How CHP+ Works for Kids with Autism in Colorado
Most parents trying to cover ABA therapy for their autistic child already know the frustration: they earn too much to qualify for full Medicaid, but not enough that private insurance costs feel manageable. That middle ground is exactly where CHP+ lives — and for a lot of Colorado families, it's the coverage that makes ABA therapy actually affordable.
CHP+ — Colorado's Child Health Plan Plus — is the state's low-cost public health insurance for children whose families earn too much for Health First Colorado (Medicaid) but too little to comfortably pay for private coverage. It covers ABA therapy, occupational therapy, speech therapy, and a wide range of other services for kids with autism.
If you're still figuring out whether your child qualifies for CHP+ or full Medicaid, aBCBA-led autism evaluation in Colorado can help clarify both your child's diagnosis status and which coverage pathway applies to your family.
What Is CHP+? The Short Version
Child Health Plan Plus is a state and federally funded health insurance program administered by the Colorado Department of Health Care Policy and Financing (HCPF). It's designed specifically for the gap between full Medicaid and private coverage.
Think of the coverage tiers this way:
- Health First Colorado (Medicaid): For families under approximately 138–142% of the Federal Poverty Level
- CHP+: For children in families between those limits and 260% of the Federal Poverty Level
- Private insurance or marketplace plans: For families above CHP+ income limits
As of January 1, 2025, all Colorado children aged 18 and younger can apply for Health First Colorado or CHP+ regardless of immigration status. Previously, immigration status was a barrier for some families — that changed with the Cover All Coloradans expansion.
A family of four generally qualifies for CHP+ with income up to approximately $55,000–$78,000 per year, depending on the specific income tables and deductions applied. Certain expenses — child care, medical expenses, child support payments, and health insurance premiums — can be deducted from gross income when determining eligibility, which sometimes extends coverage to families who might otherwise appear over-income.
Does CHP+ Cover ABA Therapy for Kids with Autism?
Yes — Colorado state law requires it.
Colorado's autism insurance mandate requires that health insurance plans in the state, including CHP+, cover ABA therapy for children diagnosed with Autism Spectrum Disorder. This is not optional for insurers operating in Colorado. The mandate ensures autistic kids across the state have access to this essential service.
What CHP+ covers for autism includes:
- Behavioral assessments — the evaluation your provider uses to confirm ASD and establish the treatment plan
- Direct ABA therapy sessions — one-on-one therapy delivered by a BCBA or supervised RBT
- Treatment plan development — the individualized behavior plan that guides the therapy
- Parent and caregiver training — sessions that help families apply ABA strategies at home
- Related therapies — occupational therapy and speech therapy are also covered under CHP+
Coverage specifics can vary between Managed Care Organizations (MCOs). When you enroll in CHP+, your county determines which MCO you join — and each MCO has its own network of providers. Before starting services, always confirm your ABA provider is in-network with your specific CHP+ MCO.
CHP+ Eligibility: Who Qualifies in Colorado?
To qualify for CHP+ in Colorado in 2025, children must meet the following criteria:
Age: Under 19 years old (newborns are eligible from birth and receive one full year of automatic coverage)
Income: Household income between the Medicaid threshold and 260% of the Federal Poverty Level — roughly $55,000 to $78,000 for a family of four, after applicable deductions
Residency: Living in Colorado
Insurance status: Not already enrolled in or eligible for other health coverage (private insurance, employer-sponsored plans, Medicare, or Medicaid)
Immigration status: As of January 2025, immigration status is no longer a barrier for children and pregnant individuals in Colorado.
One important note: even if your income appears above the CHP+ limit, it's worth running a formal eligibility check. Colorado allows certain deductions — child care costs, medical expenses, alimony, dental costs, child support payments, and health insurance premiums — that can bring your effective household income below the limit. Many families who initially thought they didn't qualify discover they do after deductions are applied.
How the ABA Coverage Actually Works: The Prior Authorization Process
This is the part that trips up most families — and where having an experienced provider makes a significant difference.
CHP+ requires prior authorization (PAR) before ABA therapy services can begin. "Prior authorization" means your ABA provider submits clinical documentation to the plan's utilization management (UM) vendor before a single therapy session takes place. Services started without approved prior authorization are generally not covered.
Here's how the process works step by step:
Step 1 — Get a formal autism diagnosis. A licensed psychologist, developmental pediatrician, or other qualified clinician must document your child's ASD diagnosis. The earlier this happens, the earlier therapy can begin.
Step 2 — BCBA assessment. Your ABA provider's Board Certified Behavior Analyst conducts a comprehensive behavioral assessment. This evaluation identifies your child's specific skill levels, behavioral patterns, and therapy goals. The results of this assessment form the core of the PAR documentation.
Step 3 — PAR submission. Your ABA provider submits the Prior Authorization Request through Colorado's UM vendor portal. The request includes the behavioral assessment, the proposed treatment plan, and documentation establishing medical necessity.
Step 4 — Review and determination. Licensed clinical reviewers evaluate the PAR. Both the family and the provider receive a determination letter. If approved, the PAR is valid for up to six months, after which a new PAR must be submitted for continued coverage.
Step 5 — Start therapy. Once the PAR is approved, your child can begin ABA therapy — at home, at school, or in a clinic setting, depending on the provider and the plan.
If a PAR is denied or partially denied, families have the right to appeal within 30 calendar days. Many denials can be resolved through a reconsideration request, where additional documentation is provided.
What CHP+ Costs for Autism Families
CHP+ enrollment itself is free. There are no monthly premiums. Where costs can arise:
- Annual enrollment fee: Up to $105 per year, depending on household income and size (not all families pay this)
- Co-pays: Small co-pays may apply for some services, ranging from $2 to $50. Preventive care has no co-pay.
- Out-of-pocket maximum: The total out-of-pocket spending across your household for CHP+ services is capped at 5% of your annual household income. For a family earning $60,000, that's a maximum of $3,000 per year — for all enrolled family members combined, not per child.
Native American and Alaska Native children enrolled in CHP+ are not required to pay co-pays.
Compared to private insurance costs — where ABA therapy can run $120 or more per hour, and comprehensive coverage can cost thousands per year in premiums — CHP+ represents a significant financial difference for families in the eligible income range.
A Colorado Example: How CHP+ Works in Practice
A family in Aurora has a 5-year-old son who received an autism diagnosis at age 4. Both parents work, and the family's combined income is approximately $62,000 per year — too high for full Medicaid eligibility, but well within CHP+ limits after their childcare deduction is applied.
They applied through Colorado PEAK online and received CHP+ enrollment confirmation within two weeks. Their son was enrolled in the Denver metro MCO serving Aurora-area families.
When they contacted Inclusive ABA — which is enrolled as a CHP+ provider — the intake team verified their specific MCO plan, confirmed in-network status, and began the behavioral assessment process. The BCBA completed the assessment, the PAR was submitted, and authorization came back approved within 10 business days. Home-based ABA therapy in Aurora began the following week.
The family's annual enrollment fee was $72, and their co-pays for ABA sessions have been $5 per visit. Total monthly cost: well under $100.
That's how CHP+ works when the process runs smoothly — and it runs smoothest when the provider handles the authorization paperwork on the family's behalf.
How to Apply for CHP+
There are three ways to apply:
- Online through Colorado PEAK: colorado.gov/PEAK — the fastest option, with real-time eligibility screening
- By phone: Call CHP+ Customer Service at 1-800-359-1991 (State Relay: 711)
- In person: At your county Department of Human or Social Services, or an application assistance site
CHP+ applications can be submitted at any time throughout the year — there is no open enrollment period. If your child needs immediate care before the full eligibility review is complete, ask about Presumptive Eligibility (PE) — a program that allows children to receive care for up to 60 days while the formal application is processed.
Once enrolled, keep coverage active by reporting income changes and completing annual renewals on time. A lapse in coverage creates gaps in therapy authorization — and gaps in therapy can mean regression for autistic kids who rely on consistency.
CHP+ vs. Other Colorado Coverage Options: A Quick Comparison
Income eligibility scale →
FPL = Federal Poverty Level. Income limits are approximate and updated annually. Source: Colorado HCPF.
If your child falls between CHP+ and the state's Children with Disabilities Buy-In program, the Buy-In allows families to pay a monthly premium to access full Medicaid benefits — including ABA coverage — for children with qualifying disabilities including autism. It covers households up to 300% of the Federal Poverty Level.
Conclusion: CHP+ Is a Powerful Tool — When You Know How to Use It
CHP+ covers ABA therapy for kids with autism in Colorado. The income thresholds are more generous than most families realize, the out-of-pocket costs are structured to stay manageable, and the coverage mandate means insurers can't simply opt out of providing ABA benefits.
The challenge is navigating the prior authorization process, understanding which MCO network applies to your family, and finding a provider who is actually enrolled and experienced with CHP+ billing. That's where a provider who handles the full process matters.
Inclusive ABA verifies your CHP+ coverage from day one — before your first appointment — so families in Denver, Lakewood, Thornton, Westminster, Arvada, Englewood, and across Colorado aren't surprised by paperwork or gaps in coverage once therapy begins.
Ready to find out what your child qualifies for? Reach out to our team to verify your CHP+ benefits — we'll check your specific MCO, confirm in-network status, and walk you through exactly what to expect before therapy starts. No waitlist. Insurance verified on your first call.
Frequently Asked Questions
Does CHP+ cover ABA therapy for autistic kids in Colorado?
Yes. Colorado state law mandates that health insurance plans — including CHP+ — cover ABA therapy for children with an autism diagnosis. Coverage requires prior authorization and medical necessity documentation. The specifics of your coverage depend on which Managed Care Organization (MCO) your family is enrolled with through CHP+.
What is the income limit for CHP+ in Colorado in 2025?
CHP+ covers children in households with income up to 260% of the Federal Poverty Level. For a family of four, that works out to approximately $78,000–$80,000 per year. Colorado also allows certain deductions — child care, medical expenses, child support, health insurance premiums — that may bring your effective income below the limit even if your gross income appears higher.
Does CHP+ cover ABA therapy in Denver or Aurora?
Yes. CHP+ coverage applies statewide in Colorado, including Denver, Aurora, and all Front Range communities. What varies by location is which Managed Care Organization you're enrolled with — which determines which providers are in-network. Inclusive ABA is enrolled with CHP+ and serves the Denver metro area and surrounding communities with home-based ABA therapy.
How do I start the CHP+ prior authorization process for ABA therapy?
The prior authorization process is handled by your ABA provider, not the family directly. Your ABA provider's BCBA conducts a behavioral assessment, creates a treatment plan, and submits a Prior Authorization Request (PAR) to CHP+'s utilization management vendor. Once approved — which typically takes 1–3 weeks — services can begin. An approved PAR is valid for up to 6 months, after which renewal is required.
What's the difference between CHP+ and Health First Colorado for autism coverage?
Health First Colorado (Medicaid) is for lower-income families and covers ABA therapy under the EPSDT mandate with no set hour cap on medically necessary services. CHP+ is for families who earn too much for Medicaid but still need subsidized coverage — it also covers ABA therapy, though coverage specifics may differ by MCO. Both programs require prior authorization.
Can undocumented children get CHP+ in Colorado?
As of January 1, 2025, all children aged 18 and younger in Colorado can apply for Health First Colorado or CHP+ regardless of immigration status. This change came through the Cover All Coloradans expansion.
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