Medicaid application colorado pdf 2026

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  1. Click ‘Get Form’ to open the Medicaid Application Colorado PDF in the editor.
  2. Begin by filling out Section I, which requires identifying information about the facility. Enter the name, address, and contact details accurately.
  3. Proceed to Section II, where you will specify the type of application. Check the appropriate box for 'New Facility' or 'Change of Ownership'.
  4. In Section III, provide detailed staffing information. List all positions along with the number of employees and their education levels.
  5. Complete Section IV by disclosing ownership and controlling interest. Ensure all names and addresses are accurate.
  6. Review your entries for accuracy before submitting. Use our platform's tools to save your progress and make edits as needed.

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It may take up to 45 days or up to 90 days if the application requires a disability determination from the date your application was received for a case number to be assigned to you. Once you are assigned a case number, you can check your status and benefits online through Colorado PEAK.
If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify.
Colorado Medicaids look-back rule This is the 5-year period that immediately precedes ones date of application. During the look-back, Medicaid checks all asset transfers to ensure none were sold or gifted under fair market value. This includes asset transfers made by ones spouse.
Documents to Include with Your Medicaid Application Drivers license or photo ID, passport, birth certificate or immigration papers to prove identity. Medicare card and any other health insurance cards including Medicare Advantage or prescription drug cards.
See if you can sign up for Health First Colorado Family SizeApproximate Monthly Family Income to Qualify for Health First Colorado Adults 19 65 Pregnant People 1 Up to $1,669 Up to $2,447 2 Up to $2,265 Up to $3,322 3 Up to $2,862 Up to $4,1963 more rows

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You can check if your Health First Colorado (Colorados Medicaid Program) coverage is active by going to the Colorado PEAK website and clicking on the Check My Benefits button or you can view your card from the Health First Colorado mobile app.
The Department verifies income information provided by either the Federal Data Services Hub (FDSH), Equifax The Work Number (TWN), and the Colorado Department of Labor and Employment (CDLE) through the Income and Eligibility Verification System (IEVS) interface. When is a member considered not reasonably compatible?

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