CHP Retiree Advantage (HMO) State of Florida

Capital Health Plan Retiree Advantage (HMO) and Capital Health Plan Retiree Classic (HMO) are retiree plans offered by the State of Florida to Medicare-eligible retirees and their Medicare-eligible dependents. This provides our members the opportunity to participate in their State of Florida-sponsored health plan after retirement and becoming Medicare eligible. These plans provide access to an expansive network of physicians, including exclusive access to the Physician Group of Capital Health Plan located at one of our three health centers.

To be eligible for either plan option, you must be entitled to Medicare Part A, enrolled in Medicare Part B, and live in the Capital Health Plan service area. Retiree Advantage (HMO) and Retiree Classic (HMO) plans will provide all of your Medicare benefits and services, including prescription drug coverage (Medicare Parts A, B, and D). Review our Medicare calendar to attend a seminar, or call our local office to talk to one of our experienced representatives to learn more.

Due to COVID-19, Capital Health Plan has pre-recorded the State of Florida Retiree Advantage (HMO) seminar for your convenience.

Retiree Advantage Annual Notice of Changes (ANOC) provides details of changed in plan benefits and coverage from one year to the next.

    The State of Florida Benefits Summary provides a summary of your plan’s benefits, premium, copayments, and coinsurance information.

      A formulary is a list of covered drugs believed to be a necessary part of a quality treatment program. The CHP Retiree Advantage Formulary was selected by CHP in consultation with a team of health care providers. You can also use our online formulary search tool.

      Your 2024 CHP State of Florida Retiree Advantage Evidence of Coverage provides details about your Medicare health and prescription drug coverage, explains how to get the care you need, and includes plan conditions and limitations.

        Sometimes you are taking a drug that is not on our formulary, and if that is the circumstance please review the Prime Medicare Transition Policy for additional information. During the time when you are receiving a temporary supply of a drug, you should talk with your provider to decide what to do when your temporary supply runs out. You can either switch to a different drug covered by the plan or ask the plan to make an exception for you and cover your current drug. For a temporary supply, please call CHP Member Services.

          To enroll in CHP State of Florida Retiree Advantage, you will need to download and complete the 2024 CHP Retiree Advantage Enrollment Application. Please return the completed enrollment application directly to CHP. You may enroll anytime within 90 days before the effective date of coverage. 

          You may be able to get Extra Help to pay for your prescription drug premiums and costs. The amount of Extra Help that you can get depends on your income and resources. If you qualify, you will get help paying for your Medicare drug plan's monthly premium and prescription copayments or coinsurance. Your premium generally will be lower if you receive Extra Help from Medicare.

          Learn more about Medicare's Extra Help program.

          You can qualify if you are eligible for Medicaid as well as Medicare. You also may qualify if your yearly income is $21,870 or less if you are single with no dependents, or $29,580 or less if you are married and living with your spouse with no dependents, and your resources are less than $16,660 if single or $33,240 if you are married and living with your spouse. If you live in Alaska or Hawaii, or pay at least half of the living expenses of dependent family members, income limits are higher.

          An advanced directive ensures that both medical professionals and your loved ones understand the end-of-life decisions you want in the event you’re unable to explain them due to a medical emergency. An advanced directive is simply a statement, made while you are competent, about the medical treatment you want if you can’t make those decisions later. Decisions made early and communicated plainly may have tremendous value for you and your family.

          To obtain a copy of Five Wishes, an advanced directive document that addresses all of an individual's needs (medical, personal, emotional, and spiritual), call Capital Health Plan's Health Information Line at (850) 383-3400.

          Through the Planning Early About Care at the End (PEACE) program, Big Bend Hospice offers individualized assistance in completing the Five Wishes Advanced Directive. To schedule an appointment with a PEACE facilitator, contact Big Bend Hospice at (850) 878-5310 or visit the Big Bend Hospice website.

          Privacy Notice - We believe our members have the right to privacy and that their nonpublic personal, financial, and health information should be kept confidential.

          Capital Health Plan makes health care decisions to ensure quality treatment and efficient use of resources. View more information about utilization management.