Health First Colorado and Foster Care: What Medicaid Covers for Foster Children

One of the most common fears prospective foster parents have is the cost of medical care. Children coming into foster care often arrive with untreated health conditions — dental problems, vision issues, unmanaged chronic conditions, or behavioral health needs that have gone unaddressed for years. The thought of absorbing those costs on top of day-to-day caregiving can make fostering feel financially out of reach.

What many people don't realize is that Colorado has a clear and comprehensive answer to this concern: every child placed in foster care is automatically enrolled in Health First Colorado, the state's Medicaid program. Medical, dental, vision, and behavioral health care for foster children do not come out of the foster parent's pocket.

What Health First Colorado Covers

Health First Colorado provides full medical coverage for all children in Colorado's foster care system. The scope is broad:

Medical care. Routine well-child visits, sick visits, specialist referrals, hospital care, and emergency services are all covered. Children entering foster care often need catch-up care — multiple health appointments in a short period to address conditions that were neglected before removal. Health First Colorado handles all of it.

Dental care. Dental coverage for foster children includes preventive care (cleanings, X-rays, sealants), basic restorative care (fillings), and more significant work when needed. Given how common dental neglect is among children entering care, this coverage is frequently one of the first benefits foster parents access after a placement.

Vision care. Eye exams and corrective lenses are covered. Undiagnosed vision problems are a significant and underidentified issue in the foster population — children who have been struggling in school because they simply cannot see clearly are often identified and fitted for glasses within the first months of a stable placement.

Behavioral and mental health care. Children in foster care have disproportionately high rates of trauma-related mental health needs. Health First Colorado covers outpatient therapy, psychiatric evaluation and medication management, and in more intensive cases, intensive outpatient programs. This coverage is one of the most important supports the state provides, because behavioral health treatment for children with complex trauma histories is expensive and often critical.

Substance use treatment. For older youth whose histories include substance use, Health First Colorado covers treatment services under the behavioral health umbrella.

How Enrollment Works

When a child is removed from their home and placed in foster care, the county department of human services handles enrollment in Health First Colorado. You do not need to do anything to initiate this — the child's Medicaid coverage is activated as part of the placement process.

What you do need as a foster parent is the child's Medicaid ID number and information about their assigned managed care organization (MCO). Colorado's Health First Colorado program uses several MCOs for managed care, and the child may be assigned to one before placement or shortly after. Your caseworker should provide this information at or shortly after placement, though in practice it sometimes takes a few days to come through.

When you need to take a foster child to a medical appointment before you have received their Medicaid information, most providers in Colorado are familiar with the process. Tell the office that the child is in foster care and that Medicaid paperwork is pending — the majority of practices will see the child and submit the claim once the ID is provided. Document the appointment date and provider in your own records.

The Interplay with the Foster Care Board Rate

The daily board rate you receive as a foster parent — ranging from $42.86 to $66.44 per day for standard care, and significantly higher for therapeutic placements — is intended to cover the day-to-day costs of caring for a child: food, clothing, transportation, school supplies, activities, and so on. It does not need to cover medical expenses, because Health First Colorado handles those separately.

This is worth understanding clearly, because one of the most common misconceptions about fostering is that you will be personally responsible for a child's health costs. The structure is specifically designed to prevent that from being a barrier to fostering.

Extended Health First Colorado Coverage

Colorado's Extended Foster Care program allows young people to remain in foster care services up to age 21 if they choose. Those who remain in extended foster care continue to receive Health First Colorado coverage. Even for youth who exit care at 18, Colorado extends Medicaid eligibility for former foster youth up to age 26 — a significant protection for young adults who might otherwise have no health coverage.

This is worth knowing if you are fostering a teenager who is approaching adulthood. The conversation about what they are entitled to after they age out is one you can have with them, and the extended Medicaid coverage is one of the concrete answers.

Prescription Medications

Prescription medications prescribed to foster children are covered by Health First Colorado. This is especially relevant for children who arrive with existing prescriptions — whether for psychiatric medications, asthma management, seizure disorders, or other chronic conditions. Your caseworker should provide you with information about current medications at placement; if that information is incomplete, the prescribing physician's office or pharmacy can often help fill in the gaps once they understand the child is in foster care.

Colorado regulations require that medications be stored locked and out of reach of children in the home, regardless of whether those medications belong to the foster child or other household members.

When Health First Colorado Has Gaps

The coverage is broad but not unlimited. There are situations where prior authorization is required for specialist visits or certain procedures, and navigating a managed care organization's approval process can be time-consuming. Private CPAs that provide wraparound support services often have staff who can help foster parents navigate these situations. Some counties also have family advocacy services that can assist.

If you encounter a situation where coverage is denied and you believe the service is necessary, you have the right to appeal. Your caseworker can assist with this process.

Knowing What Your License Covers

Understanding the full picture of financial support available to foster parents — including Health First Colorado coverage — is part of making an informed decision about fostering. The Colorado Foster Care Licensing Guide covers the board rate structure, Health First Colorado enrollment, the clothing allowance, and other supports in detail, so you can see clearly what the state provides and what you are expected to supply as a licensed foster family.

The short version: medical care for the children in your home is covered. Colorado does not expect foster families to absorb those costs, and the system is designed to make that clear from the first day of placement.

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