Colorado Medicaid Information

Medicaid benefits can be confusing - here is a brief explanation of Medicaid coverage.

Desert Sand, LLC is credentialed with Colorado’s Medicaid program - now known as Health First Colorado.

Medicaid is a state-funded health insurance program that is split up into Regional Accountable Entities (RAEs) - these are essentially separate insurance companies responsible for administering and managing health benefits. These companies cover different sections of Colorado.

There are 5 Medicaid RAEs, or companies. Each company administers the benefits for its indicated counties (refer to the image below). Western Colorado is covered by Region 1 - Rocky Mountain Health Plans (RMHP), which is partnered with United Healthcare (UHC).

How is my Medicaid “company” (RAE) determined?

When you apply for Medicaid, you're asked some basic demographic questions such as address and Primary Care Provider (PCP). If you have a PCP you regularly see who accepts Medicaid and you enter their information, your Medicaid company is based on the county of your PCP. This could mean you live in Boulder county, but if your doctor is in Denver county, your Medicaid will be with CO Access.

If you do not set a PCP at the time of application, your company is determined by your home address, and you are randomly assigned a PCP in your closest Medicaid region.

What companies (RAEs) does Desert Sand, LLC accept?

Desert Sand, LLC currently only accepts RMHP/UHC.

Is there a difference between Medicaid and Medicare?

Yes, these are two completely different insurances. Medicare is coverage for older adults aged 65+, or individuals of any age who have a disability. Typically, when you are searching for therapists who accept Medicare, you will want to find a Licensed Clinical Social Worker, or LCSW. While Megan Sand at Desert Sand, LLC is an LCSW, they are not currently paneled with Medicare and therefore unable to accept Medicare.

How much do my sessions cost through Medicaid?

Psychotherapy for Medicaid members is typically cost-free. In rare cases, your plan may include a small fee for your sessions, depending on your coverage. As a new client, Desert Sand, LLC will look into your benefits and provide you with this information as soon as possible.

Therapists in Colorado are unable to accept out-of-pocket payments (aside from plan-designated copays) from Medicaid members for all “covered services” including outpatient therapy. Medicaid members are also not charged for late-cancellation fees or no-shows. If you are a Medicaid member and have been charged out-of-pocket fees or cancellation/no-show fees by any Colorado therapist, this should be addressed with the provider involved, and if needed, reported to Health First Colorado.

Are there any limits to Medicaid coverage?

Typically, as long as "medical necessity" can be proven (i.e. you have a covered diagnosis and have a continued need for treatment), sessions are unlimited. This does, however, depend on a variety of factors. If you are receiving services from multiple Medicaid providers, please inform all such providers of this so that services do not overlap inappropriately.

Typically, multiple sessions in one day are not covered. If you are being seen for individual and family, please schedule them on different days.

All other limits depend on your plan, so it's always best to consult your RAE if you have more questions.

If you lose Medicaid coverage or switch to a different insurance company, please note that you are responsible for all fees associated with services received, and for late-cancellations or no-shows. 

If you have questions about Medicaid and how it affects your services at Desert Sand, LLC, please reach out to Megan Sand, LCSW:
megan@desertsandllc.com
(970) 235-1136

Medicaid Resources

Apply for Colorado Medicaid - check eligibility and apply.
Medicare information