How to Pay for Addiction Treatment in Colorado: Health First Colorado, Insurance, and More

Cost is one of the most commonly cited barriers to addiction treatment. When people are already struggling with the weight of a substance use disorder, navigating insurance paperwork, determining what is covered, or worrying about bills can feel impossible. But in Colorado, there are more funding options for addiction treatment than many people realize — and the vast majority of Coloradans can access quality treatment at little or no cost.

This guide walks through every major funding pathway for substance use disorder treatment in Colorado: Medicaid (Health First Colorado), private insurance, state and county funding, sliding-scale programs, and options for people who are uninsured. By the end, you will have a clear picture of what is available and how to access it.

Health First Colorado: Colorado’s Medicaid Program

Health First Colorado is Colorado’s Medicaid program, providing health insurance to low-income Coloradans who meet eligibility criteria. As of 2024, approximately 1.5 million Coloradans — roughly one in four residents — are enrolled in Health First Colorado.

What is covered for substance use treatment?

Health First Colorado is required by federal law — specifically the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act — to cover substance use disorder treatment as an essential health benefit, on par with medical and surgical care. In Colorado, Health First Colorado covers:

Outpatient counseling (individual and group)
Intensive Outpatient Programs (IOP)
Partial Hospitalization Programs (PHP / Day Treatment)
Residential treatment (short-term and long-term)
Medical detoxification (residential and non-residential)
All FDA-approved medications for opioid use disorder: buprenorphine (Suboxone, Sublocade), methadone (through licensed OTPs), and naltrexone (Vivitrol)
FDA-approved medications for alcohol use disorder: naltrexone (oral and injectable), acamprosate, disulfiram
Recovery support services including peer support specialists
Case management and care coordination

The Colorado Behavioral Health Administration (CBHA) has worked to reduce administrative barriers to accessing these benefits. Notably, Colorado removed prior authorization requirements for buprenorphine through Health First Colorado — meaning a provider can prescribe it immediately without waiting for insurance approval.

Who qualifies for Health First Colorado?

Key eligibility groups include:

Adults ages 19–64 with household income at or below 138 percent of the Federal Poverty Level (approximately $20,120 for a single person in 2024)
Children under 19 with family income at or below 260 percent of the FPL
Pregnant individuals during pregnancy and for 12 months postpartum
People who are blind or disabled
People receiving Supplemental Security Income (SSI)

Unlike some states, Colorado did expand Medicaid under the ACA, meaning low-income adults without children or disabilities are eligible — a significant difference from the pre-ACA era when childless adults were generally not eligible for Medicaid.

How to apply:

Apply online at colorado.gov/PEAK, by calling 1-800-221-3943, or in person at your county Department of Human or Social Services. Many substance use treatment programs also have eligibility specialists on staff who can assist with enrollment.

Private Health Insurance

If you have private health insurance — through an employer, a Covered Colorado marketplace plan, or directly from an insurer — your plan is legally required to cover substance use disorder treatment.

Federal parity law: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that private insurance plans provide substance use disorder benefits that are no more restrictive than medical/surgical benefits. This means your insurer cannot impose higher copays, stricter utilization review, or more limited coverage for addiction treatment than for other health conditions.

What you should expect from private insurance:

Coverage for medically necessary detox, residential, IOP, and outpatient services
Coverage for FDA-approved medications for addiction treatment
The ability to get mental health and substance use treatment without separate “behavioral health” deductibles in many plans

How to access your benefits:

Call the member services number on the back of your insurance card
Ask specifically for behavioral health or substance use disorder benefits
Request a list of in-network substance use treatment providers
Ask about prior authorization requirements and your out-of-pocket costs
If you receive a denial, you have the right to appeal — and many denials are overturned upon appeal

If you believe your insurance is improperly denying coverage or imposing discriminatory limits on behavioral health benefits, you can file a complaint with the Colorado Division of Insurance at doi.colorado.gov.

State and County Funding: Options for the Uninsured

Colorado funds a block grant-supported system of substance use treatment for people who do not have insurance or who have income too low to qualify for Health First Colorado. This system is administered through the CBHA and implemented at the county level.

Substance Abuse Prevention and Treatment (SAPT) Block Grant: Federal funds distributed to states for substance use prevention and treatment. In Colorado, these funds support a network of community behavioral health centers and treatment programs that provide services on a sliding-scale or no-cost basis for income-eligible individuals.

County Behavioral Health Programs: Each Colorado county has a designated behavioral health organization or department that receives state and county funding to serve residents who cannot afford treatment. Contact your county Department of Human Services or Health Department to access these resources.

Colorado Crisis Services: While primarily for crisis intervention, Colorado Crisis Services can connect uninsured individuals to appropriate, publicly funded treatment — and the crisis stabilization service itself is available regardless of insurance status.

Indian Health Service (IHS): For enrolled members of federally recognized tribes in Colorado, the Indian Health Service provides health services including substance use treatment. Colorado’s urban Indian health programs (including Denver Indian Health and Family Services) extend these services to Native Americans living off-reservation.

Sliding-Scale Programs

Many Colorado treatment providers offer sliding-scale fees based on income, even for people who have some insurance or modest income above Medicaid eligibility. This is particularly common at:

Federally Qualified Health Centers (FQHCs) — receive federal funding specifically to serve low-income patients regardless of ability to pay
Nonprofit treatment organizations
Faith-based programs
University training clinics

When contacting a treatment program, always ask: “Do you offer sliding-scale fees or a charity care program?” Many programs have financial assistance available that is not prominently advertised.

Financing Options

For people seeking private residential treatment programs not fully covered by insurance, some options exist:

Healthcare financing companies: CareCredit and similar healthcare financing companies offer payment plans for medical and behavioral health services. Be cautious about high-interest loans and read terms carefully.

Scholarships: Some private treatment facilities offer scholarship spots — a limited number of subsidized beds for people who cannot afford full rates. Ask specifically whether a scholarship is available.

Employee Assistance Programs (EAPs): If you are employed, your employer may offer an EAP that provides free short-term counseling, treatment referrals, and sometimes financial assistance for treatment. EAP services are confidential — your employer does not learn the details of your use.

Veterans’ Benefits

Colorado is home to a substantial veteran population. The VA Eastern Colorado Health Care System (Denver) and other VA facilities provide comprehensive substance use disorder treatment for eligible veterans, including:

Inpatient detoxification
Residential treatment at the Domiciliary program
Outpatient substance use counseling
MAT (buprenorphine, naltrexone, methadone)
Peer support services

Veterans who are not currently enrolled in VA healthcare may qualify — contact the VA at 1-800-827-1000 or visit va.gov to apply. Many veterans are unaware of their eligibility.

Understanding Your Rights

Several federal laws protect people seeking addiction treatment from insurance discrimination:

The ACA: Requires coverage of substance use disorder treatment as an essential health benefit.

MHPAEA: Requires parity between behavioral health and medical/surgical benefits.

Section 1557: Prohibits discrimination in health programs receiving federal funding based on race, color, national origin, sex, age, or disability.

If your insurance denies coverage, appeal immediately. SAMHSA’s website has resources on navigating appeals for substance use disorder treatment coverage.

Take the First Step

Figuring out how to pay for treatment should not prevent you from getting help. The Colorado Addiction Hotline can help you navigate your insurance benefits, identify publicly funded programs, and find sliding-scale options — all at no charge.

Call us today. Our specialists are available 24 hours a day, 7 days a week, and every call is confidential. Whether you have Health First Colorado, private insurance, or no coverage at all, we will help you find a way to get the care you need.

The cost of not getting treatment is far greater than any bill. Let us help you take the first step.

Sources: Colorado Behavioral Health Administration (CBHA); Colorado Department of Health Care Policy and Financing; Substance Abuse and Mental Health Services Administration (SAMHSA); Centers for Medicare and Medicaid Services (CMS); Colorado Division of Insurance