No. This program was created for people with disabilities who work. People with Buy-In coverage make too much money and/or have too many resources to qualify for other Health First Colorado programs. Complete the Health First Colorado application and submit it to your county. Applying is the only way to know for sure if you qualify for the Buy-In program.
How long does it take to get a response from ARG?
ARG has 60 days to make a decision. This timeline is dependent on many factors such as when ARG receives your medical records. ARG will contact the medical providers you listed on the application. Please remind your medical providers to send at least the last two years of your medical records to ARG. ARG cannot begin processing your application without the following:
- A complete application that includes a hand signature and date.
- Your medical records and all necessary hand signed and dated releases, such as Medical Power of Attorney, or guardianship papers, if applicable.
If ARG cannot fully process your application, they will contact your county or Medical Assistance/Eligibility Partner site to explain what they need to complete processing for the determination.
You can contact your county or Medical Assistance/Eligibility partner site ARG for a status update.
You can also contact ARG at 1-877-265-1864 or send them an email at argcoloradostatusinquiry@equusworks.com.
Contact ARG by phone if you have questions about sending personal information to them safely so your information will be protected from online security threats. Please do not send personal information to this email address, such as social security numbers or personal health information without first asking ARG how to do so without risk of security threats.
How does ARG make its decision?
Licensed physicians who have experience and training in disability determinations will review your medical records and completed applications to make their decision. If you disagree with their decision, you can appeal it. Information on how to appeal will be in the letter you will receive that explains the decision.
What happens if the disability application is not signed and dated before it is sent to ARG?
The application is only complete if the applicant or their parent, guardian, or authorized representative hand signs and dates it. ARG cannot legally process the application without a legally approved signature.
I have had Health First Colorado and a disability for a long time. Suddenly I am told my disability determination needs to be reviewed or it will expire. Why?
The disability determination has a start and end date. When the end date approaches, the determination has to be reviewed/redetermined for continued eligibility.
When might I need to complete a disability application?
- If you do not have SSI or SSDI, and you want to apply for a Health First Colorado program that requires a disability determination
- If you do not have SSI or SSDI, and you are 65 or older, and re applying for a Medicaid Buy-In program and
- If your SSDI ended due to your work activity and you have Medicaid Buy-In (Buy-in programs are for members/applicants that do not meet income eligibility requirements) but may qualify for buying into Health First Colorado programs with a monthly premium payment.
I’m not a Health First Colorado member yet. What do I need to do?
Complete a Health First Colorado application online or contact your county to apply.
If you believe you may have a qualifying disability, please also complete the disability application. The disability application and release must be signed in ink. If you are unable to sign the application in ink, you can authorize a designated representative to sign it for you. The disability application explains how to authorize someone to sign for you.
I’m already a Health First Colorado member but not on a program that requires a disability determination. Do I need to complete a disability application if I feel I have a disability?
Yes, unless you are already receiving Supplemental Security Income (SSI) or Social Security Disability Income (SSDI).
If you are not already receiving SSI or SSDI, the disability portions of the Health First Colorado application must be completed, signed and dated. If you did not fill out this part of the application when you applied before, you need to do it now. Contact your county department of human services.
Who decides if I qualify for benefits and services for my disability?
Arbor E&T LLC dba Action Review Group (ARG) is the contractor that helps Health First Colorado (Colorado’s Medicaid program) make disability determinations on behalf of the state. They are part of the process that decides if a Health First Colorado member or applicant qualifies for benefits and services for a disability. ARG is only responsible for the disability determination portion of the application.
I already receive help from SSI or SSDI. Do I need to complete a disability application?
No. If you are already receiving SSI or SSDI, you do not need to complete the disability application.
- If you are already a Health First Colorado member, please make sure to let us know you are receiving SSI and SSDI. Report this information to your county or through Colorado.gov/PEAK.
- If you are not already a Health First Colorado member, please complete the Health First Colorado application. You do not have to complete the separate disability application.