Colorado Medicaid for seniors and long-term care

Last verified: June 2026

Long-term services and supports through Health First Colorado

Health First Colorado covers a range of long-term services and supports (LTSS) for eligible seniors and adults with disabilities. Colorado has significantly expanded home and community-based services (HCBS) over the past decade, reflecting state policy preference for keeping individuals in the least-restrictive setting. The state administers LTSS through the Colorado Department of Health Care Policy and Financing (HCPF) with coordination through Regional Accountable Entities (RAEs) and Single Entry Points (SEPs).

Colorado operates multiple Section 1915(c) HCBS waivers as well as Section 1115 demonstration programs for LTSS. Eligibility requires meeting nursing facility level of care criteria and the financial requirements for long-term care Medicaid, which differ from the MAGI-based rules used for most Health First Colorado applicants.

Key LTSS programs in Colorado

Asset limits for long-term care Medicaid in Colorado

Source: Colorado HCPF long-term care eligibility rules; federal CSRA and home equity limits. Verify current asset limits with HCPF at 1-800-221-3943 or hcpf.colorado.gov, as these figures can change annually.

Single Entry Point agencies: where to start

Colorado routes LTSS applications through Single Entry Point (SEP) agencies — regional organizations that conduct needs assessments, determine HCBS waiver eligibility, and coordinate access to long-term care services. Every county in Colorado is served by a SEP.

To apply for HCBS waiver services in Colorado, contact your local SEP agency directly rather than going through the standard PEAK portal process. HCPF maintains a SEP agency directory at hcpf.colorado.gov. SEP agencies can also help identify non-Medicaid resources like the Home Care Allowance and Area Agency on Aging programs that may complement Medicaid coverage.

Medicaid estate recovery in Colorado

Colorado operates a Medicaid estate recovery program (MERP) under 42 U.S.C. § 1396p. Colorado seeks recovery from the estates of individuals who were age 55 or older when they received long-term care Medicaid services. Recovery is limited to probate assets and is deferred while a surviving spouse, minor child, or blind/disabled child is alive. Colorado's estate recovery program has specific hardship waiver provisions — families facing financial hardship due to estate recovery should contact HCPF's estate recovery unit to explore options.

Medicaid as the primary payer for long-term care

Medicare does not cover custodial nursing home care beyond 100 days following a qualifying hospital stay. Private long-term care insurance covers only those who purchased it. For the majority of Americans who need extended nursing home care, Medicaid ends up as the payer — after they have spent down their own assets to the program's limit.

Nationally, Medicaid pays for roughly two-thirds of all nursing home residents, per CMS data. Colorado's share of that population is administered through Health First Colorado (Colorado Medicaid). The rules that determine eligibility — income, assets, lookback periods, and exempt property — differ from the MAGI-based rules used for standard Medicaid.

Long-term care Medicaid also includes home and community-based services (HCBS), which allow people to receive care at home or in assisted living rather than a nursing facility. These programs operate through Section 1915(c) waivers and have waiting lists in most states.

Nursing facility coverage

Health First Colorado (Colorado Medicaid) covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.

Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance (which varies by state but is often $30–$50 per month). Medicaid covers the gap.

If income exceeds the institutional Medicaid limit, Colorado may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible. Not all states allow this; verify whether Colorado uses this approach with Health First Colorado (Colorado Medicaid).

Home and community-based services (HCBS)

HCBS waivers let states cover long-term care services outside nursing facilities — in a person's home, adult day program, or assisted living. Section 1915(c) of the Social Security Act authorizes these waivers. Each state designs its own waiver programs, so what's available through Health First Colorado (Colorado Medicaid) differs from what's available in neighboring states.

Common HCBS services include personal care assistance, home health aide visits, adult day health care, respite care for family caregivers, and modifications to make a home accessible. Some states cap the number of waiver slots, creating waiting lists that can run for months or years.

Contact Health First Colorado (Colorado Medicaid) to ask which HCBS waiver programs are currently open for enrollment and whether there is a waiting list.

Asset limits for long-term care Medicaid

Unlike MAGI-based Medicaid, long-term care Medicaid has an asset test. Countable assets — bank accounts, investments, second vehicles, vacation property — must fall below the state's limit. The specific threshold varies by state and is updated periodically; it is not a figure this page can reliably publish.

Exempt assets are not counted. The primary home is exempt while the applicant lives there or intends to return, as well as when a spouse, minor child, or disabled adult child lives there. One vehicle is typically exempt. Personal belongings and a prepaid funeral arrangement are also generally exempt.

Medicaid has a 60-month (5-year) lookback period for asset transfers. Transfers of assets for less than fair market value within those 60 months can result in a penalty period during which Medicaid will not pay for care. Consult Health First Colorado (Colorado Medicaid) or a Medicaid planning attorney before transferring assets.

Spousal protections

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse (the one still at home) is entitled to keep a minimum amount of assets — called the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income.

The CSRA allows the community spouse to keep between a federal minimum and maximum, with the exact amount varying by state and updated annually. Colorado's current CSRA is set by Health First Colorado (Colorado Medicaid) and published on their website.

The community spouse's own income is not counted toward the institutionalized spouse's Medicaid eligibility. If the community spouse has insufficient income, a portion of the institutionalized spouse's income may be allocated to them — the minimum monthly maintenance needs allowance (MMMNA).

What long-term care Medicaid typically covers

• Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
• Physical, occupational, and speech therapy provided in a nursing home
• Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
• Home health aide visits for those receiving care at home
• Adult day health care programs
• Respite care to give family caregivers temporary relief
• Durable medical equipment prescribed by a physician
• Transportation to and from medical appointments