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.1,2

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, so check the current figures on that CMS fact sheet or at medicare.gov.3 To reach a person, call 1-800-MEDICARE (1-800-633-4227), staffed 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048.1 Colorado SHIP takes calls at 1-888-696-7213.1

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.3

The hospital deductible is $1,736 per benefit period, up $60 from 2025.3 A benefit period starts on admission day and ends once you have gone 60 consecutive days without inpatient hospital care or skilled care in a skilled nursing facility. You do not have to leave the building for that clock to run, so a resident who drops from skilled to custodial care can start a new benefit period in place.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Original Medicare doesn't cover routine dental, vision, or hearing.3,6

• 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 services3

Part B is technically optional, but skipping it and enrolling late without qualifying for a Special Enrollment Period or a Medicare Savings Program 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.7 Creditable drug coverage is a Part D term and does not excuse a late Part B enrollment.7

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.6

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 offer only a handful of Medicare Advantage plans. 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. Some plans go further and may help pay part or all of your Part B premium.6,3
• Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you sign up. Emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered whether you get them in the plan's network or outside it.6
• Plans may require prior authorization (plan approval) before covering certain services, which Original Medicare generally does not.6
• 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: CMS says there is no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap, Medicaid, employer, retiree, or union coverage.6

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 help you choose a plan at no charge.1

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.4 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).8
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.4

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 projected average standalone Part D premium runs roughly $34.50 a month in 2026, though actual plan premiums vary.3 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.4 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 the federally standardized plans, labeled A-D, F, G, and K-N, regulated by the Colorado Division of Insurance (DORA).9 Plans C and F are closed to anyone who first became eligible for Medicare on or after January 1, 2020. The line is your eligibility date, not your purchase date: someone who already holds one can keep it, because any Medigap policy issued since 1992 is guaranteed renewable, and someone who was eligible before January 1, 2020 but hasn't enrolled yet may still be able to buy Plan C or Plan F. Plan G is the closest equivalent still open to people newly eligible: it covers the Part A deductible, the Part A coinsurance, the Part B coinsurance, skilled nursing facility coinsurance, and Part B excess charges, and it covers foreign travel emergency care at 80% up to plan limits.10,9 The $283 Part B deductible stays yours to pay.3

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 can't refuse to sell you any policy it offers, can't use medical underwriting to decide on your application, and can't charge you more because you have health problems.5 Outside it, Colorado insurers may apply medical underwriting, meaning they can review your health, charge more, or decline coverage.

Federal law ties that guaranteed window to turning 65 with Part B, so it does not cover people who reached Medicare through disability before 65.5 State rules on under-65 Medigap access vary and change, so confirm what's available to you with the Colorado Division of Insurance or a Colorado SHIP counselor before you apply.

Medigap or Medicare Advantage?

While you're in a Medicare Advantage plan it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. 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.6

Help Paying for Medicare in Colorado

Two programs can cut your Medicare costs sharply if your income and countable resources fall within the 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.2

QMB is the most generous: it pays your Part B premium plus your deductibles and coinsurance, and Medicare providers aren't allowed to bill a QMB enrollee for that cost-sharing.2 Colorado still applies a resource test, and for 2026 HCPF tells county eligibility workers to use $11,450 for one person and $17,910 for a couple across all three programs. That is the federal $9,950 / $14,910 limit with Colorado's burial-fund exclusion folded in ($1,500 for an individual, $3,000 for a couple), not a separate, more generous state asset ceiling, and HCPF's public page conditions the burial exclusion on your having actually set that money aside. If you check that page and see $11,160 / $17,470, you're looking at the 2025 chart HCPF hasn't updated yet, a stale display rather than a different rule.2 Income figures are tied to the Federal Poverty Level and update annually; Colorado loaded the 2026 guidelines into its county eligibility system on April 1, 2026. Each figure in the table already includes the $20 monthly general income disregard, so HCPF measures you after that subtraction rather than against your gross pay.

None of these figures is a hard cutoff to screen yourself against. HCPF prints a caveat directly above its own income list: "Remember that if you have income from working, you may qualify for benefits even if your income is higher than the limits listed."2 States can also effectively raise both the income and the resource limits by disregarding certain income and resources, so a Coloradan above these amounts should apply and let the county decide. QI-1 is the one tier you must reapply for every year; selection in one year does not carry into the next.2

To apply, contact your county of residence's Department of Human Services.2 Enrolling in QMB, SLMB, or QI-1 automatically qualifies you for Extra Help with Part D.2

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.11 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, in the 48 contiguous states and DC (Alaska and Hawaii run higher)11
• Resource limits: $16,590 for an individual, $33,100 for a couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses11
• If you're enrolled in QMB, SLMB, or QI-1, you automatically qualify for Extra Help2
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately2,11

Apply through Social Security at ssa.gov. Social Security's national line is 1-800-772-1213 (TTY 1-800-325-0778), which SSA presents as a way to make an appointment.12

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.13

Changes made during Annual Open Enrollment take effect January 1 of the following year. If you start receiving Social Security at least 4 months before you turn 65, you're enrolled in Parts A and B automatically. If not, you sign up yourself through the Social Security Administration.13

If you or your spouse are still working at 65 with health coverage from that current employer, you can delay Part B without penalty and use an 8-month Special Enrollment Period once the job or coverage ends (COBRA and retiree plans don't count), though this Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD). And if you're self-employed, or your plan isn't available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay; if it doesn't, sign up at 65. Miss that window and you're left waiting for the General Enrollment Period, where coverage now starts the month after you sign up.14

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 give free, unbiased, individualized information to help you navigate Medicare.1

Colorado houses its SHIP inside the insurance regulator, not an aging agency, and the program runs 17 local locations at partner agencies around the state, so help isn't confined to Denver.1

A Colorado SHIP counselor can help you:

• Choose a plan and review the coverage you already have
• Understand what Medicare will cost you
• Apply for Extra Help with Part D costs
• File a complaint or an appeal

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

Learn More

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.