Colorado Medicaid Buy-In: Coverage for Your Child

Even if you've been told your family makes too much money to qualify for Medicaid, Health First Colorado may not be out of reach.

Colorado has a Medicaid Buy-In program specifically for children with disabilities. The program allows qualifying children to receive Health First Colorado benefits even when their family's income would otherwise be too high for Medicaid.

As a parent of an autistic child, I know that can make a big difference. Health insurance affects everything from doctor visits and therapy to the services your child can access as they grow.

Here's what you need to know about Colorado Medicaid Buy-In, including who qualifies, how income and premiums work, what it may cover for an autistic child, and how to apply.

Key Takeaways

• Colorado has a Health First Colorado Buy-In Program for Children with Disabilities.
• The program can provide Medicaid coverage to eligible children whose family income would otherwise prevent them from qualifying.
• Eligibility depends on several factors, including your child's disability and household income.
• Some families may pay a monthly premium based on their income.
• Buy-In coverage may be used alongside other health insurance in some circumstances.
• Families can apply through Colorado PEAK or other approved application channels. If your child has Health First Colorado and you want to start ABA therapy, you can get started with Alpaca Health.

What is the Colorado Medicaid Buy-In program?

The Health First Colorado Buy-In Program provides Medicaid coverage for qualifying children with disabilities.

The key word here is “Buy-In.” Your child may be able to qualify for Health First Colorado even when your family's income is above the limit for other Medicaid eligibility categories. Depending on your family's income, you may still be required to pay a monthly premium for coverage.

This can be especially important for families who have private insurance but still face significant healthcare costs related to their child's disability.

The Buy-In Program isn't a separate type of health plan with its own medical network. An eligible child becomes a Health First Colorado member and receives covered Medicaid benefits.

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Who the Buy-In program is for

Colorado has a buy-in option for both children and adults with disabilities. However, the eligibility requirements differ.

Children with disabilities

The Health First Colorado Buy-In Program for Children with Disabilities is designed for children who meet the program's disability and eligibility requirements.

Parents should know that one of the biggest differences from traditional Medicaid eligibility is how the program handles family income. Earning too much for another Health First Colorado eligibility category doesn't automatically mean your child won't qualify for the program.

Your child still must meet the program's other requirements, even if income doesn't determine eligibility alone.

Working adults with disabilities

Colorado does have a separate program for working adults with disabilities. The program allows qualifying adults with disabilities to maintain Health First Colorado coverage while working.

The adult program has its own rules for income, employment, premiums, and eligibility. If you're researching coverage specifically for your child, make sure you're looking at information for the Children with Disabilities Buy-In instead of the working adults with disabilities program.

Income and asset limits for Colorado Medicaid Buy-In

Your family's size and income matter when applying for the Children with Disabilities Buy-In program, but the rules are different from those for regular Health First Colorado.

For 2026, the Children with Disabilities Buy-In allows qualifying children in families with counted income up to 300% of the Federal Poverty Level (FPL). The exact monthly income limit depends on your family size.

Health First Colorado makes certain adjustments to earned and unearned income before determining eligibility, so the amounts in the table aren't necessarily the same as your family's gross monthly income.

2026 Colorado Medicaid Buy-In income limits and premiums

Source: Colorado Department of Health Care Policy & Financing (HCPF), 2026 Children with Disabilities Buy-In Income Chart and Premium Guide.

These amounts are based on 2026 Federal Poverty Level guidelines and use monthly income after Health First Colorado's applicable income adjustments. Your gross household income may be higher than the amount shown in the table.

The Children with Disabilities Buy-In also doesn’t have an asset limit. Eligibility isn't based on how much your family has in savings, retirement, a home or other assets.

Even if your income is close to the program's limit, it's still worth applying rather than assuming your child won't qualify. Colorado will use the information on your application to determine eligibility based on the current guidelines.

What the monthly premium costs

Some families enrolled in the Children with Disabilities Buy-In program pay a monthly premium for their child's Health First Colorado coverage.

Source: Colorado Department of Health Care Policy & Financing (HCPF), 2026 Children with Disabilities Buy-In Income Chart and Premium Guide.

For 2026, monthly premiums range from $0 to $120 based on your family's counted monthly income. Families at 0% to 133% FPL pay no monthly premium, while families at higher income levels may pay $70, $90, or $120 per month.

FPL guidelines and Buy-In income and premium amounts may change, so check Health First Colorado for the most current guidelines.

Keep in mind that the premium is the amount you pay to maintain your child's coverage. It's not the same as paying the full cost of your child's healthcare services out of pocket.

When comparing costs with private insurance, consider more than the monthly premium alone. Think about the services your child uses regularly, what your private plan covers and what you currently pay toward deductibles, co-pays, coinsurance and therapy.

What Buy-In covers for an autistic child

Once your child qualifies for the Buy-In program, they receive Health First Colorado coverage rather than a limited disability-only benefit.

For an autistic child, covered services may include medically necessary health \care and behavioral health services depending on your child's individual needs and Health First Colorado coverage requirements.

You may find this particularly helpful when your child needs ongoing care from multiple providers. Your family may be managing pediatric appointments, developmental services, behavioral healthcare, prescriptions, and other medical needs at the same time.

Health First Colorado covers medically necessary services for eligible children through its benefits for members under age 21. The exact services your child receives depend on their needs and applicable coverage requirements.

If you're specifically looking for ABA therapy, your child's Medicaid eligibility is only one part of getting started. You also need to find a provider that accepts Health First Colorado and determine what steps you need to take before you can begin treatment.

If your autistic child has Health First Colorado and you're trying to start ABA therapy, Alpaca Health accepts that coverage and can verify your child's benefits before therapy begins.

How Buy-In differs from regular Health First Colorado

The biggest difference isn't the healthcare coverage your child receives once enrolled. It's how your child becomes financially eligible for it.

Traditional Health First Colorado programs have income requirements that may prevent some children from qualifying based on their family's household income.

The Children with Disabilities Buy-In creates another pathway for children who meet disability requirements. That allows eligible families with higher income to still access Health First Colorado coverage, sometimes by paying a monthly premium.

This is important if you have previously been told that your family earns too much for Medicaid.

A denial under one Health First Colorado eligibility category doesn't necessarily tell you whether your child qualifies for the Children with Disabilities Buy-In. When you apply, Colorado determines which program your child may qualify for based on the information you provide.

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How to apply for Colorado Medicaid Buy-In

First, submit an application and let Health First Colorado determine which programs your child may qualify for. You don't need to determine your child's eligibility on your own before applying.

What documents you need

Have your information together before you apply to make the process easier. You may need information such as:

• Your household members
• Your family's income and employment
• Other health insurance available to your child
• Your child's medical condition or disability
• Your child's Social Security number, if they have one

Colorado may also ask for additional documentation to verify information on your application. If you receive a request for more information, pay attention to the deadline so your child's eligibility determination isn't delayed.

Where to submit the application

One way to submit your application is through Colorado PEAK, the state's online benefits system. You can also get help applying through your county Department of Human Services or an application assistance site.

You don't need to submit a separate general Medicaid application and Buy-In application just to see which program your child qualifies for. Provide complete information about your child, household income and disability so the state can determine their eligibility.

What happens after you apply

After you submit the application, Colorado reviews the information to determine whether your child qualifies for Health First Colorado and which eligibility category applies.

You may also receive a request for additional information during the application process. Respond as soon as you can, and keep copies of any documents you submit.

Once Colorado makes a decision, you'll receive a notice explaining whether your child qualifies and what you need to do next.

Using Buy-In alongside private insurance

Some people may use private health insurance along with the Children with Disabilities Buy-In Program. It's not uncommon for some families to use Health First Colorado along with employer-sponsored or other private health insurance. When a child has both, private insurance generally pays first for covered services, and Medicaid may help with eligible costs or services under its coverage rules.

There's one important rule to know. If your family has access to employer-sponsored group health insurance and the employer contributes at least 50% toward the premium, Colorado may require your child to enroll in that coverage as a condition of participating in the Children with Disabilities Buy-In program.

Make sure that your healthcare providers have information for both plans. You may also want to ask how the provider coordinates private insurance with Health First Colorado before beginning a new service or therapy.

What to do if your application is denied

A denial doesn't necessarily mean you've reached the end of the process. Start by reading the Notice of Action carefully. It should explain why your child's application was denied. Sometimes an eligibility issue may involve missing information or documents that still need to be verified.

If you disagree with the decision, you have the right to appeal a Health First Colorado eligibility denial. Colorado allows you to request an informal meeting with your eligibility site, request a formal hearing or do both.

Pay attention to the deadline on your notice. Typically, you must request an appeal within 60 days of the date of the Notice of Action. You'll also want to keep your denial letter, copies of the documents you submitted, and any additional information that supports your child's eligibility.

These documents can help you understand what happened and prepare if you decide to challenge the decision.

Keeping coverage when your income changes

Your family's income may fluctuate. You or your partner may get a raise, change jobs, reduce work hours or experience another change that affects your household income.

Since the Children with Disabilities Buy-In is designed for families with income above other Medicaid limits, earning more doesn't automatically mean your child will lose Health First Colorado.

But you should report changes that could affect your child's eligibility. An income change may affect whether your child continues to qualify or how much your family is required to pay for coverage.

Don't cancel your child's coverage simply because your income changed or because you assume your family now earns too much. Instead, report the change and allow Health First Colorado to determine how it affects your child's eligibility.

How Alpaca Health helps Colorado families start ABA therapy

Getting your child covered by Health First Colorado is important. However, you may still have questions about how to start ABA therapy.

Alpaca Health matches Colorado families with independent BCBAs who accept Health First Colorado and provide ABA therapy at home or online, including families who are just starting out after an autism diagnosis.

If your child has Health First Colorado through the Children with Disabilities Buy-In program, Alpaca Health verifies your child's ABA benefits and handles prior authorization (the insurer's approval for therapy) before the first session.

Get started with Alpaca Health to get matched with a Colorado BCBA who accepts your child's plan.

You don't have to figure this out alone.

Alpaca Health matches your family with a vetted, in-network BCBA, often within days and with no waitlist. We handle the insurance paperwork so you can focus on your child.

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Frequently asked questions about Colorado Medicaid Buy-In

What is the income limit for Colorado Medicaid Buy-In?

For 2026, the Children with Disabilities Buy-In allows qualifying children in families with counted income up to 300% of the Federal Poverty Level (FPL). The exact monthly income limit depends on family size and Health First Colorado's applicable income adjustments.

How much is the Colorado Medicaid Buy-In premium?

For 2026, Children with Disabilities Buy-In premiums range from $0 to $120 per month based on counted family income. Families at 0% to 133% FPL pay $0, while families at higher income levels may pay $70, $90, or $120 per month.

Can my child have Buy-In and private insurance?

Yes. Having private insurance doesn't necessarily prevent your child from qualifying for the Children with Disabilities Buy-In. When a child has both private insurance and Health First Colorado, the plans can coordinate coverage.

Your private insurance will typically pay first, with Health First Colorado serving as a secondary payer for covered services.

Does Buy-In cover ABA therapy?

Health First Colorado covers medically necessary behavioral therapy for eligible children. This includes children with autism who meet state coverage criteria.

Having coverage doesn't necessarily mean your child begins therapy immediately. Your child may need an appropriate evaluation, treatment plan, or other documentation before services are approved.

If your child has autism and you're trying to use Health First Colorado to start ABA therapy, Alpaca Health can help by verifying your child's benefits and matching you with a BCBA who accepts the plan.