Medicaid Benefits for Adults
Below is a partial list of covered Medicaid services. If you have a
question or need a service that is not listed below, call
Medicaid Customer Service at 303-866-3513 or 1-800-221-3943.
- Please note:
- Medicaid covers services that are medically necessary, as
determined by a Medicaid primary care physician (PCP).
- Some services need Medicaids approval. Your PCP will
submit a Prior Authorization Request (PAR) to Medicaid to
determine the amount, scope, and duration of your
services.
- Present your
medical identification card (MID card) for all medical supplies,
equipment, or services (e.g., wheelchair, orthopedic shoes,
transportation).
Abortion Abortion is not normally covered. Ask your PCP to find out
when it is covered.
Ambulance Emergency ground and air transport.
Contact Lenses Covered for members over age 20 if clients have
a history of eye
surgery.
Dental Covered for members over age 20
for emergency procedures only.
Medicaid approval is needed.
Developmental Disabilities Services — Members can
apply at community center boards or online. Medicaid approval is
needed.
Dialysis Drugs, Over-the-Counter Aspirin, insulin, and prenatal vitamins are covered. Prenatal
vitamins are covered only for women who are pregnant or 90 days
postpartum. Drugs, Prescription Drugs for fertility, anti-obesity, and cosmetics are not
covered. Cough and cold drugs are not a benefit for members
over age 20.
Durable Medical Equipment Emergency Services
Eye Exams Covered for members over age 20 if client has a medical
complaint (headaches, blurred vision). Eyeglasses Covered for members over age 20 if client has a history of eye
surgery. Family Planning Services Hearing Exams
Hearing Implants Prior
Medicaid approval is needed for members over age 20. Home and Community-Based Waiver Services (HCBS)
Members can apply at
Single Entry Point Agencies. Medicaid
approval is needed. Home Health Care Services Hospice
Hospital-Inpatient Services Hospital-Outpatient Services
Hysterectomy Lab Mental Health Care Management (though BHO)
Nursing Facilities Prior
Medicaid approval is needed. Obstetric Services Out-of-State Services
If you are temporarily out of the state but are still a
resident of Colorado, you may receive some Medicaid benefits
under certain conditions:
- It is a medical emergency (life- and limb-threatening
situations).
- Your health would be endangered if you were required to
return to Colorado for the medical care/treatment.
The doctor/hospital that treats you must enroll in the
Colorado Medicaid Program. Please have that doctor work with
our Medicaid fiscal agent so that reimbursement is guaranteed.
Physical and Occupational Therapy Prior Medicaid approval is needed.
Podiatry
Smoking Cessation Covered as a one-time benefit only.
Prior Medicaid approval is
needed.
Sterilization Prior Medicaid approval is needed.
Transplants Prior Medicaid approval is needed.
Transportation Transportation to and from medical and or dental care
may require prior authorization. You may call Logisticare of
Colorado, Medicaid non-emergency transportation broker at
1-800-390-3182 for more information.
X-Ray Services
Medicaid Customer
Service 303-866-3513
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