Click on the links to find information on Capital Health Plan's Quality Improvement Program, Member Rights, Privacy Practices, and Advance Directives.
Capital Health Plan offers both employer group and Medicare Advantage coverage.
The Health Information Line is a 24-hour/day phone line staffed by health care professionals who are able to assist you with your health related questions. While not a substitute for a visit with your physician, the Health Information Line staff can provide you with tips, tools and resources to help you manage your health.
Capital Health Plan offers our members the opportunity to access their Capital Health Plan medical history, change their primary care physicians, and much more through our CHPConnect.
Capital Health Plan utilizes a Pharmacy Benefit company called Prime Therapeutics to administer our pharmacy benefits. Members can register at the Prime web-site (https://www.myprimetools.com) to find out more information about their specific medications (including refill history and cost), general information on medications (side effects, storage concerns, and drug interactions), and the benefit of using generics over brand name medications.
CHP makes decisions about coverage for health care services with two main goals as its focus: to cover quality treatment with the efficient use of resources. CHP's participating physicians coordinate preventive care and specialty services for their patients. CHP evaluates new technologies and adopts clinical treatment tools to guide the care of members. This is called "utilization management."