Not all members will be renewed at the same time. Members will be renewed according to their renewal month. Each member’s renewal month is usually based on the date you enrolled with Health First Colorado. Members who live in the same household may share the same renewal date. Some members will be automatically renewed based on the most recent information already on file with the state. Other members will need to go through the renewal process and take action. Health First Colorado will send renewal packets to those members in advance of their renewal month with key information and their individual timelines to take action.
If I’m pregnant, does that change my renewal month?
Yes. The renewal month will be 12 months after the pregnancy ends. For example, if you complete your renewal in July 2024 while pregnant and your pregnancy ends in September, your new renewal date will be September 2025, not July 2025.
Members must report their pregnancy in their PEAK account, on the Health First Colorado app, or to their county to qualify for the extended 12 months of coverage. Learn more about the expanded maternity benefit.
I’m a Health First Colorado member and received a letter stating my eligibility was being redetermined. What does this mean?
The renewal process checks to see if you still qualify for Health First Colorado or Child Health Plus (CHP+). Some members will be automatically renewed based on information we have. Other members will need to go through the renewal process.
You will get a packet in the mail or in your PEAK mailbox several weeks before your renewal date. If any information is incorrect or missing, you need to fix it. If the packet asks for proof of income and resources, you need to send copies or upload them.
After you finish filling out the packet, sign it and send it back to your local county human services department by your renewal deadline. You can also complete the renewal packet online at CO.gov/PEAK or on the Health First Colorado app.
I am covered by Medicare and Health First Colorado. Why is Health First Colorado not paying for my prescriptions?
Once a Health First Colorado (Colorado’s Medicaid program) member is entitled to receive Medicare, Medicare Part D will cover most of your prescriptions. Health First Colorado will only pay for a few medications that are excluded by your Part D plan. If you need assistance to find and enroll on a Part D plan, please call 1-888-696-7213 or 303-894-2946.
How much should I be charged for my prescription medications?
Beginning July 1, 2023 if your prescription is for a generic or brand name medication you will not have a co-pay.
Learn more about Health First Colorado Co-Pays.
Can I request an early refill if my medication was lost or stolen?
Health First Colorado (Colorado’s Medicaid Program) will cover lost, stolen or damaged medications once per lifetime for each member. Pharmacies must call for overrides for lost, stolen, or damaged prescriptions. Please call your pharmacy and they will need to call Magellan (1-800-424-5725) to request the replacement prescriptions. The replacement request and verification must be within 60 days of the last refill of the medication.
Can I get the name brand medication when a generic is available?
Through scientific testing, the Food and Drug Administration (FDA) ensures that generic drugs are safe and effective, contain the same active ingredient and work the same way as the brand name. Health First Colorado (Colorado’s Medicaid Program) can pay for a name brand drug if a generic is not available, if your doctor considers the name brand to be medically necessary or if the medication is excluded from the generic mandate (e.g., medications for mental illness, cancer, epilepsy and HIV/AIDS).
In cases where your doctor would like you to have the brand name when a generic is available, a prior authorization will need to be completed by your doctor and the prior authorization must be approved by Health First Colorado before you will be allowed to receive the brand name.
Can I get my medications early if I am going on vacation?
Health First Colorado (Colorado’s Medicaid program) does not pay for vacation supplies.
Can I get my medication early?
Early refills are covered when there is an increase in dosage or if a client is going into or leaving a nursing home. Clients may receive up to a 100 day supply of maintenance medications and up to a 30 day supply of non-maintenance medications. If you run out of medication, contact your doctor and discuss adjusting your prescription to your current needs.
Can I get help to quit smoking?
Contact the Colorado QuitLine at 1-800-QUIT-NOW (1-800-784-8669) for free coaching and support.
Talk with your health care provider about the benefits and risks of taking smoking cessation medications while you are pregnant. Health Care Colorado covers two 90-day courses of smoking cessation medication with counseling to help you quit.