Colorado’s Medicaid Buy-In income limits let a working adult with a qualifying disability earn up to 450% of the federal poverty level and still keep full Medicaid. For a single person in 2026, that works out to roughly $5,985 per month, or about $71,820 a year, with a monthly premium of no more than $200.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities The program, officially the Health First Colorado Buy-In for Working Adults with Disabilities, also has no asset limit, which is what separates it from most other Medicaid categories.
Who Qualifies
Four things have to be true. You must be at least 16, currently employed, have a qualifying disability, and have countable income under 450% FPL.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities There’s no minimum number of hours. Any employment counts. People 65 and older can qualify on the same terms.
The disability piece can be met two ways. If the Social Security Administration has already determined you have a disability, that’s enough. If not, you don’t have to apply to SSA. You can complete the Health First Colorado Disability Application, and the state’s disability determination vendor will review your case using SSA’s medical criteria. One important difference from the SSA process: the Buy-In evaluation ignores “substantial gainful activity,” so the fact that you’re working and earning income won’t disqualify you from being found disabled.2Legal Information Institute. 10 CCR 2505-10-8.100 – Medical Assistance Eligibility
How Colorado Counts Your Income
The ceiling is 450% of the federal poverty level. In 2026, 100% FPL for a single person in the 48 contiguous states is $1,330 per month, or $15,960 a year.3U.S. Department of Health and Human Services. 2026 Poverty Guidelines Multiply by 4.5, and the threshold sits at about $5,985 per month. It rises for larger households, and the dollar amounts shift every year when new poverty guidelines take effect.
Your gross paycheck isn’t what gets compared to that number. The program applies “disregards,” which are deductions subtracted from your gross earned and unearned income before the comparison.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities Your income after disregards is the figure that decides both eligibility and your premium tier. That’s why your actual gross earnings can be above the published dollar thresholds and you may still qualify.
The most useful disregard for many workers is impairment-related work expenses: out-of-pocket costs for items or services tied to your disability that you need in order to work. Medical devices, prescribed medications, attendant care to help you get to or perform your job, and vehicle modifications are common examples.4Social Security Administration. Spotlight on Impairment-Related Work Expenses These deductions apply even when the item also helps with daily living. A wheelchair used at home and at work still counts. Keep receipts; the deduction only applies to costs you pay yourself and that no other source reimburses.
Monthly Premiums by Income Bracket
You pay a monthly premium based on where your income (after disregards) falls within the FPL brackets. Effective April 1, 2026, based on the 2026 FPL:1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities
- 0–40% FPL (up to about $532/month): $0 premium
- 41–133% FPL (about $533–$1,769/month): $25 premium
- 134–200% FPL (about $1,770–$2,660/month): $90 premium
- 201–300% FPL (about $2,661–$3,990/month): $130 premium
- 301–450% FPL (about $3,991–$5,985/month): $200 premium
The dollar figures update each year with the new poverty guidelines. The premium amounts themselves have held steady.
Small copayments may apply to certain services and prescriptions on top of the premium. Federal law caps the total of all premiums and cost-sharing at 5% of family income, measured monthly or quarterly.5eCFR. 42 CFR 447.56 – Limitations on Premiums and Cost Sharing Once you hit that ceiling, you owe nothing more for the rest of the period. Falling behind on premiums can lead to disenrollment, so contact the Department of Health Care Policy and Financing early if payments become a problem; adjustments are possible.
There Is No Asset Limit
This is where the Buy-In separates itself from other Medicaid categories. Standard long-term-care Medicaid in Colorado caps countable assets at $2,000 for an individual and $3,000 for a couple. The Buy-In has no asset or resource limit. Savings, investments, and property don’t jeopardize your eligibility. The state does review any trusts connected to you before approving enrollment, because trust distributions can count as income.
Even with no asset test on the Buy-In itself, an ABLE account is still worth considering. ABLE accounts let people with disabilities save for qualified expenses like housing, education, transportation, and health care in a tax-advantaged account that stays protected from asset limits in other benefit programs such as SSI. In 2026, you can contribute up to $20,000. If you work and don’t participate in an employer-sponsored retirement plan, you can add up to another $15,650 (your earnings or that cap, whichever is less).6ABLE National Resource Center. ABLE Account Contribution Limits for the Calendar Year
What Happens If You Go Over the Limit
If your countable income rises above 450% FPL, you lose Buy-In eligibility. It doesn’t happen instantly. The state recalculates income periodically, and a one-time overtime run or bonus won’t necessarily push you off. A sustained increase above the threshold will produce a Notice of Action ending your coverage.
Colorado has an overpayment recovery process. If the state decides it paid for services during a period when you weren’t actually eligible, it can seek to recover those costs through voluntary repayment, garnishment, or state tax refund interception.7Legal Information Institute. 10 CCR 2505-10-8.065 – Recovery of Medical Assistance There is one meaningful protection: if the overpayment happened through no fault of yours, such as an HCPF calculation error, the state will not pursue recovery. The regulation explicitly exempts no-fault overpayments.
If you see income trending upward, use every disregard available. Document impairment-related work expenses, report income changes promptly, and stay in contact with your county human services office so a Notice of Action isn’t a surprise.
How to Apply
Applications go through Colorado PEAK, the state’s online benefits portal at co.gov/PEAK. Choose the Medical application option.8Colorado PEAK. Colorado PEAK – Log In or Apply for Benefits If you don’t have a current SSA disability determination, you’ll also complete the Health First Colorado Disability Application, available on HCPF’s “How to Apply” page.
Have these ready before you start:
- Proof of employment, such as recent pay stubs or a letter from your employer
- Records of all income sources, including SSDI, pensions, and any unearned income
- Disability evidence: your SSA award letter, or medical records if you’re going through the state determination process
- Receipts for impairment-related work expenses you want deducted from countable income
HCPF may request more documentation after you file. Respond quickly; delays stall the application. County human services offices and disability advocacy organizations offer free help if you need it.
Appeals If You’re Denied
If your application is denied or your benefits are reduced or terminated, you have 60 days from the date on your Notice of Action to request a state fair hearing.9Health First Colorado. Appeals Some older guides say 30 days; the current window is 60.
File with the Office of Administrative Courts by submitting a Request for State Level Hearing form, writing a letter, or calling the OAC at 303-866-5626. Include your name, contact information, the program involved, copies of the denial or termination notice, and the name of anyone representing you.10Office of Administrative Courts. Filing an Appeal – Public Benefits You can submit by email (OAC-GS@state.co.us), fax (303-866-5909), U.S. mail, e-filing, or hand delivery at 1525 Sherman Street, 4th Floor, Denver. At the hearing you can present evidence, bring witnesses, and question the state’s witnesses.11Legal Information Institute. 5 CCR 1001-1-IX – Colorado Revised Statutes Section 24-4-105(4) Colorado legal aid organizations provide free help to people with limited income navigating Medicaid appeals.