Frequently Asked Questions

Dependent Care Questions

Find the answer you're looking for when you need quick help regarding dependent care.

How do I add eligible dependents to my policy?

To add an eligible dependent, you should submit the Member Status Change Request Form to your benefit administrator during the enrollment period. Please refer to your Member Handbook for special enrollment criteria, or you may call CHP Member Services.

Can I cover a dependent who lives out of state or is away at school? 

Yes. Capital Health Plan participates in the Away From Home Care® (AFHC®) to cover routine and emergency care for members who are out of our service area for 90 or more consecutive days. Click here to learn more about AFHC®.

How long can a child be covered if he/she has disabilities?

If a child attains the limiting age for a Covered Dependent, coverage will not terminate while that child is, and continues to be, both:


  • Incapable of self-sustaining employment by reason of mental retardation or physical handicap; and
  • Chiefly dependent on the Subscriber for support and maintenance.

Please refer to your Member Handbook for more details, or you may call CHP Member Services.

How long can my child(ren) remain covered on my policy?

Your dependent children can remain on your policy through the end of the year in which they turn 26. If you have a dependent child over 26 but under 30, they can remain on your plan for an additional monthly premium*. Please refer to your Member Handbook for more details, or you may call CHP Member Services.

 

*Subject to certain requirements

How do I remove dependents from my policy?

To remove a dependent, you should submit the Member Status Change Form to your benefit administrator.

How do I obtain coverage for my newly adopted child?

For a newborn adopted child: You should submit the Member Status Change Form along with a copy of your placement papers to your benefit administrator 60 days prior to the date of birth or during the 60-day period immediately following the date of birth. The effective date of coverage would be from the date of birth for the newborn, provided a written agreement to adopt the child has been entered into prior to the birth of the child. If not, then the effective date of coverage would be the date of placement.

For adopted child(ren): You should submit the Member Status Change Form along with a copy of your placement papers to your benefit administrator 30 days immediately following the date of placement. The effective date of coverage would be the date of placement.

How can I cover my newborn from birth?

You should submit the Member Status Change Form to your benefit administrator 60 days prior to the date of birth or during the 60-day period immediately following the date of birth. The effective date of coverage would be from the date of birth for the newborn.

Where can I find benefit and claim information for my dependent(s)?

You can find benefit and claim information on CHPConnect or by calling CHP Member Services

How does the Delta Dental benefit and claim system work for my pediatric dental coverage?

Your pediatric dental coverage is administered exclusively by Delta Dental. For questions or more information, please contact Delta Dental at 1-800-471-0236.

How do I cancel my Away From Home Care® policy?

To cancel your Away From Home Care® policy, call CHP Member Services.

Once enrolled in Away From Home Care® how long can an individual stay enrolled? Does enrollment in Away From Home Care need to be renewed and if so, how often?

Subscriber Away From Home Care® (AFHC®) policies will end after 6 months. Dependent AFHC® policies automatically end after one year. Capital Health Plan will mail a letter and renewal form prior to the termination date. If you want to renew the policy, you must complete and return the form as directed.

What areas are covered with Away From Home Care®?

Below is a list of states that do not participate in Away From Home Care® (AFHC®). For states that are covered, please contact CHP Member Services to confirm there is coverage in that county.

States not covered on AFHC® include, but are not limited to: Alabama, Alaska, Idaho, Iowa, Kansas, Mississippi, Montana, Tennessee, Nebraska, North Dakota, Oregon, Puerto Rico, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia, and Wyoming.