Emergency Medicaid Frequently Asked Questions
What is Emergency Medicaid?
Emergency Medicaid provides short-term Health First Colorado (Colorado’s Medicaid program) coverage for eligible people who do not meet immigration or citizenship requirements for Medicaid and need treatment for life-threatening medical emergencies. It is sometimes also called “Emergency Medical Services,” or “EMS.”
Confidentiality Notice: Information you provide on your application is confidential and cannot be shared with any Federal agency including U.S. Citizenship and Immigration Services.
Who is Eligible for Emergency Medicaid?
To be eligible for Emergency Medicaid, applicants must meet the same eligibility requirements as all other Health First Colorado applicants, except for immigration or citizenship requirements. Applicants also must have a qualifying life- or limb-threatening medical emergency covered by Emergency Medicaid. Emergency Medicaid benefits are limited to the treatment of medical emergencies only. Health First Colorado recognizes that all situations are unique, so please apply to see if you are eligible.
While all applicants for Health First Colorado or Child Health Plan Plus (CHP+) will be asked to provide a social security number, you do not need a social security number to receive emergency services under Emergency Medicaid.
People who may qualify for Emergency Medicaid include, but are not limited to:
- Deferred Action for Childhood Arrivals (DACA) recipients
- Undocumented people (people without legal immigration status)
- Non-immigrant visa holders such as tourists and students
- Individuals granted Temporary Protected Status
- Adult legal permanent residents (‘Green Card’ holders) who have not been in the U.S. lawfully for at least five years
- This does not apply to children and pregnant people who qualify for Medicaid with full benefits
We encourage all uninsured people to apply for Health First Colorado to see if they qualify, even if they are unsure of their immigration status.
What does Emergency Medicaid cover?
Emergency services include transportation, emergency room services. Laboratory, X-ray and other medical tests may be provided during emergency room visits when ordered by a doctor.
Emergency Medicaid covers medical emergencies that:
- Place the patient’s health in serious jeopardy;
- Impair the patient’s bodily functions; or
- Cause serious dysfunction of any bodily organ or part.
Examples include but are not limited to:
- Severe symptoms from COVID-19
- Labor and delivery (does not cover prenatal or postnatal care)
- Dialysis for End-Stage Renal Disease at an inpatient or freestanding dialysis center
- Life-threatening symptoms, like chest pains
- Life-threatening illnesses, like heart attacks
- Life-threatening accidents
- Other life-threatening health emergencies
Emergency Medicaid does not cover:
- Follow-up care after the medical emergency
- Routine physician appointments
- Prenatal or postnatal care (any pregnancy related care you may receive before or after a pregnancy)
- Clients with Emergency Medicaid must arrange payment for prenatal services with their prenatal care provider
- Care that is not certified by the physician as emergency care
How can I get help with a medical emergency?
If you think you are having a medical emergency call 911, or go to the nearest emergency room. Under federal law, all hospitals are required to provide emergency medical care to anyone having a medical emergency, even if they can’t pay for it, and even if they are not a U.S. citizen.
How can I apply for Emergency Medicaid?
You can apply for Health First Colorado at the hospital when you receive emergency treatment, after being discharged, or after care received in the past three months.
If you’re pregnant and seeking coverage for future labor and delivery services, you can apply ahead of time for coverage. You can apply before you go into labor, during or after labor and delivery. You can also apply while at the hospital or after being discharged. Assisters at the hospital can help you.
While all applicants for Health First Colorado or Child Health Plan Plus (CHP+) will be asked to provide a social security number, you do not need a social security number to receive emergency services under Emergency Medicaid.
You will need to apply each time you receive emergency care. An application is valid for the full month in which the emergency medical condition occurred.
- Example: If you receive regular dialysis for End-Stage Renal Disease, you will need to reapply for Emergency Medicaid coverage every month.
UPDATE: You do not need to submit a written physician statement about your emergency medical condition. This previous requirement was removed. The physician will provide this information.
There are a few ways to apply for Emergency Medicaid:
- In-person at your county of residence’s Department of Human Services or a local application assistance site or with a paper application you send through the mail. It is a best practice to apply for Emergency Medicaid using the paper application that can be sent through the mail or submitted directly to your county of residence’s Department of Human Services or local application assistance site. Since there is no longer a physician attestation required, please indicate anywhere on the application that you are interested in the Emergency Medicaid program (i.e. write ‘Emergency Medicaid’ in the margin of the application).
- By phone at 1-800-221-3943
- Online at CO.gov/PEAK
Information provided on an application is saved in the online benefits system, so if you reapply reapply online through PEAK or by phone, you will need to verify the information on file or make appropriate changes when you reapply.
If you are applying online at CO.gov/PEAK, and you have received a benefit in the last 15 months or have a household member who is actively receiving benefits, you must apply for Emergency Medicaid through PEAK’s Report My Changes section. If you have questions about this, please contact your county of residence’s Department of Human Services or a local application assistance site.
What information will I be asked to submit with my application?
The application will ask you to submit your income information (such as a pay stub) or any other proof for your eligibility category. You will not be asked to show proof of immigration or citizenship status. You also do not need to submit a written statement from your physician proving that you experienced an emergency.
How long does coverage for Emergency Medicaid last?
Each application for emergency medical services is limited to coverage for the life- or limb-threatening medical emergency. If a new medical emergency arises, you will need to submit a new application.
I heard that I need to get a written statement from my physician that proves that the medical treatment I received was for an emergency. How do I do that?
You do not need to get a statement from your physician. You can submit your application without a statement. Your physician will provide this information to us later.
Is the information that I share on my application, including my immigration or citizenship status information, shared with other Federal agencies, including U.S. Citizenship and Immigration Services?
No. Information you provide on your application is confidential and cannot be shared with any Federal agency including U.S. Citizenship and Immigration Services.
If I already received Emergency Medicaid once in the past year, do I need to reapply for another emergency?
Yes, you will need to submit a new application for the month you receive emergency care. If the emergency lasts longer than one month (i.e. regular dialysis for End-Stage Renal Disease) you will need to reapply for Emergency Medicaid coverage each month.
You can apply online at CO.gov/PEAK, by phone at 1-800-221-3943, in-person at your county of residence’s Department of Human Services or a local application assistance site, or with a paper application sent to you through the mail. Information provided on an application is saved in the online benefits system, so if you reapply online through PEAK or by phone, you need to verify the information on file or make appropriate changes.
Each application for emergency medical services covers you for one month, so if your emergency lasts more than one month, or if you experience a new emergency, you will need to apply again.
I received a letter that my application was denied, but still have questions and/or think I should be eligible. What should I do?
You can always contact your county of residence’s Department of Human Services. This phone number will be listed on the bottom of the letter you received. An assister at a local application assistance site can also help you with your questions.
I still have questions about Emergency Medicaid and/or need help in completing my application. What should I do?
For in-person help, please visit your county of residence’s Department of Human Services or a local application assistance site. They can help you with:
- Applying for Health First Colorado benefits, including Emergency Medicaid
- Questions about your benefits and co-pays
- Questions or issues with bills
For help over the phone, contact the Health First Colorado Member Contact Center.
