Colorado’s Medicaid Buy-In program for working adults with disabilities sets its income limit at 450% of the federal poverty level. For 2026, that works out to roughly $5,985 per month, or about $71,820 per year, for a single person. The ceiling rises with household size. What matters for eligibility is your countable income after allowable deductions, not your gross paycheck, and if you qualify you pay a monthly premium between $0 and $200 depending on where your income falls.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities
How the Income Limit Is Calculated
The 450% FPL cap is applied to countable income, which is your gross earned and unearned income minus “disregards.” Disregards are deductions the state subtracts before comparing your income to the threshold.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities Because of this, your actual gross earnings can exceed the published dollar thresholds and you may still qualify.
The 2026 federal poverty guideline for a single person in the 48 contiguous states is $1,330 per month, or $15,960 per year.2U.S. Department of Health and Human Services. 2026 Poverty Guidelines Multiplying that by 4.5 gives the single-person Buy-In ceiling of approximately $5,985 per month. For larger households, each additional person raises both the 100% FPL figure and the 450% cap.
The most important disregard for most enrollees is impairment-related work expenses. These are 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 for getting to or performing your job, service animals, disability-related transportation, and vehicle modifications all qualify.3Social Security Administration. Spotlight on Impairment-Related Work Expenses An item still counts even if it also helps with daily living; a wheelchair used at home and at work is still deductible. Standard public transit fares don’t qualify, and only costs you pay out of pocket (and that no other source reimburses) are deductible. Keep receipts for everything you want counted.
What You Pay at Each Income Level
Your premium is set by where your countable income falls within the FPL brackets. The tiers, effective April 1, 2026 using the 2026 FPL figures, are:1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities
- 0 to 40% FPL (up to about $532/month): $0 premium
- 41 to 133% FPL (about $533 to $1,769/month): $25 premium
- 134 to 200% FPL (about $1,770 to $2,660/month): $90 premium
- 201 to 300% FPL (about $2,661 to $3,990/month): $130 premium
- 301 to 450% FPL (about $3,991 to $5,985/month): $200 premium
The dollar figures shift each year when new poverty guidelines take effect, but the premium amounts have remained stable at $0 to $200.
Beyond the premium, you may owe small copayments for certain services and prescriptions. Federal law caps the combined total of premiums and cost-sharing at 5% of your family’s income, calculated monthly or quarterly.4eCFR. 42 CFR 447.56 – Limitations on Premiums and Cost Sharing Once you reach 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 if you can’t pay; adjustments are possible.
The Other Qualifying Requirements
Income is only one piece. To enroll, you also need to be at least 16 years old, currently employed, and have a qualifying disability.1Department of Health Care Policy and Financing. Health First Colorado Buy-In Program For Working Adults With Disabilities There is no minimum number of hours. Any employment counts. People 65 and older can qualify as long as they meet the same disability, employment, and income rules.
The disability requirement can be met two ways. If you already have a Social Security Administration disability determination, that satisfies the requirement. If you don’t, you’re not required to apply to SSA. You can instead submit the Health First Colorado Disability Application, and the state’s disability determination vendor will evaluate you using SSA’s medical criteria with one important difference: the Buy-In evaluation ignores whether you’re engaged in “substantial gainful activity,” so the fact that you’re working and earning won’t disqualify you from the disability finding.5Legal Information Institute. 10 CCR 2505-10-8.100 – Medical Assistance Eligibility
No Asset Limit
The Buy-In program has no asset or resource limit. This is a significant departure from standard long-term-care Medicaid in Colorado, which caps countable assets at $2,000 for an individual and $3,000 for a couple. Under the Buy-In, you can hold savings, investments, and property without affecting your eligibility. The state does review any trusts connected to you before approving enrollment, because distributions from a trust can count as income.
Even without an asset ceiling here, an ABLE (Achieving a Better Life Experience) account remains worth considering, because funds held there stay protected from asset limits in other benefit programs like SSI. In 2026, you can contribute up to $20,000 to an ABLE account. If you work and don’t participate in an employer-sponsored retirement plan, you can contribute an additional $15,650 (your earnings or that cap, whichever is less).6ABLE National Resource Center. ABLE Account Contribution Limits for the Calendar Year
If Your Income Goes Over the Limit
Countable income above 450% FPL ends your Buy-In eligibility. This doesn’t happen instantly. The state recalculates income periodically, and a one-time spike from overtime or a bonus won’t automatically remove you. A sustained increase above the threshold will produce a Notice of Action telling you coverage will end.
Colorado can pursue recovery of medical costs it paid during any period you weren’t actually eligible, through voluntary repayment, garnishment, or state tax refund interception.7Legal Information Institute. 10 CCR 2505-10-8.065 – Recovery of Medical Assistance The regulation explicitly exempts no-fault overpayments, so if the error was HCPF’s rather than yours, the state will not pursue recovery.
If your income is trending upward, document every impairment-related work expense you can and report changes promptly. Those deductions directly lower your countable income and can keep you under the cap longer than your gross paycheck would suggest.
How to Apply
Applications go through Colorado PEAK, the state’s online benefits portal at co.gov/PEAK.8Colorado PEAK. Colorado PEAK – Log In or Apply for Benefits Choose the Medical application. If you don’t have a current SSA disability determination, you’ll also need the Health First Colorado Disability Application, available on HCPF’s “How to Apply” page.
Gather these documents before you start:
- Proof of employment, such as recent pay stubs or a letter from your employer
- Documentation of all income sources, including SSDI, pensions, and unearned income
- Disability evidence, meaning your SSA award letter or your medical records if you’re applying through the state determination process
- Receipts for impairment-related work expenses you want deducted from your countable income
HCPF may ask for additional documentation after you submit. Respond quickly, because delays can stall your application. County human services offices and Colorado disability advocacy organizations offer free application help if you need it.