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How Do I Apply for Medicaid?

• You can apply for Medicaid by downloading an application or picking up an application at any Boulder County Social Services office or select clinic locations. You must submit the completed application in person at a Boulder County Social Services office. If you can't leave your home, you can still apply. Call Social Services and ask how this can be done.
• If you are an adult over 20 years of age with no minor children and are not receiving Supplemental Security Income (SSI), you need to complete the two-part Single Purpose Application (SPA).
  • Download SPA Part 1 (PDF 413 KB).
  • Download SPA Part 2 (PDF 91 KB).
• If you are applying ONLY for Medicaid and are:
  • A pregnant woman,
  • A person under age 20, or
  • A head of a household with a child or children under age 20, you need to complete the Baby Care Kids Care (BCKC) application.
    • Download English Application (PDF 1536 KB).
    • Download Spanish Application (PDF 2521 KB).
• If you are applying for other programs in addition to Medicaid, such as food stamps or old age pension, you need to complete the two-part SPA application.

The Application Process

• Download or pick up an application.
• Submit the application, in person, to any Boulder County Social Services office.
• The application is valid when received and dated by the Boulder County Department of Social Services.
• An eligibility technician will review the application for completeness and request any needed documentation that is not verified. All correspondence will have the name and phone number of the technician handling your application.
• Social Services Medicaid technicians are allowed 45 days to determine eligibility for non-disabled persons and 60 days for disabled persons.
• You have 10 days to return all requested documentation. Failure to do so may result in denial of your application.
• You may call a Boulder County Department of Social Services office if you have not received any notice of eligibility status after 45 days.

How can I get help filling out an application?

Call or visit a community based organization for help in filling out your Medicaid application.

When you turn in your Medicaid application, you should bring:

• Proof of identity and citizenship or alien status.
• Recent paycheck stubs (if you are working).
• Proof of your income from sources like retirement, Social Security, Supplemental Security Income (SSI), Veteran's Benefits (VA) .
• Insurance benefit card or the policy (if you have any other health insurance).

• Medicare Benefit Card.

Helpful Tips for Completing the Application

• Make sure the application is signed, dated, and initialed.
• Make sure the application is complete, including all requested documentation.
• Complete the application in blue or black ink only. Applications completed in pencil are not accepted.
• Report ALL changes that happen to the household within this 45-day period, including:
  • Address.
  • Household members.
  • Earned income (e.g., termination of employment, increase/decrease in wages).
  • Unearned income (e.g., SSI, child support, etc.).
• If eligible, Medicaid may cover medical care received in the three (3) months prior to the application date, if it is requested.  (Write the date or dates of the Medicaid backdate requested on the application where applicable, and provide income verification for the dates submitted.)