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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

35 b) Medical Buy-In Program for Working Adults with Disabilities (including with Home and Community Based Services), Medicaid Buy-In Program for Children with Disabilities, and Long-Term Care waivers except Program of All Inclusive Care for the Elderly (PACE) Effective July 1, 2026, the Department will assess the total number of enrolled children described in 8.100.3.G.1.viii.1. An enrollment cap must be initiated if one of the following conditions occurs: a) Enrollment exceeds 25,000 children; or b) Total spending for Medical Assistance in a fiscal quarter is over the allocated state budget by more than 5%. If the enrollment cap is initiated, it will take effect on the first day of the month, following 60 calendar days after the Department determines that one of the conditions described above is met. The cap will remain in place until the Department determines that the conditions described above are no longer met. During this time, children described in 8.100.3.G.1.viii.1 will be assessed for eligibility under all other Medical Assistance programs, or (if ineligible) transferred to the state insurance marketplace. 2) Individuals aged 19 or older, who are either pregnant or are within the first 12 months of their postpartum period, can be assessed for eligibility in the following Medical Assistance categories, regardless of immigration status: a) MAGI Pregnant, Psych <21, Transitional Medical Assistance, 4 Month Extended Medical Assistance, and MAGI Prenatal Presumptive Eligibility