Welcome Federal Employees Health Benefits Members
About Capital Health Plan
For federal employees in our coverage area, Capital Health Plan (CHP) offers high-quality health plans options that provide comprehensive coverage and meet the requirements for Federal Employees Health Benefits (FEHB) plans. Both our Medicare and Employer Group Health Plans consistently earn top ratings, and they have a full range of benefits, including a large, stable pool of in-network providers, access to urgent care, and away-from-home care options.
Each year the National Committee for Quality Assurance (NCQA) rates health plans across the country and CHP has continued to earn top ratings since NCQA began comparing health plans in 2005. Click here for more information.
2025 FEHB Health Benefits
Download important information about your employer group health benefits from Capital Health Plan:
Choosing Your Physician
Find a doctor through CHP’s large network of primary and specialty care physicians:
- Find a Doctor
- Find a Behavioral Health Provider
Dependent Information - when your dependent is going to be out of the service area for 90 days or longer.
Disputed Claims Process
- Download Claims Form and submit in writing a request to reconsider the initial decision to CHP.
- Post-Service Claims have 30 days from the date we receive your request to respond by either paying the claim, maintaining the denial, or requesting additional information.
- If you do not agree, you may ask OPM to review the request by submitting a request in writing to OPM.
- OPM will review request and will send you a final decision within 60 days
For more information, please refer to page 72 of the FEHB Brochure.
Fertility
CHP’s Federal Drug List (formulary) currently covers fertility drugs associated with artificial insemination procedures when medically necessary, and the cost of IVF-related drugs for three cycles annually.
Infertility is defined as inability to:
- Conceive after 1 year of unprotected sex when female (or individual with female reproductive organs) is under 35 years of age, or 6 months for female (or individual with female reproductive organs) age 35 and older;
- Conceive after a period of artificial insemination (AI for a period of time, for example 12 months).
- Or demonstration of a disease or condition of the reproductive tract such that unprotected sex or AI would be ineffective.
For more information, please refer to page 36-37 of the FEHB Brochure.
Capital Health Plan Prescription Drug Coverage
Federal employees health benefits (FEHB) program members and prospective members can access covered medical drug information by the following links: