I’m looking in moving to Colorado from Utah for better heath insurance. It appears that in Colorado if you have a disability (type 1), You can qualify for Medicaid regardless of income. Has this worked for anyone here?
And if so , how is your coverage?
Hi @Dean, welcome! Not sure I’m the best person to ask, but from what I understand only some select people who are elderly and disabled quality regardless of income requirements:
Looks like it’s a special exemption for those with disabilities, but what I can’t tell from the text is whether people who are simply diagnosed with T1D, but do not have significant functional impairment, qualify. I would suspect not:
Hope this is a helpful place to start. You might try calling some of the phone numbers listed on that page if you haven’t already.
ETA: Also, and this is before the Medicaid Expansion through ACA went through, so it may no longer be true, but I knew someone who was quadriplegic and in order for him to qualify for Medicaid, despite his obvious need for 24-7 in-home care, his funds needed to be kept in a special trust which he technically had no control over. So if you have other assets (savings, etc.) it may be that you need to either use those first or have them in a special legally approved financial setup to qualify.
My son qualifies for Medicaid due to disability in Alaska regardless of our incomes but the disability requirements were far far beyond what having a type 1 diabetes diagnosis would allow for… I suspect they are pretty strict in who qualifies and who doesn’t… like people with major disabilities who could not work in any circumstance or occupation…
This is what I suspect too. Basically, my suspicion is it means you have difficulty addressing daily life needs, like dressing yourself, feeding yourself, or require so much daily medical care that you need in-home nursing care, etc.
I am not trying to collect disability, just qualify for Medicaid. I am just hoping to find better coverage, I think I will still need to pay, but it would be less then now.
https://www.colorado.gov/pacific/hcpf/medicaid-buy-program-working-adults-disabilities
Wow, interesting! Thanks for posting @Dean
Good luck with it, I still suspect that a diagnosis of t1 diabetes won’t qualify. (Unless many horrific complications had occurred as a result) Let me know if it does, I may have to move when I retire:)
Their determination appears to be linked to social security disability, although not dependent on it— and at a glance SSI says:
Having been through a states medicaid eligibility process every year with earnings that would normally exclude us, I can assure you that where I live it is a pain in the butt and if not truly and completely disabled there’s no way anyone would qualify… they turn over every stone, interview caretakers, doctors, teachers, therapists, demand reems of documentation… it’s a nightmare. We actually have to hire a care coordinator to help get our sons medicaid squared away, and it only acts as a secondary coverage to his private insurance…
Sam,
Thanks. But I feel like we are talking about different things here.
I want to get on Colorado Health First. This is a Medicaid program, in that it is government funded.
I believe I may quilify for it because of Type 1 which is a listed Disability.
I am not Disabled to the point I cant work. I really don’t feel disabled at all, besides that injecting daily or die thing.
I don’t want what most people call Disability Pay, I want good health insurance that will not change because of a preexisting condition.
"For Our Members › List of All Programs › Health First Colorado Buy-In Program For Working Adults With Disabilities
Health First Colorado Buy-In Program For Working Adults With Disabilities
The Health First Colorado Buy-In Program for Working Adults with Disabilities lets adults with a disability who qualify to “buy-into” Health First Colorado (Colorado’s Medicaid Program). If you work and earn too much to qualify for Health First Colorado you may qualify. If you qualify, you pay a monthly premium. Your monthly premium is based on your income.
Who qualifies?
You must be between 16 and 64 years old,
You must be employed,
You must have a qualifying disability. The Social Security Administration (SSA) listings describes what disabilities qualify, and
Your income must be below 450% of the Federal Poverty Level (FPL). For example, you can make about $4,523 a month and qualify.
You are not required to apply for SSA disability. If you do not have a current disability determination from the Social Security Administration, fill out the Health First Colorado Disability Application and Medical release form on the How To Apply page. We will determine if you qualify using the Social Security Administration (SSA) listings, without regard to your substantial gainful activity or your ability to work.
https://www.colorado.gov/hcpf/medicaid-buy-program-working-adults-disabilities
I think we’re talking about the same program although a different states version of it… where I live it’s called Denali kid care, which is our states medicaid program m… it doesn’t involve disability payments just Medicaid coverage for people (in my case children) whose household’s income are in excess of the cutoffs for Medicaid eligibility…
I’d love to know if you’re successful in qualifying! That could be a plan changer for me!
From your link:
That’s where I think it’s a tough sell unless diabetes has caused things like blindness, amputations, etc…
I could be wrong, but just think, if they qualify uncomplicated diabetes as a disability for Medicaid think of all the other things they’d have to also, the majority of the state would qualify it seems
Always happy to learn of new options. One never knows when the healthcare system is going to go down the crapper. One also never knows when they’ll lose their job…Colorado is a beautiful place to boot AND allows the recreational use of wacky weed…what’s not to love about it?
I guess I consider not producing insulin a severe functional limitation , don’t you?
No, not at all IMO, it’s a situation that requires someone take medication, and monitor their blood sugars but in and of itself not a functional limitation at all I don’t think…
But you could also say, it’s a severe functional limitations that requires someone take medication, and monitor their blood sugars
Do you not believe type one is a disability?
I agree, its not that difficult to manage and getting easier I hope. But its still a disability to me.
I do not consider myself disabled in any way by T1… it’s a huge burden yes, but that differs from a disability, to me…
If you are able to get the approval I’d love to know how the process goes
I suspect “severe functional disability” would mean things like walking, using your hands, speaking, seeing, etc but I could be wrong. Would be interesting to see what they say if you apply
perhaps this is a state-by-state program. I’m guessing Medicaid requirements vary considerably by state.
Yeah Medicaid does vary a lot from state to state I think
How is Diabetes Defined as a Disability Under Federal Law?
The following key points apply to federal law:
Diabetes is a disability because it substantially limits the function of the endocrine system
Diabetes can be an “invisible” disability
Diabetes is still a disability, even if a person is healthy and diabetes is well-managed
Diabetes limits the endocrine system. This is the system that regulates insulin and blood glucose (sugar). Specifically, federal laws, such as the Americans with Disabilities Act and the Rehabilitation Act, protect qualified individuals with a disability. Since 2009, amendments and regulations for these laws make clear that diabetes is a disability since it substantially limits the function of the endocrine system. This internal limitation is enough—no outside limitation is necessary. This means diabetes can be an “invisible” disability.
Federal law does not take into account mitigating measures such as medication use when determining whether an individual is a qualifying person with a disability. A person may have diabetes completely under control through medicine and lifestyle changes, and still have a qualifying disability. That means that for the purpose of defining disability, the laws look at how the person would be if they stopped treating diabetes in any way. Usually, that would be very bad. As a result, diabetes is almost always a disability.
Maybe the Colorado department of health and social services (or whatever they call it there) would be able to clarify directly as to what it might m qualify for etc… It is a big investment to decide to move to a different state-- and it sounds like it’s just a discount program based on your income?
Unfortunately no. If you are at extreme disability( unable to work at all) then possibly. I do think you have to prove it in court. I live in Colorado