Frequently Asked Questions

Benefits and Claims Questions

Looking for help regarding benefits and claims? Here are answers to common questions.

What type of benefit plans do you offer?

Capital Health Plan offers employer-based coverage for those who live or work in our service area and Medicare Advantage plans for individuals with Medicare.

How can I order a new member ID card?

Members can order a new CHP ID card on CHPConnect or by calling CHP Member Services.

What happens to the coverage of my spouse if I divorce?

Contact your benefits administrator, as your spouse may be able to continue coverage under COBRA.

What happens to my coverage if I retire?

Contact your benefits administrator. Depending on your age and employer, you may be eligible for a retiree plan or a Medicare Advantage plan. You may also call CHP Medicare Services for more information.

What happens to my coverage if I leave my job?

Contact your benefits administrator, as you may be able to continue your coverage under COBRA.

What happens to my coverage if I move out of the CHP service area?

If you relocate outside of the CHP service area, you are no longer eligible for CHP coverage.

Am I covered for emergencies if I am out of the CHP service area?

Members are covered for emergencies and urgently needed care anywhere in the world. In addition, members have access to our national Pharmacy Network and national LabCorp Network.

Where can I find more information on my medical claims?

You can view your claim information on CHPConnect or you may call CHP Member Services.

Where can I find my Summary of Benefits & Coverage (SBC)?

Non-Medicare members can request their SBC from their benefits administrator. You can also access your SBC Form on Capital Health Plan or on CHPConnect.

For Medicare Advantage members, your Summary of Benefits is listed by your plan type:

Where can I find my benefit documents electronically?

For Non-Medicare members, your benefit documents are available on CHPConnect.

For Medicare Advantage members, your benefit documents are listed by your plan type: