Health First Colorado (Colorado’s Medicaid Program) Member Benefits & Services
In Colorado, Medicaid is called Health First Colorado. As a Health First Colorado member enrolled in the Accountable Care Collaborative (ACC) plan, you now have one regional organization that will coordinate your physical and behavioral health care. Colorado Community Health Alliance (CCHA) is your regional organization if your primary care provider’s (PCP’s) office is in one of these counties: Boulder, Broomfield, Clear Creek, El Paso, Gilpin, Jefferson, Park or Teller County. We support this network of providers to make sure you can access care in a coordinated way. CCHA services are part of your Health First Colorado benefits, so there is no extra cost to you.
Our goal is to help increase access to services that will help improve your overall well-being. You have a whole team that works together to guide you through the health care system. We also help make sure you get connected to the right services for your unique needs. This includes physical and behavioral health care, dental care, and resources such as food, housing, transportation and childcare.
You Get the Regular Health First Colorado Benefit Package
You Have a Primary Care Provider as Your Medical Home Where You’ll Get Most of Your Care
You Get Extra Care Coordination Services from CCHA
I’m enrolled in a different Health First Colorado plan, but I’m interested in the ACC option. How do I find out if I’m eligible?
You can start by learning more about Health First Colorado health plan options. If you are interested in changing to the ACC option, contact Health First Colorado Enrollment (formerly HealthColorado). They will provide you with additional information and guide you through the selection process.
I’m already enrolled in the ACC. Now what?
As a Health First Colorado ACC member, you are part of a team that helps make sure you get connected with the care and resources you need for your health and well-being. This team includes you, your family members or caregivers, your primary care provider (PCP), and CCHA care coordinators. Call CCHA if you have questions about your health care or covered benefits. We can also help with things such as:
- Finding a provider who is the right fit for you
- Getting appointments for all your health needs
- Connecting with nonmedical resources
- Signing up for programs to help with your health
What health care benefits do I get with Health First Colorado?
The Health First Colorado Member Handbook provides information about covered health benefits and services. This includes physical health, behavioral health, dental, vision, and prescription services. You can also view videos that explain your Health First Colorado benefits.
What are my rights and responsibilities as a Health First Colorado member?
You can learn about your rights and responsibilities as our member in the Member Handbook.
If I need care, how soon can I get it?
Our goal is to help you get the most from your health care and live a healthy life. We want you to be able to get care at any time. When your PCP’s office is closed, you have options.
- Leave a message with your PCP’s office. The on-call provider will call you to talk about your concern and set up an appointment.
- Call the Health First Colorado Nurse Advice Line at 1-800-283-3221 for free advice 24/7 or visit an urgent care center near you.
- Call 9-1-1 or go to the nearest emergency room if you have an urgent health need that could be life threatening or cause serious harm to your body.
- Call the confidential Colorado Crisis Support Line 24/7 at 1-844-493-8255 or text TALK to 38255 if you are struggling with mental health, substance use or emotional issues.
If you get care from a provider who is not your PCP, follow up with your PCP as soon as you can.
You can expect to see providers for:
- Urgent care — within 24 hours of request
- Outpatient follow-up care — within 7 days of discharge from an inpatient hospital stay
- Non-urgent, routine care — within 7 days of request
- Well-care visits — within one month of request, or sooner if health screenings are needed
Contact CCHA Member Support Services if you need oral interpretation services or information in large print or other formats.
What if I have a complaint or want to appeal a decision about my health care services?
Call us. We’re here to help. If you have a problem with your Health First Colorado services or providers, we would like you to tell us about it. Call CCHA Member Support Services at 1-855-627-4685 (711 TTY) and we’ll try to solve the problem on the phone.
Filing a Complaint
If we can’t take care of the problem when you call us, you can file a complaint. Once you file a complaint, it will be reviewed and you will get a letter with a decision. If you do not agree with the answer you get, you may be able to ask for a second review.
Filing an Appeal
There may be times when a service that was approved will be denied, end or be reduced. Or all or part of the care your provider asked for may not be paid. You will get a letter called a Notice of Action for any decision that affects your coverage or services. It will tell you the decision, why it was made and how to appeal if you disagree.
For help filing a complaint or appeal, call:
Ombudsman for Health First Colorado Managed Care
1-877-435-7123 (toll free)
Your Health First Colorado Member Handbook will tell you more about your rights to file a complaint or an appeal. If you have questions about anything you read here or in the Member Handbook, contact CCHA Member Support Services.