Health First Colorado (Colorado’s Medicaid program) Members

Miembros
Miembros de Health First Colorado (programa de Medicaid de Colorado)

Colorado Access: Your Health First Colorado Regional Organization

Every member of Health First Colorado is part of a regional organization. As the regional organization for Adams, Arapahoe, Denver, and Douglas counties, we work with Health First Colorado to connect you to doctors and community services that support your health. We can also help coordinate your care when you need extra support or a guide through the health care system.

Encontrar un doctor

Quick Guide: Who to Contact for Help with Health First Colorado

To apply, renew your benefits, or report changes to your household	Go to co.gov/PEAK or contact your county human services office.
To find a provider	Ve a healthfirstcolorado.com/find-doctors or coaccess.com/findaprovider (best for behavioral health). Or call Colorado Access at 800-511-5010 (TTY: 888-803-4494).
To change your primary care provider (PCP)	Ve a Health First Colorado Enrollment or call 888-367-6557 (State Relay 711).
To get your ID card	Ve a co.gov/PEAK or use the Health First Colorado app. You can also call Health First Colorado Member Contact Center at 800-221-3943 (State Relay 711).
To request rides to your appointments	Book a ride with Intelliride/Transdev online or call 855-489-4999 (State Relay 711).
To request a care coordinator or get help with finding community support, like food and housing	Call Colorado Access at 866-833-5717 (TTY: 888-803-4494).
To ask for help with a bill you received	Call Colorado Access at 800-511-5010 (TTY: 888-803-4494).
To file a grievance (complaint)	or call Colorado Access at 800-511-5010 (TTY: 888-8034494).
To appeal a decision about your care	Follow the directions in the letter you received.
To get free medical advice, 24 hours a day, 7 days a week, in English or Spanish	Call the free Nurse Advice Line at 800-283-3221.
To get help with dental care	Llámenos al DentaQuest Member Services at 855-225-1729 (State Relay 711).
To get help with long-term services and supports	Contacta al case management agency.

Summary of Benefits

For a full list of benefits, see the Health First Colorado member handbook (English and Spanish) or use the Health First Colorado app. Your Health First Colorado benefits include:

Physical health care: Primary care and specialist visits; hospital care; lab services; family planning; maternity and newborn care; physical, occupational, and speech therapy.
Cuidado de la salud mental: Counseling/psychotherapy (individual, group, family, in-home); drug screening and monitoring; medication management; intensive outpatient services; partial hospitalization services; residential care; inpatient hospital.
Substance use disorder treatment: Counseling/psychotherapy; withdrawal management (detox); medication-assisted treatment; intensive outpatient services; inpatient hospital; residential treatment.
Pharmacy and medical equipment: Health First Colorado covers many prescription medications. Talk to your provider about which prescription drugs are covered, or read the list of covered drugs. Some prescription drugs may need prior authorization. Your benefits also include medical equipment such as oxygen, wheelchairs, or walkers.
Cuidado dental: Your dental benefits are through DentaQuest. If you need help finding a dental provider, call DentaQuest Member Services at 855-225-1729 (State Relay 711) Monday through Friday, 8:00 a.m. to 5:00 p.m. or go to com/en/providers/colorado.
Transporte: Emergency ambulance services are covered without prior authorization for emergencies. For non-emergency rides to appointments, schedule a ride online with Transdev or call 855-489-4999 (State Relay 711).

Special Benefits for Children and Youth: EPSDT

Health First Colorado covers all medically necessary care for members who are 20 years old or younger through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. This benefit ensures that they get the right preventive, dental, vision, hearing, developmental, mental health, and specialty services at no cost, even if it’s not a covered service or there are service limits for adults. If your child needs a service and you are not sure it is covered, always ask. EPSDT might cover it.

Pregnancy and Postpartum Benefits

You have coverage as soon as you are pregnant until 12 months after your pregnancy ends. You must tell Health First Colorado that you are pregnant to get this coverage, even if your doctor already knows. Use PEAK or the Health First Colorado app to tell us if you’re pregnant. Or call Health First Colorado at 800-221-3943 (State Relay 711).

Prenatal benefits include doctor visits, mental health care, substance use treatment and recovery, and all medically necessary tests and screenings. Services from midwives and doulas are covered, too. After pregnancy, you get all the postpartum care you need, including family planning. Pregnant members are included in the EPSDT benefit. If you are pregnant and you need a service, always ask. EPSDT might cover it.

Our care coordinators offer extra support during and after your pregnancy. A care coordinator can help if you have preexisting physical or mental health needs, your pregnancy is high-risk, or you want support with substance use recovery. Care coordinators can also help you find community resources, like food and housing. Call us at 866-833-5717 (TTY: 888-803-4494) to request a care coordinator.

mujer joven en silla de ruedas con ayudante

Encontrar cuidado

You can see any physical health provider that takes Health First Colorado. For mental health or substance use treatment, you can see any provider that takes Health First Colorado and is in the Colorado Access network.

To find a provider, use our Find a Doctor search tool at coaccess.com/findaprovider or the Find a Doctor tool at saludprimerocolorado.com, or the Health First Colorado mobile app.

If you need to choose a new primary care provider (PCP) or change your PCP, go to inscribirse.healthfirstcolorado.com or call 888-367-6557 (State Relay 711).

Tu puedes necesitar after-hours care when you need care quickly and you cannot get an appointment with your PCP in time. Ask your PCP what to do if you need care during evenings or weekends. You can also go to a participating urgent care near you. The Health First Colorado Nurse Advice Line is also available 24 hours a day, every day of the year at 800-283-3221.

Vaya la sala de emergencias or dial 911 when something could cause serious harm if you do not get immediate help. You do not need prior authorization for emergency services.

Connect with a Care Coordinator

Our care coordinators can help you find the care and services you need to support your health. To request care coordination, call us at 866-833-5717 (TTY: 888-803-4494).

If You Get a Bill

You should not get bills for services that Health First Colorado covers. Federal and state law say that providers cannot bill you for covered services.

If you get a bill or collection notice for services you got while you were a Health First Colorado member:

Check to make sure you were eligible for Health First Colorado on the date you got the service.
If you were eligible, call the provider’s office and tell them you were eligible for Health First Colorado on the date you got the service.

If you cannot resolve a billing problem with your provider, call us at 800-511-5010 (TTY: 888-803-4494). Monday to Friday, 8:00 a.m. to 5:00 p.m. The call is free.

Make sure the providers you choose to see accept Health First Colorado. We cannot reimburse for care you pay for.

Denver Health Elevate Medicaid Choice Members

If Elevate Medicaid Choice is your health plan, be sure your providers are in Denver Health’s network. We work with Denver Health to provide behavioral health benefits to Elevate Medicaid Choice members. To find care, or if you have questions about your benefits, call Denver Health at 303-602-2116.