Medicaid for nursing home and home care in Colorado

Who qualifies

To get long-term care through Health First Colorado, you must:

• Live in Colorado.
• Be 65 or older, or be blind or have a disability.
• Need the level of care a nursing home gives. A Case Management Agency checks this with an assessment.
• Meet the income and savings rules below.

If your income is over the limit: the income trust

Colorado does not turn you away just because your income is above $2,982. Instead, you must set up an income trust (the state form is called the Irrevocable Income Trust Agreement). Each month, income is moved into the trust and used toward your care.

• In a nursing home: all of your income goes through the trust.
• Getting care at home: the amount over the limit goes into the trust.
• The state (HCPF) must approve the trust before you can be found eligible. Your county sends you the forms.
• When you die, or when the trust is no longer needed, what is left in it goes to the state, up to what Medicaid paid for your care.
• Your county gives you a ledger that shows how much must go into the trust each month. It changes when your income changes.

What counts and what does not

• Income that counts includes Social Security, pensions and other money paid to you. The income limit is checked against your gross (before-tax) income.
• Savings that count include cash, bank accounts and other things you could turn into cash.
• Your home usually does not count, but only if your equity in it is $1,130,000 or less.
• Giving things away or selling them for less than they are worth can delay when Medicaid starts paying. Ask your county before you make large gifts.

If you are married and your spouse stays at home

Colorado protects the spouse who stays at home (the "community spouse").

• Savings: Your spouse can keep up to $162,660 of the couple's savings in 2026. You keep your own $2,000 on top of that.
• Income: If your spouse's own income is low, some of your income can go to them. The most your spouse can end up with is $4,066.50 a month.

What you pay and what you keep

In a nursing home, most of your income goes toward the cost of your care. You keep $110.36 a month for personal needs, such as clothes and haircuts. If you expect to go home within six months, you may be able to keep up to $1,640 a month to keep up your home.

Programs that pay for care

Nursing home care

Health First Colorado pays the nursing home directly once you qualify and your share is set.

Elderly, Blind, and Disabled (EBD) Waiver

This pays for help so you can stay at home or in the community. It is for people 65 and older with a serious need for help, and adults 18 to 64 who are blind, have a physical disability, or have HIV or AIDS. Services include:

• Adult day services
• Alternative care facilities (a kind of assisted living)
• Home changes for safety, such as ramps or grab bars
• Non-medical rides
• Respite care to give a family caregiver a break

Community First Choice

This is a regular Health First Colorado benefit, not a waiver. It covers personal care, homemaker help, home-delivered meals, medication reminders, and emergency response buttons.

PACE

PACE combines medical care and home care for people 55 and older who need nursing home level care. It is offered only in some parts of the state.

Waivers can have waiting lists when money runs short.

How to apply

1. Apply for Health First Colorado if you do not have it. Apply online at co.gov/peak, or print the Colorado Application for Public Assistance and mail it or drop it off at your county human services office. You can also get help at a local application assistance site.
2. Ask for a long-term care assessment. If you already have Health First Colorado, call your local Case Management Agency to start the EBD Waiver or check for nursing home level care.
3. Send proof your county asks for, such as bank statements, income letters and proof of your home's value.
4. Set up an income trust if your county says your income is over the limit. Return the signed forms quickly. Your case stays pending until the state approves the trust.

For questions, call the Health First Colorado Member Contact Center at 1-800-221-3943 (State Relay: 711).

After you apply

• Renewals: Your county will review your case at renewal. If you have an income trust, it will ask for the trust's account statements then.
• Changes: Report changes in income, savings, or where you live. If your income changes, your trust ledger is updated.
• Appeals: If you are denied or your benefits are cut, you generally have 60 days from the date on your Notice of Action to ask for a state fair hearing. To keep your benefits during the appeal, the Office of Administrative Courts must get your appeal no later than 10 days after the date of action. File by mail or in person at the Office of Administrative Courts, 1525 Sherman St., 4th floor, Denver, CO 80203, by phone at 303-866-2000, by fax at 303-866-5909, or by email to [email protected]. You can also ask your county for an informal meeting.

Things people often miss

• High income does not end your chance. An income trust is the way in, not a reason to give up.
• Underfunding the trust can cause problems. If the right amount does not go into the trust each month, your eligibility can be at risk.
• Estate recovery. After death, Colorado must seek repayment from the estates of people who got nursing home or home care paid after age 55, with some exceptions. Ask your county for the Estate Recovery Program brochure.

Free help

• Aging and Disability Resources for Colorado (ADRC): Free options counseling about long-term care. Call 1-844-265-2372.
• Colorado SHIP: Free Medicare counseling at 1-888-696-7213.
• Your county human services office handles applications and income trust paperwork.

See also paying for a nursing home, Medicare, and all benefits in Colorado.

Phone numbers: Free help lines for Colorado agencies

Check what you may qualify for