05/06/2026
🚨 Important Medicaid Waiver Eligibility Alert
Don’t lose waiver coverage on May 31 because paperwork is lost.
If you received a letter from Health First Colorado saying “Action Needed: Follow up with your Case Management Agency” (see image below) DO NOT IGNORE IT.
We know. The letter is about as clear as mud.
Here’s what it is trying to say:
--Your Medicaid Waiver eligibility is currently being kept open through a temporary automatic extension process.
--That extension is happening because your county Human Services (DHS) office does not have your Level of Care paperwork for your current waiver service plan year.
--You did not do anything wrong. This is a systems/paperwork/IT handoff problem.
--The automatic extension process ends for everyone on May 31, 2026.
--If DHS does not receive and process your current Level of Care by then, you may lose waiver coverage.
In plain English:
Your case manager may have done the Level of Care, but DHS may not have it. And if DHS doesn’t have it, the computer will decide your waiver eligibility ends.
What to do now:
Contact your case manager right away and ask them to:
1) Send you a copy of your current Level of Care (LOC) Certification.
2) Send you the "Confirmation Number showing the LOC was sent, found in the alert box on the CCM."
Contact your county Human Services/DHS office and ask them to:
1) Confirm they received your current Level of Care.
2) Confirm it is connected to your Medicaid case for your current waiver/service plan year.
The IT systems between agencies are complicated, and LOCs are getting lost between systems. Please do not assume this is handled just because your case manager completed your renewal or service plan.
If you received this letter, follow up now and keep documentation of every call, email, confirmation number, and name of the person you spoke with. This is one of those annoying situations where you may need to be the squeaky wheel, the paper trail keeper, and the person who says, “Can you please confirm that in writing?” more than once even though it shouldn't be your problem to solve.
*If you receive a termination notice in the next couple of weeks, appeal right away and request "continuation of benefits during the appeal process" so your benefits can continue while this gets resolved. Appeal instructions should be included on the termination notice. Also stay tuned for an instructional video to help walk through the appeal process coming out from us in the next week.*
