Medicare in Colorado: Plans and Coverage (2026)

Medicare in Colorado runs on federal rules, but the state adds free SHIP counseling through DORA and administers its Medicare Savings Programs through HCPF. This guide covers Medicare in Colorado for 2026: what each part costs, how plan choice varies across the state, and the programs that lower the bill.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Colorado (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Colorado
• Help Paying for Medicare in Colorado
• Medicare Enrollment Periods
• Free Medicare Help: Colorado SHIP
• Frequently Asked Questions

About these numbers: Premiums and deductibles come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Colorado SHIP at 1-888-696-7213.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government and works the same in Colorado as it does in every other state. It has two parts.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

The hospital deductible is $1,736 per benefit period, up $60 from 2025. A benefit period starts on admission day and ends after you've been out of the hospital and any skilled nursing facility for 60 consecutive days. Get readmitted after that gap closes, and a new deductible applies.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It doesn't cover routine dental, vision, or hearing.

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most covered services

Part B is technically optional, but skipping it and enrolling late without other creditable coverage triggers a 10% late penalty for every 12 months you could have had it, and that surcharge lasts as long as you hold Part B.

Medicare Advantage in Colorado (Part C)

Medicare Advantage plans are sold by private insurers approved by Medicare. They bundle Parts A and B coverage (except hospice, which stays with Original Medicare) and most plans add Part D drug coverage plus extras like dental, vision, and hearing.

Colorado's plan availability varies significantly by geography. Residents in the Denver metro and the Front Range corridor typically have the broadest selection of plans and carriers. Communities along the I-25 corridor from Fort Collins to Pueblo generally fare well. Rural Colorado tells a different story: the eastern plains and the San Luis Valley have noticeably fewer plan options, and some counties may have only one or two Medicare Advantage plans available. Ski resort communities in the mountain corridor fall somewhere in between. Plan availability, networks, and premiums change each year, so compare what's actually offered at your address before enrolling.

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium. CMS estimates the average Medicare Advantage premium at about $14 a month in 2026, and many plans charge $0 extra.
• Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you sign up.
• Most plans require prior authorization before covering certain services, which Original Medicare generally does not.
• Every plan caps your in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap.

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions to see which plans cover them and what your estimated cost would be. A Colorado SHIP counselor can walk through the results with you at no charge.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan alongside Original Medicare or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the coverage gap, so the old donut hole is gone. Part D now works in three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
2. Initial coverage: you pay copays or coinsurance while your plan and drug manufacturers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

The $2,100 cap is the number that matters most. It was $2,000 in 2025 and adjusts with drug-spending growth each year. The average standalone Part D premium is about $46.50 a month in 2026, though actual plan premiums vary. Every Part D and Medicare Advantage drug plan is also required to offer the Medicare Prescription Payment Plan, which lets you spread out-of-pocket drug costs into capped monthly installments across the year instead of paying the full amount at the pharmacy. People who qualify for Extra Help often pay much less, sometimes nothing.

Medigap in Colorado

Medigap policies are sold by private insurers to cover the cost-sharing that Original Medicare leaves on you: deductibles, coinsurance, and copays. They work with Original Medicare only, not Medicare Advantage.

Colorado offers all the federally standardized plans, labeled A through N, regulated by the Colorado Division of Insurance (DORA). Colorado has no state-specific Medigap switching rule, so the federal rules govern when you can buy with guaranteed issue. Plans C and F are closed to anyone who first became eligible for Medicare on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.

Your strongest window is the federal Medigap Open Enrollment Period, the six months that start when you're 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate regardless of your health. Outside it, Colorado insurers may apply medical underwriting, meaning they can review your health, charge more, or decline coverage.

Unlike states with legislated protections for under-65 Medicare beneficiaries, Colorado has no state law requiring insurers to offer Medigap to people who reached Medicare through disability before age 65. Those beneficiaries are subject to insurer discretion outside of any federally guaranteed window.

Medigap or Medicare Advantage?

You can't hold both. Medigap keeps you on Original Medicare with the freedom to see any provider who accepts Medicare nationwide, typically at a higher monthly premium. Medicare Advantage trades some of that freedom for a provider network and often a lower upfront cost. For a side-by-side look at the trade-off, see our guide to Original Medicare vs. Medicare Advantage.

Help Paying for Medicare in Colorado

Two programs can cut your Medicare costs sharply if your income and assets fall within federal limits.

Medicare Savings Programs

Colorado administers its Medicare Savings Programs through HCPF, the Colorado Department of Health Care Policy and Financing. Colorado uses the standard federal income tiers and resource limits.

QMB is the most generous: it pays your Part B premium plus your deductibles and coinsurance, and federal law prohibits providers from billing a QMB enrollee for that cost-sharing. The 2026 resource limit is $9,950 for one person and $14,910 for a couple across all three programs. Income figures are tied to the Federal Poverty Level and update each April.

You apply through Connect for Health Colorado or your local county human services office. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, covers Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024 the partial-subsidy tier is gone, so everyone who qualifies gets the full subsidy.

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
• Resource limits: $16,590 for an individual, $33,100 for a couple
• If you're enrolled in QMB, SLMB, or QI-1, you're automatically enrolled in Extra Help

Apply through Social Security at ssa.gov or call 1-800-772-1213.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or lasting penalties. These dates are federal and identical in Colorado and every other state.

Changes made during Annual Open Enrollment take effect January 1 of the following year. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically. If not, you sign up yourself through the Social Security Administration.

For a full breakdown of windows, deadlines, and penalties, see our guide to Medicare Enrollment Periods.

Free Medicare Help: Colorado SHIP

You don't have to sort this out alone, and you don't have to pay a broker. Colorado runs the State Health Insurance Assistance Program (SHIP) inside the Colorado Division of Insurance (DORA). Counselors are trained volunteers who give free, unbiased help and don't sell insurance or earn commissions.

Colorado houses its SHIP inside the insurance regulator, not an aging agency. That placement gives counselors direct access to current Colorado Division of Insurance data on plan filings and rate approvals, which can be useful when comparing Medigap policies.

A Colorado SHIP counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for Colorado's Medicare Savings Programs and Extra Help
• Work through claims, denials, and appeals

Call 1-888-696-7213 to reach the Colorado SHIP through the Division of Insurance.

Learn More

• Medicare: The National Guide
• Original Medicare vs. Medicare Advantage
• How Medigap Works
• Medicare Part D Drug Coverage
• Medicare Enrollment Periods

Find personalized help comparing your Medicare plan options in Colorado at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.