Healthline member newsletter

The Service Area is Expanding!

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Beginning in 2011, Capital Health Plan will serve Calhoun and Liberty counties. Members renewing effective January 1, 2011 will be eligible if they live or work in Leon, Calhoun, Gadsden, Jefferson, Liberty, or Wakulla counties. Medicare members will be eligible to enroll in a Capital Health Plan Medicare Advantage plan if they live within the expanded service area.

 

We look forward to providing even more members with quality, affordable care.

Making It Easy to Get the Care You Need

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

At Capital Health Plan, we strive to make it easy for you to get the care, tests and treatments you need. We continually look for new ways to improve the quality and accessibility of our services. Here are some of the ways that we have worked to make it easy for you to get care:

 

  • Capital Health Plan’s large network now includes over 125 Primary Care Physicians and over 300 Specialists.
  • Most local participating specialists do not require prior authorization for an appointment.
  • Preventive screenings such as mammograms and colon screenings do not require an authorization prior to the services.
  • Two CHP Eye Care Centers provide vision services when you need it.
  • CHP has a network of over 62,000 participating pharmacies nationwide to make it easy and convenient to fill your prescriptions.
  • When you need immediate care, CHP’s Urgent Care is available by appointment, Monday through Friday from 11am to 10pm, and weekends from 9am to 8pm.
  • CHPConnect allows you access to your medical information and test results 24/7.
  • While traveling outside the service area, CHP provides coverage for emergency services through Blue Cross Blue Shield providers nationwide.
  • Our local Member Services Staff is Available to Assist you and answer your questions.

 

Peace of Mind Away from Home

Note: This article is over 60 days old, and may contain information that is out of date, or has been superseded by newer information.

Capital Health Plan’s Away From Home Care®

“My child is going away for college. Can he/she keep their CHP coverage?”

“My job is transferring me temporarily to another part of the country. What will this do to my CHP coverage?”

“My children live with their mother/ father in another state but I have to keep their coverage with CHP. How do I do that?”

The answer is Capital Health Plan’s Away From Home Care® program.

What is CHP’s Away From Home Care®? Away From Home Care® is a network of HMOs in which CHP participates to provide coverage for our members who are out of our service area for 90 consecutive days or more. 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 available to CHP members at no additional cost.

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.
  • Dependants on the policy can be enrolled for up to one year and must renew their guest membership each year.

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 Get Away From Home Care® Started? It is a very simple process, as easy as 1-2-3-4-5:

  1. Contact Capital Health Plan’s Member Services at 850-383-3311. Have the address, phone number, county and state where you (or your family member) will be.
  2. Member Services will verify that there is a participating HMO in the area (not all areas have a participating HMO).
  3. Once verified, an application is generated and mailed to the policy holder for signature.
  4. Complete the application, sign it and return it to CHP. If the application is for someone over the age of 18, he or she must sign the paperwork as well. Please make sure you send your application at least 15 days before you would like it to be effective.
  5. The application is then sent to the Host HMO and that HMO will mail you information on their plan.

Will I Get A New ID Card?

Medical Services: Yes. Once the Host HMO processes your application, you will receive a new ID card fromthem to use for your medical services.

Prescription Services: You will continue to use your CHP ID card whenever you fill prescriptions while on Away From Home Care®, so you will need to keep this card handy as well.