Health First Colorado covers doctor visits, hospital stays, emergency room and urgent care, prescription drugs, dental services, behavioral and mental health services, X-rays and blood work, well-child visits, maternity care, newborn care and many others. Learn how to apply on the Health First Colorado website.

As a Health First Colorado member, you are part of a team that helps make sure you get connected with what you need to get and stay healthy. This team includes you, your family members or caregivers, your primary care provider (sometimes called a PCP), and CCHA care coordinators. If you have questions about your health care or covered benefits, contact CCHA Member Support Services. We can help you:

• Find a provider who is the right fit for you
• Get appointments for all your health needs
• Connect with non-medical resources

Sign up for programs to help with your health

To find helpful information about language assistance services, including the written, oral interpretation and auxiliary aids/services that are free of charge, contact CCHA Member Support Services.

Health First Colorado members can change their primary care provider using any of the three options below through Health First Colorado Enrollment.

1. Online.
2. By phone at 303-839-2120 Outside of Denver, call 1-888-367-6557(State Relay 711). Monday through Friday from 8 a.m. to 5 p.m.
3. In person at Health First Colorado Enrollment office in Glendale, Colorado. Call to find out more about in-person enrollment help.

For more information, please visit the Health First Colorado enrollment site and their Frequently Asked Questions.

You can learn about your rights and responsibilities as our member in the Member Handbook.

As a member of Health First Colorado and CCHA, you have the right to:

1. Get the information in the Member Handbook and about your coverage, plans, benefits and services
2. Be treated with respect and consideration for your privacy and dignity
3. Get information in a way you can easily understand
4. Get information from your provider about treatment choices for your health condition
5. Be involved in all decisions about your health care and say “no” to any treatment offered
6. Not be secluded or restrained as a punishment or to make things easier for your provider
7. Ask for and get a copy of your medical records and ask that they be changed or corrected
8. Get health care services and freely exercise your choice of provider.
9. Use your rights without fear of being treated poorly
10. Any other rights guaranteed by law
11. Be free from discrimination based on race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, disability or health status
12. Ask your health plan for help if your provider does not offer a service you need because of moral or religious reasons (CCHA does not deny access to service due to moral or religions reasons.)

If you have questions about your member rights, do not feel like you are able to use your member rights, or believe you are being treated poorly because you used your rights, contact CCHA Member Support Services for more information on how to file a complaint.

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 primary care provider (sometimes called a PCP) 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 (TTY 711) 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 (TTY 711) 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.

We are committed to helping you access quality physical and behavioral health care services in a timely manner. View our Access to Care Standards to learn more about what you can expect.

Contact CCHA Member Support Services if you need oral interpretation services or information in large print or other formats.

Behavioral health services include both mental health and substance use treatment. We’re here to help connect you to services and resources you need for your health and well-being.

If you or a family member need help getting behavioral health services, please contact CCHA Member Support Services. We can help you find a behavioral health provider if you need one.

Your Health First Colorado benefits include:

• Psychiatrist
• Licensed Mental Health Professional (LMHP); an LMHP is a provider who works with members who have behavioral health concerns.
• Alcohol and drug: screening, counseling, treatment*
• Behavioral health assessment, evaluation and testing*
• Emergency and crisis services
• Inpatient psychiatric hospital services for a mental health diagnosis*
• Medication-assisted treatment*
• Outpatient day treatment, nonresidential*
• Medication management*
• Psychotherapy: family, group or individual*

See your member handbook to learn more about your benefits

You don’t need a referral from your primary care provider (PCP) to see a behavioral health provider.

*Some treatments and services may need approval before you get them. For information about services that need preapproval, please see your member handbook.

If you are temporarily out of the state but still a resident of Colorado, you may receive some Health First Colorado benefits under certain situations:

• It is a medical emergency
• Your health would be endangered if you were required to return to Colorado for the medical care/treatment

The health care provider that treats you must enroll in the Health First Colorado program. Health care providers can visit the For Our Providers page for more information.

If you have more questions about seeing a health care provider out of state, call the Health First Colorado Customer Contact Center.

Health First Colorado members who have no other means of transportation can ask for a ride to and from their appointments. Types of transportation may include:

• Mileage reimbursement
• Public transportation
• Private vehicle or taxi
• Wheelchair or stretcher van
• Other options may also be available

Transportation can only be provided for appointments with Health First Colorado providers. Transportation cannot be used for picking up prescriptions, medical equipment or completing interviews and paperwork.

For help coordinating transportation, contact CCHA Member Support Services.

As a Health First Colorado member, you can receive dental services such as cleanings, fillings, root canals, crowns, partial dentures and others. In addition, children under age 20 can receive preventive services including exams, cleanings, X-rays, sealants, space maintainers, fluoride treatments and more.

Call DentaQuest at 1-855-225-1729 (TTY 711). For more help finding a dentist, contact CCHA Member Support Services.

The adult dental benefit is available to eligible adult Health First Colorado members (age 21 and over) and covers:

• Basic preventive dental exams
• Diagnostic and restorative dental services (such as X-rays and fillings)
• Extractions (tooth pulling)
• Root canals
• Crowns
• Partial dentures
• Complete dentures
• Periodontal scaling
• Root planing
• Other procedures requiring prior authorization

For more information about adult and children’s dental benefits, visit the Health First Colorado dental benefits page.

Health First Colorado provides pharmacy benefits. For more information about pharmacy benefits and the Health First Colorado formulary, go to the Health First Colorado Pharmacy Benefits page.

To request a copy, contact CCHA Member Support Services.

Advance directives are written instructions to those caring for you that tell them what to do in case you can’t make decisions for yourself. They list the type of care you do or do not want if you become so ill or injured that you cannot speak for yourself. Advance directives include, but are not limited to, medical durable powers of attorney, durable powers of attorney, or living wills. CCHA provides information on advance directives, so you can plan and make decisions accordingly. Learn more about advance directives.

The Colorado Medical Treatment Decision Act (C.R.S.15-18-101) recognizes the right of an adult or his or her authorized surrogate decision-maker to accept or reject medical treatment and artificial nutrition or hydration. Each adult has the right to establish, in advance of the need for medical treatment, directives and instructions for the administration of medical treatment in the event the adult later lacks the decisional capacity to provide informed consent to, withdraw from, or refuse medical treatment.

The Colorado Medical Assistance Act – (C.R.S. 25.5-4-413) states each hospital, nursing care facility, home health agency, hospice program, and health maintenance organization participating in the state medical assistance program or providing medical assistance pursuant to parts 3 to 12 of article 6 of this title shall provide written information to all adult patients of such providers concerning patients' rights under state law to make medical treatment decisions, including the right to accept or refuse any medical or surgical treatment and the right to formulate advance directives regarding said decisions. As used in this section, "advance directives" includes any written or oral instructions recognized under state law concerning the making of medical treatment decisions on behalf of or the provision of medical care for the person who provided the instructions in the event such person becomes incapacitated.

You may request information on advance directive via mail at any time by contacting CCHA Member Support Services.

You may file a complaint concerning non-compliance with advance directives, by using this grievance form.

Complaints concerning noncompliance with advance directive requirements may be filed with the Colorado Department of Public Health and Environment.

For more information go to CCHAcares.com/EPSDT

For more information go to CCHAcares.com/EPSDT

Colorado makes the final determination of medical necessity and it is determined on a case-by-case basis. Provider recommendations will be taken into consideration, but are not the sole determining factor in coverage. Colorado determines which treatment it will cover among equally effective, available alternative treatments.

Providers can access medically necessary services by submitting a prior authorization request (PAR) to coloradopar.com. All requirements for completing a request apply to those requesting any exception to state plan benefit limits. EPSDT cannot override licensing or other payment restrictions for providers.

Learn more about EPSDT.

Each year, Health First Colorado (Colorado’s Medicaid Program) conducts the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to measure members’ care experience. CCHA shares this data with primary care providers and uses it to identify areas of improvement.

Overall, CCHA’s scores were higher in 2020/21 than in 2019/20 in Region 6 and Region 7 for children and adults. CCHA scored the highest in comprehensiveness of care for all populations.

Areas for improvement included access to care, patient-centered communication, and coordinating medical care. CCHA’s practice transformation coaches have been continuously working with the surveyed providers to address these areas by planning and testing improvements to workflows, including patients and families in decisions around communication and staff training. CCHA is tracking efforts to improve CAHPS scores and will continue to evaluate member care experience going forward.

The Health First Colorado Nurse Advice Line provides Health First Colorado members free 24/7 access to medical information and advice in both English and Spanish by calling 1-800-283-3221 (TTY 711).

• Available free of charge, 24 hours a day, 7 days a week, 365 days a year.
• Nurses will answer your medical questions, provide care advice and help you determine if you should be see a doctor right away.
• Get help with medical conditions, such as diabetes or asthma.
• Get advice on the type of doctor that may be right for your medical condition.

Learn more about the Health First Colorado Nurse Advice Line.

Colorado Community Health Alliance (CCHA) serves the following primary functions for assigned Health First Colorado members:

• Help find a provider
• Coordinate care and services
• Provide utilization management and payment for capitated behavioral health services
• And more!

For more information about how CCHA can help you, contact CCHA Member Support Services.

No, CCHA does not restrict a member’s choice of provider. For help finding a provider, contact CCHA Member Support Services. You can also search for a provider in our online provider directory.

For information, see the Health First Colorado website.

Colorado Community Health Alliance (CCHA) is the regional organization for Health First Colorado members whose primary care provider is located in one of these counties: Boulder, Broomfield, Clear Creek, El Paso, Gilpin, Jefferson, Park or Teller. For help finding a provider, contact CCHA Member Support Services. You can also search for a provider in our online provider directory.

CCHA does not restrict or limit any Health First Colorado services because of moral or religious objections. If your provider will not provide a covered service to you due to a moral or religious obligation, contact CCHA Member Support Services.

Visit CCHA cares.com/findadoc to find primary care, behavioral health or specialist providers who are located in any of these counties: Boulder, Broomfield, Clear Creek, El Paso, Gilpin, Jefferson, Park and Teller. You can search for provider or practice type, location and other options to find a provider who’s the right fit for you. If you need help or have questions, view our search tips or contact CCHA Member Support Services.

The 2-1-1 Colorado Database for Health and Human Services provides thousands of resources across the state for a wide range of needs including Housing and Shelter Resources. If you are unable to find what you need on the 2-1-1 website, dial 2-1-1 for additional help.

Additionally, Colorado Housing Connects can provide help with housing resources. Call Colorado Housing Connects at 1-844-926-6632 or visit their website at Coloradohousingconnects.org.

You can apply for Disability benefits online, or if you prefer, you can apply by calling the toll-free number, 1-800-772-1213. Representatives there can make an appointment for your application to be taken over the telephone or at any convenient Social Security office.

People who are deaf or hard of hearing may call our toll-free "TTY" number, 1-800-325-0778, between 7 a.m. and 7 p.m. on Monday through Friday.

2-1-1- can also provide assistance with applying for Social Security Disability or Supplemental Security Income. Dial 2-1-1 to speak with a representative.

You can check if your Health First Colorado (Colorado’s Medicaid Program) coverage is active by going to the Colorado PEAK website and clicking on the Check My Benefits button or you can view your card from the PEAKHealth mobile app.

You can also call your local County Department of Social/Human Services or the Colorado Department of Health Care Policy and Financing Member Contact Center for assistance.

You can find the regional PIAC charters, list of voting members and more on our Advisory Committee page.

You have the right to a second opinion. You do not need a referral to see a participating provider for a second opinion about your care. You may need to pay a co-pay at your visit.

For automated outbound calls, members can opt out of all automated outbound call campaigns in three different ways:

• By pressing 9 during an active automated outbound call
• By calling the local call center and verbally requesting opt-out
• Toll Free: 1-855-627-4685 Region 6 (local): 303-256-1717 Region 7 (local): 719-598-1540 Hearing/speech assistance: 711 (TTY) Full services Mon – Fri, 8 am – 5 pm Limited services 24/7
• By requesting opt-out via letter
  Colorado Community Health Alliance Member Support Services
  P.O. Box 13406
  Denver, CO 80202

For text messages, members can opt out of all text message campaigns in three different ways:

• By replying “STOP” to any of CCHA’s outreach messages
• By calling the local call center and verbally requesting opt-out
• Toll Free: 1-855-627-4685 Region 6 (local): 303-256-1717 Region 7 (local): 719-598-1540 Hearing/speech assistance: 711 (TTY) Full services Mon – Fri, 8 am – 5 pm Limited services 24/7
• By requesting opt-out via letter
  Colorado Community Health Alliance
  P.O. Box 13406
  Denver, CO 80202

Change your mind? To opt back in to automated messages, contact CCHA Member Support Services.

CCHA’s annual quality reports are posted to CCHA’s Governing Board webpage.

Hospital Transplant Teams can easily access CCHA Care Coordination by contacting Member Support Services.