Medicare

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877-247-6512
850-523-7441
850-383-3534 (TTY)
1-800-955-8771 (TTY)

Call us seven days a week
8 a.m. - 8 p.m.

2140 Centerville Pl
1491 Governor's Square Blvd
1545 Raymond Diehl Rd
Tallahassee

Mailing address:
Post Office Box 15349
Tallahassee FL 32317-5349

Capital Health Plan is a health plan with a Medicare contract. The contract is renewed annually and the availability of coverage beyond the current year is not guaranteed.

Benefits, formulary, pharmacy, network premium and/or copayments/coinsurance may change on January 1, 2011. Please contact Capital Health Plan for details.

Please call Capital Health Plan Member Services Department to obtain documents in alternate formats or languages.

To ensure that beneficiaries receive appropriate care, Capital Health Plan will follow policies and procedures as directed by CMS (Centers for Medicare and Medicaid Services) in the event of an emergency situation designated by the Department of Health and Human Services.

This page was last updated on: April 30, 2010.

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Additional Copayments/Coinsurance

Below are additional medical copayments for the CHP Advantage Plus (HMO) and CHP Preferred Advantage (HMO) plans. For a complete list see the Summary of Benefits.

Service

Copayment/Coinsurance
Ambulance $100 per service
Out-Patient/Ambulatory Surgery $100 per visit
Diagnostic CT/MRI/PET/Thalium Scans $100 per scan
Other Lab/X-ray $0 - $100 per service
Home Health $0
Durable Medical Equipment 20% per device
Radiation Therapy 20% of the cost
Hearing Testing $25 per test
Skilled Nursing Facility $0 per day - days 1-6
$75 per day - days 7-100
Chiropractic $15 per visit
Podiatry $15 per visit
Diabetic supplies 20% of the cost
$3,400 annual out-of-pocket limit. (Excludes out-patient prescription drugs)