An adult with a low income
Does Medicaid Cover Residential Treatment in Colorado?
Does Health First Colorado (Colorado Medicaid) cover residential addiction treatment? See how coverage works and where to start. Coverage check happens on the call.
Clinically reviewed by Tia Conard, LCSW-S — Vice President of Clinical Services, Alsos Behavioral Health
Yes. Health First Colorado, Colorado's Medicaid program, covers residential treatment for substance use disorders when it is medically necessary. What many people search for as inpatient treatment is 24/7 residential care, and that is the level of care this page covers. Coverage check happens on the call.
We accept Health First Colorado.
Understanding your Health First Colorado coverage for residential addiction treatment
Taking the first step when you're ready for addiction treatment is the hardest. Knowing you have insurance coverage can take a lot of pressure off your decision to move forward.
Does Health First Colorado (Medicaid) cover residential treatment for substance use?
Yes. Health First Colorado provides coverage for medically necessary residential and inpatient services for both substance use disorders and mental health conditions. Coverage depends on your plan and eligibility. Coverage check happens on the call.
Will I need a prior authorization?
Usually. Health First Colorado generally requires prior authorization for residential treatment. Other services, like substance use assessments and therapy sessions, may need it too. These services are typical in residential treatment centers.
Will I have co-pays? What about cost limits?
What you pay depends on your plan and eligibility. Health First Colorado covers mental health and substance use disorder treatment, including residential treatment, when it is medically necessary. Coverage check happens on the call.
What if I need help?
You can contact your Health First Colorado Regional Organization or primary care provider. If you're ready to start residential addiction treatment, you can also get in touch with us here at Sheridan Grove Recovery, and we can help you navigate your coverage.
What is residential treatment?
The term "residential treatment" can refer to different levels of care, but it has a more specific definition for Medicaid coverage. Under Health First Colorado, "residential services" means:
"The on-site service for individuals whose mental health and/or substance use issues and symptoms are severe enough to require a twenty-four (24)-hour per day structured program and oversight, but that do not require hospitalization."
Clinicians use the American Society of Addiction Medicine (ASAM) criteria to match a person to a level of care, and the assessment decides which level fits.
Who is eligible for Health First Colorado?
Before you can use Medicaid benefits, you need to be enrolled. Eligibility for Health First Colorado is generally based on your income and household size. You may qualify if you are:
A parent or caretaker of a child
Pregnant
A person with a disability
A child or teenager
Income limits can change year-to-year, so don’t assume you won’t qualify. Coverage check happens on the call.
What residential treatment at Sheridan Grove Recovery includes
Residential treatment means living on site with 24/7 nursing support while you focus on recovery. It's a structured program that combines therapy, medical care and 24/7 nursing support. We offer these services at Sheridan Grove Recovery in Aurora:
- Individual and group therapy: Work one-on-one with a therapist to explore the root causes of your addiction and develop personal coping strategies. Group sessions connect you with a community of peers who understand what you’re going through.
- Medication-assisted treatment (MAT): For opioid and alcohol use disorders, MAT combines FDA-approved medications (like buprenorphine or extended-release naltrexone, Vivitrol) with counseling. MAT can reduce cravings, and some MAT medications ease withdrawal symptoms, so you can engage more fully in therapy.
- Medication management: Our medical team manages medication-assisted treatment and reviews your medications with you throughout your stay.
- Crisis stabilization: If you experience a mental or emotional crisis during treatment, our team can help you stabilize and regain your footing in a supportive environment.
Coverage check happens on the call.
How to access care and find a provider
Getting into addiction treatment when you need it can be overwhelming, but it's probably not as hard as you think. If you're ready to start, we can help you through the process. Get in touch with Sheridan Grove Recovery by contacting us online or calling 303.268.2987.
1. Apply for Health First Colorado
If you're not already enrolled, the first step is to apply. You can apply online through the Colorado PEAK website, by phone, by mail, or in person at your local county office. You will need documents like proof of identity and income.
2. Talk to your doctor or a treatment professional
With Health First Colorado, you're assigned a primary care provider, and you can talk to them about starting addiction treatment. You don't need a referral for substance use disorder treatment under Colorado Medicaid, but they can still point you in the right direction. Don't stress if you don't talk to a primary doctor regularly or don't want to talk to them about treatment. You can also contact an addiction treatment center directly.
3. Get a clinical assessment and authorization
To cover residential care, Medicaid requires that it be "medically necessary." This is determined through a clinical assessment. A healthcare professional at a treatment center will talk with you about your substance use history, your health, and your living situation. Based on this, they will recommend a level of care and work on getting a prior authorization if necessary.
4. Find a Medicaid-approved treatment center
Choose a treatment center that is in-network with Health First Colorado. Your Regional Organization can provide a list of approved providers in your area. You can also call treatment centers directly and ask if they accept Colorado Medicaid.
At Sheridan Grove Recovery in Aurora, we accept Health First Colorado, also called Colorado Medicaid. Medicaid, commercial insurance and private pay are accepted. Coverage check happens on the call. Admissions answers 24/7.
Contact us about using Colorado Medicaid for residential treatment
We know how hard it is to ask for help. Our team is here to help you navigate the Health First Colorado system so you can focus on what truly matters: recovery.
Whether you're ready to begin treatment or just want to ask a few questions, admissions answers 24/7. Get in touch with us online or by calling 303.268.2987 now.
Questions, answered
Frequently asked questions.
What if I need help?
You can contact your Health First Colorado Regional Organization or primary care provider. If you're ready to start residential addiction treatment, you can also get in touch with us here at Sheridan Grove Recovery, and we can help you navigate your coverage.
What is residential treatment?
The term "residential treatment" can refer to different levels of care, but it has a more specific definition for Medicaid coverage. Under Health First Colorado, "residential services" means: "The on-site service for individuals whose mental health and/or substance use issues and symptoms are severe enough to require a twenty-four (24)-hour per day structured program and oversight, but that do not require hospitalization." Clinicians use the American Society of Addiction Medicine (ASAM) criteria to match a person to a level of care, and the assessment decides which level fits.
Who is eligible for Health First Colorado?
Before you can use Medicaid benefits, you need to be enrolled. Eligibility for Health First Colorado is generally based on your income and household size. You may qualify if you are: An adult with a low income A parent or caretaker of a child Pregnant A person with a disability A child or teenager Income limits can change year-to-year, so don’t assume you won’t qualify. Coverage check happens on the call.
What residential treatment at Sheridan Grove Recovery includes
Residential treatment means living on site with 24/7 nursing support while you focus on recovery. It's a structured program that combines therapy, medical care and 24/7 nursing support. We offer these services at Sheridan Grove Recovery in Aurora: Individual and group therapy: Work one-on-one with a therapist to explore the root causes of your addiction and develop personal coping strategies. Group sessions connect you with a community of peers who understand what you’re going through. Medication-assisted treatment (MAT): For opioid and alcohol use disorders, MAT combines FDA-approved medications (like buprenorphine or extended-release naltrexone, Vivitrol) with counseling. MAT can reduce cravings, and some MAT medications ease withdrawal symptoms, so you can engage more fully in therapy. Medication management: Our medical team manages medication-assisted treatment and reviews your medications with you throughout your stay. Crisis stabilization: If you experience a mental or emotional crisis during treatment, our team can help you stabilize and regain your footing in a supportive environment. Coverage check happens on the call.
What will I have to pay?
What you pay depends on your plan and eligibility. Health First Colorado covers medically necessary residential treatment. Coverage check happens on the call.
Is transportation covered?
We help arrange transportation. Health First Colorado also has a transportation benefit for eligible members. Coverage check happens on the call.
Are there any non-covered items?
Medicaid is designed to cover clinical services. It may not cover things like the cost of room and board at a separate sober living home after you complete residential treatment. Discharge planning starts when you arrive, as part of your treatment plan.
Take the next step
Ready when you are.
Admissions answers 24/7. Coverage check happens on the call.