Frequently Asked Questions

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.

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®.

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.

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

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

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.

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.

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

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

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

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.

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.