Submitting your Application

What type of information is asked for when applying to HIBI?

  • Commercial health insurance plan member’s social security number
  • Policy number
  • Group number
  • Employer and  employee share of premium cost
  • Health First Colorado (Colorado’s Medicaid Program) member’s name and Health First Colorado identification number

Besides my application, will I need to submit any other documents?
Yes. To process your application, we will need the following documents:

•  A copy of the front and back of your insurance card
•  Premium rate sheet provided by your Human Resources department or insurance carrier
•  Summary of benefits document (if available)
•  Pay stub or other proof of a premium payment

Mailing and faxing information.
Can the Health First Colorado office help me apply for HIBI?
Your Colorado Health First Colorado caseworker may help you start the HIBI application process.  For further assistance, you are welcome to contact the HIBI Program.