You have rights and responsibilities if you leave Capital Health Plan Advantage Plus, Preferred Advantage, or Retiree Advantage (HMO).

Disenrollment Periods

You may end your membership in our plan only during certain times of the year known as enrollment periods.

Let Capital Health Plan take the guess work out of retirement

Shouldn’t your Medicare plan deliver the benefits that matter most to you? At Capital Health Plan, we want to help you into retirement by getting the most of out of your Medicare doctor or provider. Choose from three Medicare Advantage (HMO) plans, including our new $0 premium plan, that will fit your needs and your budget.

To Our Members:

Capital Health Plan knows that the way we conduct our business offers us the opportunity to earn your respect and trust. Our members are our reason for being. To that end, we believe our members have the right to privacy and that their nonpublic personal, financial, and health information should be kept confidential. Our practices to protect your privacy are not new. However, laws now require that we notify you annually about our privacy policy concerning:

Here are three general rules about drugs that Medicare drug plans will not cover under Part D:

This section gives information on what to do if you need to ask us to make an exception to our Part D prescription drug coverage rules.

**You cannot request coverage for a prescription drug that does not meet the definition of a Part D drug. There are a few specific drugs that your Medicare plan cannot cover.**

The Medication Therapy Management Program (MTMP) works to identify members at risk for potential drug-related problems and helps these members better understand the drugs they take. Some members have several complex medical conditions or they need to take many drugs at the same time, or they may have very high drug costs. This program helps members manage their drugs and helps reduce potential problems. The Medication Therapy Management Program can help you and your doctors get the most benefit from your drugs.  

You can qualify if you are eligible for Medicaid as well as Medicare. You also may qualify if your yearly income is $18,735 or less if you are single with no dependents, or $25,365 or less if you are married and living with your spouse with no dependents, and your resources are less than $14,390 if single or $28,720 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.

Other locations on the website with the extra help info: 

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.

You may appoint a relative, friend, advocate, attorney, or your physician to act as your representative. A representative who is appointed by the court or who is active in accordance with State law may also file an appeal or grievance for you. To appoint a representative you must complete an Appointment of Representative Form.