Have Medicare and Health First Colorado? What You Get
If you have Medicare and Health First Colorado, or your income is close to qualifying, you may be leaving help on the table. How Medicare Savings Programs, Extra Help and dual plans work in Adams County.
Key takeaways
- A Medicare Savings Program can pay your Part B premium ($202.90 a month in 2026). The QMB program can also cover Medicare deductibles and coinsurance.
- In 2026, Colorado uses the federal income limits: $1,350 a month single or $1,824 married for QMB, and up to $1,816 or $2,455 for QI (NCOA 2026 chart).
- Colorado's 2026 resource limit for QMB, SLMB and QI is $11,450 single or $17,910 for a couple, including a burial allowance (HCPF).
- For 2027, Adams County has 19 Dual-Eligible Special Needs Plans (D-SNPs) from 8 carriers in the CMS plan files.
- People with Medicaid or Extra Help can use a monthly Special Enrollment Period, but only for one kind of move: switch to a stand-alone Medicare drug plan (keeping or returning to Original Medicare). It does not let you switch from one Medicare Advantage plan to another. Full Medicaid members have a separate monthly window to join an integrated D-SNP.
If you have both Medicare and Health First Colorado, you are what Medicare calls "dual eligible." That status can lower or remove your premiums, deductibles and drug copays, and it opens plan choices most people never hear about. If your income is modest but you do not have Health First Colorado, you may still qualify for part of that help.
The trouble is that the help comes from three different places: Medicare, Health First Colorado (Colorado Medicaid, run by the Department of Health Care Policy and Financing, or HCPF) and Social Security. Each has its own name, its own application and its own letter. People in Brighton and across Adams County often have one piece and miss the others.
Here is how the pieces fit, what the 2026 limits are, which plans are built for dual eligible members in Adams County for 2027, and how to apply. As Lisa says, we ask questions and listen first, because the right answer depends on your exact income, savings and coverage.
What does dual eligible mean in Colorado?
Dual eligible means you are enrolled in Medicare and also get help from Health First Colorado. Some people get full Health First Colorado benefits. Others qualify only for a Medicare Savings Program, which pays some of their Medicare costs but is not full Medicaid coverage.
| Program | Run by | What it can do |
|---|---|---|
| Medicare Parts A and B | Federal government (CMS) | Your main health coverage: hospital, doctors, outpatient care |
| Medicare Savings Program (QMB, SLMB, QI) | Health First Colorado (HCPF and your county) | Pays the Part B premium; QMB also covers Medicare deductibles and coinsurance |
| Full Health First Colorado | HCPF and your county | Can cover services Medicare does not, such as some long-term care and supports |
| Extra Help (Part D Low-Income Subsidy) | Social Security and Medicare | Lowers Part D premiums, deductibles and drug copays |
Do I qualify for a Medicare Savings Program in 2026?
You may qualify if your monthly income is at or below about $1,816 single or $2,455 married and your countable resources are under $11,450 single or $17,910 for a couple. The exact program depends on where your income falls.
| Program | Monthly income, single | Monthly income, married | What it pays |
|---|---|---|---|
| QMB (Qualified Medicare Beneficiary) | $1,350 | $1,824 | Part B premium ($202.90), Part A premium if owed, deductibles and coinsurance |
| SLMB (Specified Low-Income Medicare Beneficiary) | $1,616 | $2,184 | Part B premium |
| QI (Qualifying Individual) | $1,816 | $2,455 | Part B premium |
Income limits include the standard $20 disregard, and Health First Colorado decides what counts, so treat the table as a starting point, not a ruling. Your home, one car and personal belongings generally do not count as resources. If you are near the line, apply anyway. Your county human services office makes the decision.
- Colorado MSP resource limit, single, 2026
- $11,450
- Colorado MSP resource limit, couple, 2026
- $17,910
- Extra Help resource limit, single, 2026
- $18,090
- Extra Help resource limit, couple, 2026
- $36,100
How does Extra Help lower drug costs?
Extra Help, also called the Part D Low-Income Subsidy, lowers what you pay for Part D premiums, deductibles and copays. If you have full Health First Colorado or a Medicare Savings Program, you generally get Extra Help automatically. If you do not, you can apply through Social Security.
- Automatic: people with full Health First Colorado, QMB, SLMB or QI are generally enrolled in Extra Help without a separate application.
- By application: others with limited income and resources (under $18,090 single or $36,100 for a couple in 2026, per HCPF) can apply at ssa.gov or by calling Social Security.
- Plan choice: Extra Help works with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.
Extra Help also changes when you can switch plans, but the monthly window is narrower than many people think. Since 2025, when the CMS Contract Year 2025 final rule replaced the old quarterly window with a once-a-month one, Medicare.gov lists two moves it allows once a calendar month for people with Medicaid or Extra Help: switch to a different stand-alone Medicare drug plan, or drop a Medicare Advantage plan with drug coverage by joining a stand-alone drug plan and returning to Original Medicare. The change starts the first day of the next month. It does not let you move from one Medicare Advantage plan to another; for that you use the fall Open Enrollment Period, the January to March Medicare Advantage Open Enrollment Period, another Special Enrollment Period, or, with full Health First Colorado benefits, the integrated D-SNP window below. People flagged as at-risk in a plan drug management program cannot use it.
What dual plans are available in Adams County for 2027?
For 2027, the CMS plan files list 28 Special Needs Plans in Adams County, and 19 of them are Dual-Eligible Special Needs Plans (D-SNPs). A D-SNP is a Medicare Advantage plan only for people who have both Medicare and Medicaid help. 11 of the 19 show a $0 monthly plan premium.
Source: CMS Medicare Advantage and Part D Landscape, CY2027 (September 2026), Adams County, CO, retrieved October 14, 2026.
Carriers with a D-SNP in the 2027 Adams County file: Aetna Medicare, Anthem Blue Cross and Blue Shield, Devoted Health, Elevate Medicare Advantage, HealthSpring, Humana, Kaiser Permanente, UnitedHealthcare. Not every D-SNP accepts every level of Medicaid help. Some are for people with full Health First Colorado benefits only, and some also accept people with a Medicare Savings Program. The plan name and the plan's own materials say which.
How do I apply and what should I bring?
Apply for Health First Colorado and the Medicare Savings Programs through Colorado PEAK online or through your county human services office. Apply for Extra Help through Social Security if you do not get it automatically.
- Gather documents: your Medicare card, photo ID, proof of income (Social Security award letter, pension statements) and recent bank statements.
- Apply for the Medicare Savings Program through PEAK or the Adams County human services office. You can apply even if you are not sure you qualify.
- Watch the mail. Approval letters come from the county and HCPF; a Part B premium change appears on your Social Security payment after the state starts paying it.
- Review your plan. Once approved, compare your current plan with the D-SNPs and Part D plans that fit your doctors and drugs.
- Renew on time. Health First Colorado eligibility is reviewed every year. Answer renewal letters quickly so your help does not lapse.
What mistakes do dual eligible members make most?
- Paying bills you do not owe. Medicare.gov says providers cannot bill people in the QMB program for Medicare deductibles, coinsurance and copays. Show your Health First Colorado card and ask the office to rebill.
- Missing the renewal. A missed renewal letter can end both Health First Colorado and the Medicare Savings Program, and the Part B premium comes back out of your check.
- Choosing a plan your doctors do not take. Check that your doctors accept both the Medicare plan and Health First Colorado.
- Waiting for fall. With Medicaid or Extra Help you do not have to wait for October to fix a drug plan that is not working.
For a free, no-obligation review of your own situation, call Lisa at (303) 887-8584. For Health First Colorado applications, contact your county human services office or PEAK, and Medicare.gov or 1-800-MEDICARE can answer questions about your Medicare record.
The bottom line
If you have Medicare and Health First Colorado, or your income is near the 2026 limits, check three things: whether a Medicare Savings Program pays your Part B premium, whether you get Extra Help on drugs, and whether one of the 19 Adams County D-SNPs for 2027 fits your doctors. Those three can change your yearly costs more than any other choice you make.
Frequently asked questions
Can I have Medicare and Health First Colorado at the same time?
Yes. People who qualify for both are called dual eligible. Medicare generally pays first, and Health First Colorado or a Medicare Savings Program helps with costs Medicare leaves behind.
What is the income limit for QMB in Colorado in 2026?
Colorado uses the federal limits: $1,350 a month for a single person and $1,824 for a married couple in 2026, according to NCOA's 2026 chart. The resource limit is $11,450 single or $17,910 for a couple, per HCPF.
How many D-SNPs are in Adams County for 2027?
The CMS CY2027 landscape lists 19 Dual-Eligible Special Needs Plans in Adams County, out of 28 Special Needs Plans in total.
How often can I change plans if I have Extra Help?
Only in limited ways. Medicare.gov says people with Medicaid or Extra Help can, once a calendar month, switch to a stand-alone Medicare drug plan or leave a Medicare Advantage drug plan for Original Medicare plus a stand-alone drug plan, starting the first day of the next month. It does not allow a switch between Medicare Advantage plans. People with full Medicaid can also join or switch to an integrated D-SNP once a month. Members flagged as at-risk in a drug management program are excluded.
Sources
- NCOA: Medicare Savings Programs, Eligibility and Coverage (2026) National Council on Aging
- HCPF OM 25-078: 2026 Increase to Resource Limits, Medicare Savings Programs and Low-Income Subsidy Colorado Department of Health Care Policy and Financing
- CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services
- Medicare.gov: Special Enrollment Periods Centers for Medicare & Medicaid Services
- CMS fact sheet: Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) Centers for Medicare & Medicaid Services
- Medicare.gov: Medicare Savings Programs Centers for Medicare & Medicaid Services
- 2026 Medicare Parts A & B Premiums and Deductibles Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Currently we represent 10 organizations which offer 106 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Headwaters Health and Wealth is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information. This article is general information, not medical, tax or legal advice.
