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877-247-6512
850-523-7441
850-383-3534 (TTY)
Call us seven days a week
8 a.m. - 8 p.m.

2140 Centerville Place
1491 Governor's Square Boulevard
1545 Raymond Diehl Road
Tallahassee

Mailing address:
Post Office Box 15349
Tallahassee FL 32317-5349

Referral Line: 850-383-3530

Capital Health Plan is a health plan with a Medicare contract. The contract is renewed annually and the availability of coverage beyond the current year is not guaranteed.

Benefits, formulary, pharmacy, network premium and/or copayments/ coinsurance may change on January 1, 2009. Please contact Capital Health Plan for details.

To ensure that beneficiaries receive appropriate care, Capital Health Plan will follow policies and procedures as directed by CMS (Centers for Medicare and Medicaid Services) in the event of an emergency situation designated by the Department of Health and Human Services.

This page was last updated on: July 27, 2008.

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Enrollment

Want to know how to enroll in CHP Advantage Plus and CHP Preferred Advantage? This section will answer the most frequently asked questions on enrollment in a Capital Health Plan Medicare Advantage plan.

Where can I enroll in a Capital Health Plan Medicare Advantage plan?

To get information about our Medicare Advantage plans and to request an enrollment application, please call Capital Health Plan at one of the telephone numbers listed on this page or visit our Medicare Sales Representative at 1545 Raymond Diehl Road, Suite 300, Tallahassee, FL 32308. You also may download the Capital Health Plan Medicare Advantage plan enrollment form (pdf 194.50 kB) , then complete it and submit to us at the address on this page.

You may also enroll in a Capital Health Plan Medicare Advantage plan through the Medicare online enrollment center at www.medicare.gov or by calling the 1-800-MEDICARE call center.

When can I enroll in a Capital Health Plan Medicare Advantage plan?

The annual election period for Medicare enrollment is each year from November 15 through December 31. You may be eligible for a special election period, such as when you first become eligible for Medicare or when you move into our service area. Please call us at one of the telephone numbers listed on this page if you have questions about when you may enroll in a Capital Health Plan Medicare Advantage plan.

When will my enrollment be effective?

Applications received within any given month will be processed for enrollment for the first day of the following month (for example, if we receive your enrollment application on January 22, your coverage will begin on February 1). However, you may direct us to hold your application if necessary (for example, if we receive your enrollment application on January 22, you can ask us to begin coverage on March 1).

If you enroll late in the month, you may not receive your acknowledgment letter, confirmation letter, or membership card by the day that your coverage starts.

You will get an acknowledgment letter from us within approximately seven days after we receive your enrollment application. If you need to fill a prescription after you get the acknowledgment letter but before you receive your membership card, take your acknowledgment letter with you to the pharmacy.

If you need to fill a prescription and you haven't received a letter or membership card:

  1. If you have both Medicare and Medicaid or have been approved for the low income subsidy (extra help paying for prescriptions), bring a copy of your yellow automatic enrollment letter from Medicare, a Medicaid card, an approval letter from the Social Security Administration, or other proof that you qualify for extra help. Let your pharmacist know your plan name and bring one of the above items to get your prescription.
  2. You might be asked to pay out-of-pocket costs for your prescription. In this case, save your receipts and work with us to be reimbursed. To learn how to submit a paper claim, please refer to the paper claims process described here.

Medicare Part D Late Enrollment Penalty

Effective August 2007, Medicare began a program that requires beneficiaries to pay what is known as a "late enrollment penalty."

If you don't join a Medicare drug plan when you are first eligible, and you go without creditable prescription drug coverage (as good as Medicare's) for 63 continuous days or more, you may have to pay a late enrollment penalty to join a plan later. This penalty amount changes every year, and you will have to pay it as long as you have Medicare prescription drug coverage.

However, if you qualify for extra help, you may not have to pay a late enrollment penalty, or you may get help paying your late enrollment penalty.

If you must pay a late enrollment penalty, your penalty is calculated when you first join a Medicare drug plan. To estimate your penalty, take 1% of the national base beneficiary premium for the year you join ($27.93 x 1% = $.28 in 2008). Multiply it by the number of full months you were eligible to join a Medicare drug plan but didn't, and then round this amount to the nearest ten cents. This is your estimated penalty amount, which is added each month to your Medicare drug plan's premium for as long as you have a plan.

For example, if in 2008 you were eligible but did not join a Medicare drug plan for 5 months, your estimated penalty amount would be $1.40 ($.28 x 5 = $1.40), and $1.40 would be added to your Part D premium for as long as you are enrolled in a Medicare Part D plan. In 2008, this would mean:

  • For CHP Advantage Plus, a monthly premium of $36.80
  • For CHP Preferred Advantage, a monthly premium of $49.80

If you disagree with your late enrollment penalty, you may be eligible to have it reconsidered (reviewed). Call Member Services at one of the telephone numbers on this page to find out more about the reconsideration process and how to ask for a review.