You can get Outpatient Physical and Occupational Therapies (PT/OT) at a clinic, a rehab center, or a hospital. Your provider can help you pick the best place for you to get therapy services.
Where can I find more information about Outpatient Physical and Occupational Therapy (PT/OT) services?
Your provider will be able to help answer questions about your Outpatient Physical and Occupational Therapy (PT/OT) services.
You can read about the PT/OT services Health First Colorado (Colorado’s Medicaid program) members can get on our Benefits & Services page.
What is Outpatient Physical and Occupational Therapy?
Physical and Occupational Therapies (PT/OT) are services meant to help you recover from an acute injury, illness, or surgery. Some therapies are meant to help you maintain physical ability, or help children reach developmental milestones.
PT/OT is performed by licensed professionals. Health First Colorado (Colorado’s Medicaid program) limits the number of PT/OT services you can get in a year. Get more information on PT/OT limits.
I receive Health First Colorado services through a waiver program. How many Outpatient Physical and Occupational Therapy (PT/OT) hours do I get?
Health First Colorado (Colorado’s Medicaid program) members who get services through a waiver program have Outpatient Physical and Occupational Therapy covered to the same extent as members who are not enrolled on a waiver program.
How many times can I get Outpatient Physical and Occupational Therapy services?
The benefit does not have a hard-annual limit for children or adults. The benefit is limited by the number of visits which are authorized.
Your provider will be able to help answer your questions about PT/OT services and how many you are able to get in 12 months.
You can read about the PT/OT services a Health First Colorado (Colorado’s Medicaid program) member can get on the Benefits & Services page.
You can also contact the Health First Colorado Member Contact Center for more information.
Do I need a referral or a provider’s permission to get Outpatient Physical and Occupational Therapy (PT/OT)?
Yes. Your primary care doctor, or the hospital you are discharged from, may order or refer you to a physical or occupational therapist to help you recover. You may also go directly to a therapist for care, but that therapist must contact your primary care doctor to get approval for your treatment plan.
Children ages 0 to 3 may receive Outpatient Physical and Occupational Therapy (PT/OT) without a referral if it is coordinated through Early Intervention Colorado.
¿Qué pasa si yo ya no califico para la cobertura de Health First Colorado o CHP+?
Si usted ya no califica para Health First Colorado o CHP+, usted tiene un tiempo limitado para solicitar otra cobertura. El tiempo que usted tiene para solicitar una nueva cobertura, conocido como “período de inscripción especial,” varía según el proveedor de cobertura.
Otras opciones de cobertura de salud incluyen:
- Cobertura a través de su empleador. Consulte con su empleador para conocer opciones, reglas y fechas límite.
- Cobertura a través del seguro de salud de un familiar, como un cónyuge, o de sus padres si usted tiene 25 años o menos.
- Cobertura a través de Connect for Health Colorado (el mercado de seguros de salud oficial de Colorado). Puedes calificar para asistencia financiera para reducir el costo de su prima.
- Para obtener ayuda gratuita para inscribirte en la cobertura de Connect for Health Colorado, comunícate con un asistente certificado en línea o llamando al 855-752-6749. TTY: 855-346-3432 Cobertura a través de Medicare para personas mayores de 65 años o personas menores de 65 con ciertas discapacidades o enfermedad renal en etapa terminal. Si usted necesita ayuda para encontrar un plan, contacta al Programa de Asistencia de Seguro de Salud de Colorado (Colorado SHIP, un programa de asistencia de Medicare) al 888-696-7213.
- Cobertura para militares activos o veteranos a través de Tricare (activo) o VA (veteranos).
Si usted ya no califica porque perdió la fecha límite para responder, usted puede volver a solicitar Health First Colorado.
Para obtener ayuda gratuita para llenar una solicitud de cobertura de Health First Colorado o CHP+, o para aprender sobre otras opciones de cobertura, llame y haga una cita en un sitio certificado para asistencia de solicitudes.
How can I get my prescription by mail?
1. Check with your pharmacy: Ask your current pharmacy if they provide mail delivery for your prescriptions.
2. If your current pharmacy does not offer mail delivery, and you want to stay local:
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- Search for nearby pharmacies using the Find a Doctor tool.
- Enter your address in the “Find Providers Near Me” field, or click the “Find Me” button to see your location.
- Adjust the “Within” tool to set how far you are willing to travel.
- Select “Pharmacy” from the “Find Providers by Type” dropdown list.
- Call nearby pharmacies to ask about their delivery options.
3. If no local pharmacies offer mail delivery:
- Search for mail order pharmacies using the Find a Doctor tool.
- Select “Pharmacy” from the dropdown list.
- Zoom out using the “-” button on the map to find other areas or out-of-state pharmacies that might offer mail order services.
- If you choose mail order services, you can get new or refill prescriptions for chronic conditions in a supply of up to 100 days. These are called maintenance medications, which are taken regularly to manage a wide range of ongoing or long-term conditions and illnesses.
Important
Health First Colorado does not keep an official list of pharmacies that offer mail delivery. We recommend that you call pharmacies directly and ask if they can meet your specific medication needs.
Questions?
If you need more information, call the Pharmacy Liaison at 303-866-3588.
My pharmacy told me my medication is denied because a prior authorization was needed. What should I do?
Some medications require your doctor to file a prior authorization request before a medication will be covered. Please ask your doctor to contact Health First Colorado (Colorado’s Medicaid program) at 1-800-424-5725 to request a prior authorization for your medication. Once the prior authorization is submitted, it will take up to 24 hours to process.
My pharmacy told me my diabetic supplies are not covered. Is that true?
Diabetic supplies such as test strips, lancets and syringes are a covered medical benefit and not a pharmacy benefit. Please ask the pharmacy to bill DME-Supplies. Pharmacies can call 1-800-237-0757 if they require additional assistance billing supplies.