Frequently Asked Questions

Welcome to Capital Health Plan! View our New Member section for some information and resources we’ve put together to help you get started with our plan. 

You should receive your Member ID card within 10 business days of CHP’s receipt of a complete and accurate enrollment application.

Yes. You may print a temporary Member ID card on CHPConnect or contact CHP Member Services to request your Member ID number. Additionally, you can provide your name and date of birth to your Provider and they can contact CHP to verify eligibility and copayment information.

A PCP is a physician you select to serve as your primary physician to maintain your needs. They handle a variety of health-related problems, keep a medical history and medical records, and can help coordinate care with a specialist or other health care professional.

Learn how to select a primary care physician (PCP).

The Physician Group of Capital Health Plan provides comprehensive health care exclusively for Capital Health Plan members. Their goal is to promote disease prevention and healthy living, so in addition to diagnosing and treating illnesses, they also provide preventive care, health risk assessments, immunizations, screening tests, comprehensive management of chronic conditions, and education on maintaining a healthy lifestyle.  You can learn about what services are offered in the Physician Group of Capital Health Plan at any time.

Yes, all services must be performed by a network physician or facility, unless a prior authorization has been completed in advance or in an emergency.

Members have direct access to a network of specialists for office visits and consultations. Your primary care physician should be able to assist you for other services that may require a referral or prior authorization. 

Members can utilize LabCorp’s nationwide lab network. Find a participating lab.

Yes. Flu vaccines can be obtained by calling your primary care physician’s office, visiting your local health department within our Service Area, or at retail pharmacies in our network if you have a prescription benefit.

Retail pharmacy vaccination programs apply to adults 18 years of age and older. Patients under the age of 18 should see their primary care physician for the flu vaccine.

For after-hours care or if your physician is not available, please contact CHP Urgent Care. Additionally, you may utilize the telehealth services available via Amwell.  For emergencies, please call 911 or go to the nearest Emergency Room.

Urgent medical conditions that might be treated include:

• Upper respiratory infections (e.g. colds, ear infections, and sore throats)

• Minor trauma (e.g. ankle sprains or cuts)

• Abnormal symptoms (e.g. fevers, nausea, vomiting)

• Urinary tract infections

View CHP Urgent Care’s hours of operation and telephone number.

To submit a complaint, please contact CHP Member Services. You may also refer to your Member Handbook or Evidence of Coverage for more details on the complaint, grievance, and appeal process.