Direct Pay Plans

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877-247-6512
850-523-7441
850-383-3534 (TTY)
1-800-955-8771 (TTY)

Call us seven days a week
8 a.m. - 8 p.m.

2140 Centerville Pl
1491 Governor's Square Blvd
1545 Raymond Diehl Rd
Tallahassee

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

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, 2011. Please contact Capital Health Plan for details.

Please call Capital Health Plan Member Services Department to obtain documents in alternate formats or languages.

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: April 30, 2010.

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Enrollment

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

To enroll in a Capital Health Plan Medicare Advantage plan, choose one of the following options:

  • NEW! Enroll electronically through the Centers for Medicare & Medicaid Services Online Enrollment Center by clicking on one of the following links:
Enroll Advantage Plus Medicare external link icon
external link icon
  • Download documents from the Capital Health Plan Medicare Advantage Enrollment Packet, inluding the Enrollment Form (pdf 351.40 kB) , then complete it and submit to us at the address on this page.
  • Visit the Centers for Medicare & Medicaid Services Online Enrollment Center, located at http://www.medicare.govexternal link icon or call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. (TTY users should call 1-877-486-2048).
  • Call Capital Health Plan to request an enrollment packet at one of the telephone numbers listed on this page.
  • Visit a Capital Health Plan Medicare Sales Representative at 1545 Raymond Diehl Road, Suite 300, Tallahassee, FL 32308.

 

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

  • The Annual Enrollment Period for Medicare is each year from November 15 through December 31, for an effective date of January 1.
  • The Open Enrollment Period is January 1 through March 31 during which you may make one change to a like plan.
  • 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?

Generally, applications received within a given month will be processed for enrollment for the first day of the following month. In some circumstances, you may direct us to process your application with a later effective date if necessary. Applications received during the Annual Enrollment Period (November 15 through December 31) will be processed with an effective date of January 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 receive an acknowledgment letter within approximately seven days after we receive your application. If you need to fill a prescription after you receive 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 and you have both Medicare and Medicaid or have been approved for 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.

 

If you are asked to pay out-of-pocket for your prescription, save your receipts and contact Capital Health Plan for reimbursement. To learn how to submit a paper claim, please refer to the paper claims process described here.

 

Medicare Part D Late Enrollment Penalty

If you did not join a Medicare prescription drug plan when you were first eligible, and you went 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 when you join a plan. This penalty amount could change every year, and you will have to pay it as long as you have Medicare prescription drug coverage.

 

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, multiply the “1% penalty calculation” which is $.32 in 2010, 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 for 2010. This penalty may increase every year.

 

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.