ColoradoCare will greatly expand access to and improve the quality of health care. Health benefits include primary, mental health, and specialty care. Patients can choose their primary care providers. Amendment 69 specifically states: ColoradoCare shall contract with providers and pay for health care services to beneficiaries that
must include:

  • Ambulatory patient services including primary and specialty care
  • Hospitalization
  • Prescription drugs and durable medical equipment
  • Mental health and substance use disorder services including behavioral health treatment
  • Emergency and urgent care
  • Preventive and wellness services and chronic disease management
  • Rehabilitative and habilitative services and devices
  • Pediatric services including oral vision and hearing care
  • Laboratory services
  • Maternity and newborn care
  • Palliative and end of life care
  • The board may authorize payment for benefits not specified in paragraph of subsection of this
    section.

 

Z

Primary Care

Z

Mental Health

Z

Specialty Care

Z

Choice of care provider

Benefits under ColoradoCare

The benefit coverage listed below is set by the Amendment and by the Health and Human Services and Medicaid state and federal requirements. These constitute the legal minimums. The ColoradoCare Board of Trustees, acting on the wishes of members, may increase benefits.

 

  • Outpatient services for both primary and specialty care
  • Emergency and urgent care services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs and durable medical equipment
  • Rehabilitative services and services that help patients acquire, maintain, or improve skills necessary for daily functioning and the devices needed for these services
  • Laboratory services
  • Wellness, including integrative and some alternative medicine
  • Chronic disease management
  • Pediatric services, including vision and hearing care
  • Dental care for children and low-income people over 60
  • Palliative and end-of-life care
  • Local health care services when temporarily in another state (residents, ColoradoCare beneficiaries, include students and others who continue to list Colorado as primary residence, pay taxes here themselves, or are a dependent of a resident)
  • No annual dollar cap on services
  • No deductibles
  • No copayments for most preventive and primary care
  • Services regardless of whether illness or injury occurs at work, in an accident, or otherwise
  • When Medicaid eligible, and in some other circumstances determined by the Board of Trustees:
    • Home health services
    • Children with autism
    • Telemedicine
    • Adult vision
    • Adult dental
    • All other programs connected with Medicaid funding by federal or state statues would be continued as conditions of the Medicaid waiver.

Download this list of benefits

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