CHP Retiree Advantage (HMO)
Advanced Directives and Living Wills
An advanced directive ensures that both medical professionals and your loved ones understand the end-of-life decisions you want in the event you’re unable to explain them due to a medical emergency. An advanced directive is simply a statement, made while you are competent, about the medical treatment you want if you can’t make those decisions later. Decisions made early and communicated plainly may have tremendous value for you and your family.
Determinations, Grievances & Appeals
For instructions on how to use the form to appoint a representative, visit Appointment of Representative Form Instructions.
Privacy Notice
Privacy Notice - We believe our members have the right to privacy and that their nonpublic personal, financial, and health information should be kept confidential.
Utilization Management
Capital Health Plan makes health care decisions to ensure quality treatment and efficient use of resources. View more information about utilization management.
Extra Help & LIS Chart
You may be able to receive assistance in the form of Medicare's Extra Help Program to pay for your prescription drug premiums and costs. The amount of Extra Help that you can get depends on your income and resources. If you qualify, you will get help paying for your Medicare drug plan's monthly premium and prescription copayments or coinsurance. Your premium generally will be lower if you receive Extra Help from Medicare.
Annual Notice of Changes
The 2020 Retiree Advantage Annual Notice of Changes (ANOC) provides details of changed in plan benefits and coverage from one year to the next.
Summary of Benefits
The Summary of Benefits provides a summary of your plan’s benefits, premium, copayments, and coinsurance information.
Formulary
A formulary is a list of covered drugs believed to be a necessary part of a quality treatment program. The 2020 CHP Retiree Advantage Formulary was selected by CHP in consultation with a team of health care providers. You can also use our online formulary search tool.
Evidence of Coverage
Your 2020 CHP Retiree Advantage (HMO) Evidence of Coverage provides details about your Medicare health and prescription drug coverage, explains how to get the care you need, and includes plan conditions and limitations.