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Emergency Medicaid Services (EMS) Overview

The Emergency Medicaid Services (EMS) benefit covers family planning , family planning-related, and services necessary to treat an emergency medical condition for people who qualify. EMS is a limited benefit that does not cover all medical services. It is also known as “Emergency Medical Services” or Emergency Medicaid and Reproductive Health Care Services (EMS/RHCS).

Who Qualifies for EMS?

To qualify for EMS, 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 include, but are not limited to:

• Deferred Action for Childhood Arrivals (DACA) recipients
• People without legal 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
  • Children 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.

Please apply to see if you qualify — even if you are unsure if you qualify or about your immigration status. You do not need a Social Security number to qualify for EMS.

If you qualify for EMS and family planning services, we will send you a letter confirming your coverage. EMS members have coverage for 12 months until it’s time for renewal or there is a qualifying life event that changes your eligibility.

If you don’t qualify, but you have questions or think you should qualify for EMS, you can call your county’s Department of Human Services. This phone number will be listed on the bottom of the letter received. You can also get help applying at your local application assistance site.

Covered EMS Benefits and Services

EMS is a limited benefit plan. EMS only covers family planning, family planning-related, and services necessary to treat an emergency medical condition. You will not have full Health First Colorado coverage.

How long does coverage last?

EMS members are covered for family planning and emergency services necessary to treat an emergency medical condition for 12 months unless you have certain life changes that changes eligibility. After 12 months, you will need to complete the renewal process to determine if you still qualify for health coverage.

How to apply

Online: Go to CO.gov/PEAK and create an account to apply for public benefits, including EMS.

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. You do not need a Social Security number to apply. Go to this list of what you need to apply.

Confidentiality Notice: Information you provide on your application is confidential and cannot be shared with U.S. Citizenship and Immigration Services. Colorado law protects your personal information when applying for or enrolling in most public benefits. Your information may only be shared with some federal agencies if there is an audit from the Center for Medicare and Medicaid Services and the Office of the Inspector General. If shared, the information does not impact your immigration status and can’t be used in a public charge decision.

Cover All Coloradans: Expanded coverage for pregnant people and children

Coming in 2025: Expanded health coverage for pregnant people and children, known as Cover All Coloradans, will expand Health First Colorado and CHP+ benefits to children and people who are pregnant regardless of their immigration or citizenship status. Pregnant people will be covered for 12 months following the end of a pregnancy, and children will be covered until they turn 18. Learn more about the new Cover All Coloradans benefits.

Additional Resources

Frequently asked questions:

• Health First Colorado Card
• Health First Colorado Provider Search Tool
• Application Resources
• Reproductive and Maternal Health Programs Resources
• EMS Family Planning Expansion Updates

For more information contact

Current members can call the Health First Colorado Member Contact Center: 800-221-3943 (State Relay: 711)

Provider information can be found on our Maternal and Reproductive Health Resources page or through the Gainwell Provider Portal.

Emergency Services

The Emergency Medicaid Services (EMS) benefit covers family planning, family planning-related and services necessary to treat an emergency medical condition for people who qualify. To qualify for EMS, you must meet all requirements for Health First Colorado (Colorado’s Medicaid program) except for immigration or citizenship status requirements. It is also known as “Emergency Medical Services” or Emergency Medicaid and Reproductive Health Care Services (EMS/RHCS).

Covered benefits and services

EMS includes emergency transportation and services necessary to treat an emergency medical condition — including but not limited to, laboratory, X-ray and other medical tests when ordered by a provider.

EMS covers services 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,
• Serious dysfunction of any bodily organ or part.

These services are also covered:

• Labor and delivery (EMS does not cover prenatal or postnatal care)
• Dialysis for End-Stage Renal Disease at a freestanding dialysis center
• Life-threatening or severe symptoms, like chest pains or trouble breathing
• Life-threatening or severe illnesses, like appendicitis
• Life-threatening or severe accidents

This list is not complete. If this is an emergency, please call 911 or go to the nearest emergency department.

Members do not need a provider’s note saying that the services provided were for an emergency. The provider will give this information to Health First Colorado.

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

Applying for EMS coverage

You do not need a Social Security number to get EMS.

You can apply for EMS

• at the hospital when you get emergency treatment
• after you leave the hospital
• for any emergency care you got in the past three months

If you’re pregnant and need health coverage for future labor and delivery services, you can apply before, during, or after labor and delivery. People at the hospital can help you apply for EMS coverage.

Confidentiality Notice: Information you provide on your application is confidential and cannot be shared with U.S. Citizenship and Immigration Services. Colorado law protects your personal information when applying for or enrolling in most public benefits. Your information may only be shared with some federal agencies if there is an audit from the Center for Medicare and Medicaid Services and the Office of the Inspector General. If shared, the information does not impact your immigration status and can’t be used in a public charge decision.

Cost of services

There is no cost if the providers say you are having a medical emergency.

Get help during a medical emergency

If you think you are having a medical emergency call 911 or go to the nearest emergency room.

Under federal law, all hospitals must provide emergency medical care to anyone having a medical emergency, even if they can’t pay for it, and even if they are not a U.S. citizen.

For more information contact

Current members can call the Health First Colorado Member Contact Center: 800-221-3943 (State Relay: 711)

Provider information can be found on our Maternal and Reproductive Health Resources page or through the Gainwell Provider Portal.

Reproductive Health Services

The Emergency Medicaid Services (EMS) includes Reproductive Health Care Services (RHCS) coverage of family planning and family planning related services. This is in addition to coverage of services needed to treat an emergency medical condition, and you will not need to reapply for coverage of the different types of care. EMS is also known as “Emergency Medical Services” or Emergency Medicaid and Reproductive Health Care Services (EMS/RHCS).

Covered benefits and services

EMS covers both family planning services, such as birth control, and family planning-related services, such as sexually transmitted infection testing or cervical cancer screening and prevention.

Family planning services include 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
  • And more
• 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.

Family planning-related services include services provided in a family planning setting during or in follow-up to a family planning visit.

• 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

To learn more about covered services, please visit the Benefit and Services page.

Applying for EMS coverage of family planning and family planning-related services

You do not need a Social Security number to apply for and get EMS coverage. You do not need to reapply for coverage of emergency services. To qualify for EMS, you must meet all the requirements for Health First Colorado except for immigration or citizenship status requirements.

If you have received family planning services in the last 90 days, you might be able to get help paying the bill.

Apply today to see if you qualify.

Confidentiality Notice: Information you provide on your application is confidential and cannot be shared with U.S. Citizenship and Immigration Services. Colorado law protects your personal information when applying for or enrolling in most public benefits. Your information may only be shared with some federal agencies if there is an audit from the Center for Medicare and Medicaid Services and the Office of the Inspector General. If shared, the information does not impact your immigration status and can’t be used in a public charge decision.

Cost of services

Family planning and family planning-related services should be provided at no cost to the member.

For more information contact

Current members can call the Health First Colorado Member Contact Center: 800-221-3943 (State Relay: 711)

Provider information can be found on our Maternal and Reproductive Health Resources page or through the Gainwell Provider Portal.