Alternative Benefit Package: Update on Medicaid benefits for newly eligible

Monday, December 16, 2013 03:45 PM

Beginning Jan. 1, 2014, more Coloradans will be newly eligible for free or low-cost coverage through Colorado Medicaid. Currently, Medicaid offers primary care, behavioral health, hospitalization, rehabilitative services, laboratory services, outpatient care, prescription drugs, emergency care, dental care, maternity care and newborn care.

The benefit package for newly eligible Medicaid clients will be largely the same as the current Medicaid benefits, including the new dental benefit and enhanced mental health and substance use disorder benefit.

In accordance with federal law, the newly eligible Medicaid clients will receive preventive and wellness services as defined by the U.S. Preventive Services Task Force. In an effort to align Medicaid benefits, the current Medicaid benefit package will be expanded to include these preventive and wellness services.

Additionally, the newly eligible Medicaid clients will receive habilitative services, which are considered to help individuals maintain skills necessary for daily living.

The benefit package for the newly eligible providing general Medicaid coverage, additional preventive and wellness services and habilitative services must be approved by the Centers for Medicare and Medicaid Services. The Department of Health Care Policy and Financing will continue to update you on the approval process.

For information view a fact sheet here. If you have questions regarding the department’s implementation of the Affordable Care Act check out FAQs at Colorado.gov/Health, Colorado.gov/HCPF/ACAResources or submit questions to ACAImplementation@hcpf.state.co.us.

Also, HCPF encourages all health care providers to check out the department’s new ACA resources page specifically developed for providers. Click here for key information about health care reform, the Medicaid expansion and Connect for Health Colorado.