Using Your Benefits: Regional Organizations, Providers, Rides, Language & Appeals
Colorado Department of Health Care Policy and Financing with the regional organizations
What can I do if Health First Colorado says something is covered but I still can't actually get or use the care?
Needs recheck — read this as research, not as a benefit you can rely on yet.
What this is
This is the practical layer. Your regional organization coordinates your physical and behavioral health care and can help with providers and social supports. Find a Doctor exists for searching. Non-emergent medical transportation (NEMT) covers rides. A 24/7 Nurse Advice Line, a Managed Care Ombudsman, and an appeal route complete the picture.
Why it matters after birth
Coverage is not an appointment. Rides, networks, and knowing who to call are what decide whether care happens.
You may qualify if
For NEMT you must be a current Health First Colorado member, have no other transportation option, and be travelling to a covered service with an enrolled provider. Under the cited eligibility document, CHP+ members are not eligible for Medicaid NEMT. For an eligibility appeal, you have 60 days from the date on the Notice of Action.
What you actually get
Regional organization care coordination and help with providers and social supports; Find a Doctor; NEMT rides, listed without a copay for eligible Health First Colorado members; the 24/7 Nurse Advice Line at 800-283-3221 in English and Spanish; the Managed Care Ombudsman; and eligibility appeals.
How long it lasts
Available while you are covered. An eligibility appeal must be made within 60 days from the date on your Notice of Action.
What it costs
NEMT is listed without a copay for eligible Health First Colorado members. Pregnant and postpartum members have no copays for maternity benefits; CHP+ and other categories can differ.
How to use it
Start with your regional organization for provider help and social supports, and use Find a Doctor to search. For a ride, arrange NEMT as a Health First Colorado member travelling to a covered service with an enrolled provider. For clinical questions any time, call 800-283-3221. If you disagree with an eligibility decision, appeal within 60 days of the date on the Notice of Action; the Managed Care Ombudsman can also help.
What you'll need
Your Health First Colorado member information, and your Notice of Action if you are appealing.
Important limitations
NEMT requires that you have no other transportation option and are travelling to a covered service with an enrolled provider, and CHP+ members are not eligible for Medicaid NEMT under the cited eligibility document. The eligibility appeal window is 60 days from the date on the Notice of Action — that date, not the day you opened the letter. TMO has not confirmed official URLs for these routes, which is why this profile is labelled Needs recheck.
How it works with other benefits
This is what turns your 12-month coverage, doula benefit, behavioral-health care, Prenatal Plus, and Special Connections into appointments you can attend.
Finding a provider or service
Use Find a Doctor and your regional organization, which maintains networks and can help with both providers and social supports.
Language & cultural access
The 24/7 Nurse Advice Line, 800-283-3221, operates in English and Spanish. Ask your regional organization about interpretation for appointments.
If you do not qualify
If you are not covered, apply through PEAK or 1-800-221-3943. If immigration status is the barrier, read Colorado's coverage-for-immigrants guidance and ask about Cover All Coloradans.
Access in practice
Being covered and being able to use it are different things. This is what the sources say about actually reaching this support.
- Provider availability
- Regional network capacity is distinct from coverage and varies across the state.
- Provider rules
- Regional organizations coordinate care and maintain networks; providers must be enrolled for NEMT-covered travel.
- Getting there
- NEMT is for current Health First Colorado members with no other transportation option, travelling to a covered service with an enrolled provider, and is listed without a copay. CHP+ members are not eligible for Medicaid NEMT under the cited eligibility document.
- Appeals and help
- Eligibility appeals must be made within 60 days from the date on the Notice of Action. A Managed Care Ombudsman is also available.
- Known barriers in practice
- Transport eligibility conditions, regional network capacity, and the 60-day appeal window are where covered care most often fails to reach a member.
In plain terms
What this means for you
Your regional organisation is the number that matters — providers, behavioural health, social supports. Rides are covered if you have no other way to get to a covered appointment, though not on CHP+. And if a decision goes against you, you have 60 days from the date on the notice, so check that date the day it arrives.
Your next step
What to do next
Save your regional organization's number and 800-283-3221 for round-the-clock nurse advice. Arrange NEMT before your next appointment if you have no other way to travel. If you receive a Notice of Action you disagree with, appeal within 60 days of the date on it.
Official sources
Last verified September 16, 2026 · Needs recheck
3 official sources
Authority: Accountable Care Collaborative regional organizations; non-emergent medical transportation (NEMT); Medicaid eligibility appeals; Managed Care Ombudsman
Recheck when: Source ledger incomplete: TMO has not confirmed official URLs for the regional organizations, Find a Doctor, NEMT, appeals, and the Managed Care Ombudsman. Recheck and attach those before this profile is marked Ready.
Still being verified
- Official Colorado URLs for regional organizations, Find a Doctor, NEMT, appeals, and the Managed Care Ombudsman are not yet in TMO's source ledger.
- NEMT booking mechanics beyond the eligibility conditions stated here are not verified.
This is plain-language public-policy information, not legal, medical, or benefits advice, and it is not specific to your situation. Policy changes, so confirm current rules with the agency or your health plan.