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Federal law has changed. Health First Colorado (Medicaid) coverage is NOT changing today – but new rules will take effect later in 2026 and 2027. Here is what you need to know and do NOW to protect your coverage. 

Your are likely not affected if you are: 

  • A child (0 to 18)
  • An adult age 65 or older
  • Current members who were pregnant within the last 12 months or are currently pregnant
  • Enrolled in long-term services and supports (LTSS) or buy-in programs

What is changing – and when?

October 2026

October 2026

Some Immigrants May Lose Medicaid

Some immigrants (refugees/asylees) may lose Medicaid. Lawful permanent residents keep coverage.

January 1, 2027

January 1, 2027

New Work Rules for Some Adults 19-64

Some adults 19-64 must show 80 hour per month of work, school, training, or volunteering. Renewals now every 6 months (used to be 12 months).

 January 2027

January 2027

Coverage Will Only Go Back 30 Days

If you have a hospital or doctor visit in the past and haven't applied yet, coverage will only go back 30 days. Apply early.

What Can You Do About This?

Step 1
Update your contact info.
Log in to Colorado PEAK at co.gov/peak or call 1-800-221-3943. Make sure your address and phone number are correct. This is how you will get prompt renewal notices. 

Step 2
Check your mailboxes.
Be on the lookout in your mailbox for anything from Health First Colorado. Affected Medicaid members will be notified. Respond immediately to official notices – don’t wait!  

Step 3
Track your work hours. 
Because some adults 19-64 on Medicaid must show 80 hours/month of work, volunteering or school training, start keeping records now. 

Step 4
Stay informed.
Visit HealthFirstColorado.com/Changes for additional guidance on these changes.

October 2026 – More About Changes Impacting Immigrants

Some immigrants with these and other statuses will lose Medicaid coverage:

  • Current refugees and asylees
  • Humanitarian parole
  • Certain survivors applying for protections
  • Some other humanitarian immigration statuses

Starting October 1, 2026, some immigrants who currently qualify may lose full Medicaid coverage. You will receive a letter before anything changes. Here's what you can do right now. 

  • Update your information at Colorado PEAK (co.gov/PEAK), the Health First Colorado app, or your county human services office. 
  • Use your coverage now – schedule medical, dental, and behavioral health appointments and refill prescriptions. 
  • Watch for official letters and respond to any you receive. 
  • Reach out to someone you trust. Local organizations are ready to help.

Official guidance at HealthFirstColorado.com/Changes. 

January 1, 2027 – More About New Work Requirements for Adults 19-64

Some adults ages 19-64 who earn up to 133% of the federal poverty level may have to demonstrate 80 hours of community engagement when apply for or renewing Medicaid coverage. There are some exceptions – certain exempt individuals and those facing temporary hardship. 

Who might be an exempt individual?

  • Children 18 and younger
  • Adults 65 and older
  • Former foster care youth age 19-26 (who aged out of foster care)
  • Pregnant 
  • Enrolled in certain programs:
    • long-term services and supports (LTSS)
    • Medicaid buy-in programs
    • treatment or rehab for mental health or substance use disorder
    • qualify or enrolled in Medicare receiving supplemental security income (SSI) or Social Security Disability Insurance (SSDI)
  • Medically frail or have a disability or serious health condition
  • Certain Caregivers: 
    • Primary caregiver for a child age 13 or younger
    • Primary caregiver for someone with a disability

Who might qualify for a temporary hardship?

  • Economic hardship (live in a county with a high unemployment rate)
  • Live in a declared disaster area
  • Acute medical care/inpatients
  • Need to travel for medical care

For those who are not an exempt individual or quality for a temporary hardship, they must complete at least 80 hours of approved activities in one calendar month since their last renewal deadline. 

Activities may include:

  • SNAP: documented compliance with SNAP/TANF work requirements
  • Work: earn about $580 in a qualifying month 
  • Work Training: participate in an approved work training program
  • Education: enrollment at an accredited academic institution 
  • Volunteer: 80 hours of documented volunteer activity
  • Combination: show 80 hours of some of these activities together