage of the Federal Poverty Level (FPL)
| Family size | 2023 income numbers | 2024 income numbers |
| For individuals | $14,580 | $15,060 |
| For a family of 2 | $19,720 | $20,440 |
| For a family of 3 | $24,860 | $25,820 |
| For a family of 4 | $30,000 | $31,200 |
| For a family of 5 | $35,140 | $36,580 |
| For a family of 6 | $40,280 | $41,960 |
| For a family of 7 | $45,420 | $47,340 |
| For a family of 8 | $50,560 | $52,720 |
| For a family of 9+ | Add $5,140 for each extra person | Add $5,380 for each extra person |
These figures are subject to change based on updated federal poverty guidelines.
To see if your household qualifies based on income and other factors, you can visit the Colorado PEAK website.
What Documents Do I Need For The Medicaid Colorado Application for ABA Therapy?
Before you apply, it’s helpful to have all the necessary documents ready to make the process smoother. You’ll likely need the following:
- Proof of income: Pay stubs, tax returns, or unemployment records.
- Proof of Colorado residency: A utility bill or lease agreement.
- Birth certificates or Social Security numbers for your child and family members.
- Medical records: If applying based on a disability or developmental diagnosis, you’ll need documents confirming the child’s condition from a medical provider.
Having these documents on hand before starting the application can help prevent delays.
How to Apply for Medicaid Colorado to Receive ABA Therapy?
Once you have the necessary documents, you can apply for Medicaid through several methods:
- Online via the Colorado PEAK system: This is the easiest and quickest way to apply. Click here to create an account and fill out the Medicaid application.
- In person at a local county office: If you prefer, you can apply in person. Locate your county’s human services office and bring the required documents for assistance with the application. Find your local office here.
- By phone: Call the Health First Colorado Member Contact Center at 1-800-221-3943 to apply by phone. For TTY services, dial 1-800-659-2656.
- By mail: Download and complete the Medicaid application form here, and then mail it to: Health First Colorado
P.O. Box 929
Denver, CO 80201-0929
These multiple application methods provide flexibility to fit your needs.
After you’ve applied, Medicaid will review your application to determine eligibility. This process typically takes 45 days but may be faster if your child has an urgent medical need, such as ABA therapy. If more information is needed, they’ll reach out to you for clarification.
How To Confirm Your Medicaid Enrollment for ABA Therapy In Colorado?
Once approved, you will receive a letter confirming your Medicaid enrollment. You can then begin the process of accessing ABA therapy for your child by obtaining a referral from your doctor and finding a Medicaid-approved ABA provider.
If your application is denied, don’t worry! You have the right to appeal the decision. It’s important to contact your local Medicaid office to understand why your application was denied and gather any additional documentation they may need. Click here to file an appeal.
Bright Pathways ABA Is Here to Help!
Navigating the Medicaid eligibility process can be confusing, but once you’ve confirmed your coverage, accessing ABA therapy is the next step. At Bright Pathways ABA, we are dedicated to providing personalized, evidence-based ABA therapy to children with autism and developmental disabilities. Our team is experienced in working with Medicaid and can help guide you through the next steps in securing the best care for your child. Contact us today for more information!
Disclaimer
The information provided in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Bright Pathways ABA does not assume any responsibility for any outcomes or consequences resulting from the use of this information. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition or behavioral intervention.
