Away From Home Care
If you’re interested in Away From Home Care®, here are some of the questions our members ask most frequently.
You may also download the Away From Home Care Brochure (pdf 3.45 MB) .
What is Away From Home Care®?
Away From Home Care® is a program that Capital Health Plan participates in to cover our members who are out of our service area for 90 consecutive days or more. Members can take advantage of the Away From Home Care® benefit when families are apart such as a child away in college, family members residing in different HMO service areas, and/or long term travelers. This benefit allows our members to seek routine and emergency care while outside our service area for an extended period of time.
Does Away From Home Care® cost extra?
No, Away From Home Care® is a benefit offered to Capital Health Plan members as part of your plan with us. A guest membership is set up with a participating HMO in the area where the member is staying. (Note: Some areas of the country do not have a participating HMO.)
Is there a limit as to how long I can be out of the service area?
There are certain criteria that must be met for you (or your family) to be eligible for Away From Home Care®:
- A member must be out of the service area for at least 90 consecutive days.
- A policyholder can ONLY be a guest for a maximum of 6 months each year.
- Dependents on the policy can be enrolled for up to one year and must renew their guest membership each year.
- Other restrictions may apply.
Will the copays be the same?
The copays under Away From Home Care® depend on the copays established by the HMO where you are a guest (also called the Host HMO).
How do I start Away From Home Care®?
It is a very simple process, as easy as 1-2-3-4:
- Call Capital Health Plan Member Services at 850-383-3311. Have the address, phone number, county, and state where you (or your family member) will be. Member Services will verify that there is a participating HMO in the area.
- Look for an application in the mail (to be completed by the policy holder).
- Complete and sign the application; send it back to CHP at least 15 days before you would like it to be effective.If the application is for someone over the age of 18, he or she must sign the paperwork as well.
- Look for plan information in the mail from the Host HMO.
Can I choose a Primary Care Physician (PCP) just like I do at Capital Health Plan?
Yes. Once you receive information from the Host HMO, it will include a list of providers that you can use for medical care.
- Please remember that you are not able to see your Capital Health Plan PCP when you are home for holidays or brief visits. You can use the CHP Urgent Care for urgent medical needs when you are in the Tallahassee area.
Can Away From Home Care® cover my whole family?
All family members are eligible for Away From Home Care®. Each family member will need to have his or her own guest membership.
Will I get a new ID card?
Medical Services: Yes. Once the Host HMO processes your application, you will receive a new ID card from them to use for your medical services. You will also receive a New Member Package from the Host HMO that you will use when you seek services in that area.
Prescription Services: If your prescription drugs are covered under your CHP plan, you will continue to use your Capital Health Plan ID card whenever you fill prescriptions while on Away From Home Care®, so you will need to keep this card handy as well.
How do I renew Away From Home Care®?
Your dependent’s guest membership will end automatically after one year unless you renew the Away From Home Care® membership. We will send you a letter and renewal form prior to the termination date on your Away from Home Care® membership to remind you that your coverage is about to end. You will need to complete the renewal form and return it to Capital Health Plan.
- If you are the policy holder, your guest membership will end after 6 months. You can renew for 6 months in the following calendar year.
What if I move or change my address while covered under Away From Home Care®?
Please call Member Services to ensure that your coverage with the Host HMO is still applicable.
I’ve moved back into the Capital Health Plan service area. How do I cancel my Away From Home Care® membership?
Please call Member Services to terminate your Away From Home Care® coverage. You will need to select a new PCP in our network.
- You may not be able select the same PCP you had prior to starting Away From Home Care® if your original physician is not accepting new patients or has left the CHP network.
Some restrictions may apply.