What does dual-eligible mean?
A dual-eligible beneficiary qualifies for both Medicare and Medicaid (called Health First Colorado in Colorado). About 150,000 Coloradans are dual-eligible. If you're one of them, you may qualify for significant cost savings and specialized health plans.
Medicare Savings Programs
Even if you don't qualify for full Medicaid, Colorado offers programs that help pay your Medicare costs:
| Program | What it pays |
|---|---|
| QMB (Qualified Medicare Beneficiary) | Part B premium + all Medicare deductibles and coinsurance |
| SLMB (Specified Low-Income Beneficiary) | Part B premium only |
| QI (Qualifying Individual) | Part B premium only (slightly higher income limit than SLMB) |
D-SNP plans in Colorado
Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans designed specifically for people with both Medicare and Medicaid. These plans often include extra benefits beyond standard Medicare:
- $0 or very low premiums
- $0 copays for most services
- Dental, vision, and hearing coverage
- Transportation to medical appointments
- Over-the-counter health product allowances
- Care coordination between Medicare and Medicaid benefits
Extra Help / Low-Income Subsidy
If you're dual-eligible, you automatically qualify for Extra Help (also called the Low-Income Subsidy or LIS), which pays most of your Part D prescription drug costs. This means little to no cost for covered medications.
How to apply
Apply for Health First Colorado through Colorado PEAK or call 1-800-221-3943. Once approved for Medicaid, your dual-eligible status is automatic. A licensed Medicare agent can help you find D-SNP plans available in your county.