Emergency Medicaid Services (EMS) and Reproductive Health Care Services (RHCS)
The Emergency Medicaid Services (EMS) and Reproductive Health Care Services (RHCS) benefit, also known as EMS/RHCS, covers services necessary to treat an emergency medical condition and offers reproductive health care coverage.
EMS/RHCS is a limited benefit. It is not full Health First Colorado coverage.
You can request EMS/RHCS any time, even if you haven’t experienced an emergency.
EMS covers services a medical provider considers necessary to treat an emergency medical condition.
RHCS covers preventative screenings, reproductive health diagnosis and treatment, and family planning services.
Who Qualifies?
To qualify for EMS/RHCS you must meet all the requirements for Health First Colorado (Colorado’s Medicaid program) except for immigration or citizenship status requirements.
People who may qualify for EMS/RHCS include, but are not limited to:
- Deferred Action for Childhood Arrivals (DACA) recipients
- People without a qualifying immigration status.
- Non-immigrant visa holders such as tourists and students
- People with Temporary Protected Status
- Adult legal permanent residents (green card holders) who have not been in the U.S lawfully for at least five years
Cover All Coloradans: Health coverage for pregnant people and children
Children ages 18 and younger and anyone who is pregnant may qualify for full Medicaid even if they haven’t been in the U.S. lawfully for at least five years through a Medicaid program called Cover All Coloradans. A qualified person may be enrolled in Cover All Coloradans and EMS/RHCS at the same time. Learn more about Cover All Coloradans. [link to: healthfirstcolorado.com/cac]
My kids and I have health coverage through Cover All Coloradans. Do we need Emergency Medicaid Services and Reproductive Health Care Services (EMS/RHCS)?
If you qualify, you can be on both EMS/RHCS and Cover All Coloradans at the same time. That way, once you no longer qualify for Cover All Coloradans, you will still have EMS/RHCS coverage. This will help cover you in case of an emergency or if you need reproductive health care services.
Benefits and Services
EMS/RHCS covers services necessary to treat an emergency medical condition and offers reproductive health care coverage.
Emergency Medicaid Services (EMS)
EMS covers services to treat an emergency medical condition that, without immediate medical attention, could reasonably be expected to result in:
- Placing the member’s health in serious jeopardy
- Serious impairment to bodily function, or
- Serious dysfunction of any bodily organ or part
Emergency services include services necessary to treat an emergency medical condition including but not limited to:
- Health emergencies (such as chest pain, heart attack, appendicitis, etc.)
- Labor and delivery (not including prenatal or postpartum care)
- Dialysis for End-Stage Renal Disease at a freestanding dialysis center
The lists above are not complete. If this is an emergency, please call 911 or go to the nearest emergency department.
Benefits and services that are NOT covered
EMS does not cover the following:
- Follow-up care after the medical emergency
- Routine provider appointments
- Prenatal or postnatal care (any pregnancy-related care you may get before or after a pregnancy)
- Organ transplants
- Care that is not for an emergency medical condition
Reproductive Health Care Service (RHCS)
RHCS covers family planning services intended to delay, prevent or plan for a pregnancy, including:
- A 12-month supply of birth control, including:
- Oral birth control pill
- Vaginal ring
- Birth control shot
- Birth control patch
- Long-acting reversible contraception (LARC) devices such as an IUD or the implant. This includes coverage of the device and insertion, monitoring and removal.
- Sterilization services such as tubal ligations and vasectomies.
- Basic fertility assessments.
- Contraceptive counseling services to find out what method works best for you.
RHCS also covers services provided in a family planning setting during or in follow-up to a family planning visit, including:
- Diagnosis, treatment, prevention and follow up visits for sexually transmitted infections, lower genital tract and genital skin infections and urinary tract infections.
- Cervical cancer screening and prevention.
- Related evaluations or preventative services such as tobacco cessation services or depression screenings.
How do I find a doctor?
- You may see any Health First Colorado provider.
When do EMS/RHCS services end?
- EMS/RHCS coverage lasts for 12 months. Similar to all Health First Colorado programs, you must complete the renewal process to see if you qualify again.
What does it cost?
- EMS: There is no cost if the providers determine that you are having a medical emergency. Find a list of benefits and services that are not covered by EMS above.
- RHCS: Family planning and family planning-related benefits and services should be provided at no cost to the member.
How to apply
- Online: Go to CO.gov/PEAK and create an account to apply for public benefits, including EMS/RHCS.
- Phone: Call 800-221-3943 (State Relay: 711). Phone applications are available Monday through Friday from 8 a.m. to 4 p.m.
- Mail: Download and print a paper application. (Available in English and Spanish).
- In person: Apply in person at your county’s Department of Human Services or a local application assistance site.
What do I need to apply?
- You do not need a Social Security number to apply.
- Go to this list of what you need to apply.
Privacy and Security
Under state and federal law, information shared with HCPF to determine eligibility for Medicaid and CHP+ programs, including immigration status, is private and secure.
However, we cannot know how federal laws or processes may change in the future and these current laws have exceptions for law enforcement.
For answers to questions about what data is collected and reported, or about state and federal laws for data sharing, go to frequently asked questions about privacy and security.
