Skip to main content

Look out for our Member Experience Survey, arriving in your inbox this week!

Look out for our Member Experience Survey, arriving in your inbox this week!

CHPConnect
About Us
News
Calendar
Careers
Document Center
FAQ
Healthline

Medicare
Individual & Family
Employers
CHP Health Centers
Urgent Care

Members
Doctors and Providers
Employers
Agents

Home / Documents / 2023 Capital Selection 15.30.50 Schedule of Copays

2023 Capital Selection 15.30.50 Schedule of Copays

Submitted by Renee Ryals on Mon, 08/15/2022 - 18:00

File:

2023-Capital-Selection-15.30.50-schedule-of-copay-sheet.pdf

Site location:

Medicare

We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex. You may access the Nondiscrimination and Accessibility Notice here.

Transparency in Coverage | Privacy Practices | Privacy Policy | Our Locations | Disaster Care | Compliance | Careers | Contact Us | For Doctors and Providers

© 2025 Capital Health Plan, An Independent Licensee of the Blue Cross and Blue Shield Association. All rights reserved.

Warning!

By clicking on this link you will be leaving the Capital Health Plan Medicare Advantage (HMO) information.

OK, I Understand
No, Stay Here

+

CHPConnect
About Us
Individual & Family
News
Calendar
Careers
Document Center
FAQ
Healthwise
Medicare
CHP Health Centers
Urgent Care
Members
Providers
Employers
Agents
Healthline