Child Health Plan Plus (CHP+)

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Child Health Plan Plus (CHP+) is public low-cost health insurance for certain children and pregnant women. It is for people who earn too much to qualify for Health First Colorado (Colorado's Medicaid program), but not enough to pay for private health insurance.

COVID-19 Information for CHP+ members

Thank you for continuing to do your part to keep Colorado safe during this pandemic. While COVID vaccines are being rolled out, it’s important that we all continue to wash our hands, wear our masks and maintain 6-feet of physical distance from those outside our households.

People age 5 and over can now get a Pfizer COVID-19 vaccine, and people 18 and older can also get the Moderna or Janssen (Johnson & Johnson) vaccine. You do not need to be a U.S. citizen or prove lawful presence to get vaccinated.

The vaccine is free. There is no charge for the office visit or co-pays, either.

If you are pregnant, breastfeeding, or have other risk factors or concerns, talk with your doctor about whether you should be vaccinated. You can learn more at covid19.colorado.gov/higher-risk-severe-illness.

Contact your Managed Care Organization (MCO) if you need help figuring out when and where to get vaccinated. For more information about the COVID-19 vaccine, where to get it, safety information and more, visit the Centers for Disease Control website and CDPHE website, or call 1-877-COVAXCO.

CHP+ Program Information

Who Qualifies?

  • Children age 18 and under and pregnant women age 19 and over.
  • Applicants with household income under 260% of the Federal Poverty Level (FPL). See Do You Qualify For Child Health Plan Plus? for more details.
  • Colorado Residents
  • Lawfully residing children and pregnant women with no five year waiting period
  • Applicants not eligible for Health First Colorado
  • Applicants who do not have other health insurance

Benefits and Services

CHP+ covers:

  • Primary Care
  • Emergency Care and Urgent Care
  • Hospital Services
  • Dental Care (for children and for pregnant women)
  • Prescriptions
  • Immunizations
  • Maternity Care (prenatal, delivery and postpartum care)
  • Mental/Behavioral Health Care

What Does It Cost?

CHP+ costs vary depending on your household size and income. CHP+ members may have to pay an annual enrollment fee. This fee is due within 30 days of your CHP+ approval. If the enrollment fee is not paid within the 30 days allowed then the family will be denied and will need to re-apply. Some CHP+ clients may also have to pay co-pays to their health care provider at the time of service. Prenatal women, American Indians and Alaskan Natives do not have to pay annual enrollment fees or co-pays.

Fees and Co-Pays

Annual Enrollment Fees

The standard fees are:

  • $0 for an adult pregnant woman in the CHP+ Prenatal Care Program
  • $25 to enroll one child
  • $35 to enroll two or more children

American Indians and Alaskan Natives do not have to pay a fee

Families earning more than 214% of the Federal Poverty Level will pay higher fees (see the CHP+ Income Chart):

  • $75 to enroll one child
  • $105 to enroll two or more children

Co-Pays

You may also have to pay small co-pays when you or your child receives CHP+ services. There are no co-pays for preventative care, such as prenatal care and check-ups. Other services may require co-pays that vary based on your income. Native Americans and Alaskan Natives do not have to pay co-pays.

The chart below is a summary of co-pays -- not an all-inclusive list.

Summary of Child Health Plan Plus Co-pays
Family Income (% FPL) ER Visit Urgent/After Hour Ambulance/ER Transport Inpatient Hospital Physician Services at Hospital Outpatient Hospital Prescriptions Lab/Imaging
< 101% $3 $1 N/A N/A N/A N/A N/A N/A
101-156% $3 $1 $2 $2 $2 $2 $1 N/A
157-200% $30 $20 $15 $20 $5 $5 $3-10 $5
201-260% $50 $30 $25 $50 $10 $10 $5-15 $10

Out of Pocket Limit

Each year, the maximum amount of money (referred to as out-of-pocket limit) that you are required to spend on health care payments for all members of your household that are enrolled in CHP+ is 5% of your annual income. For more information about your out-of-pocket limit, please contact CHP+ customer service at 1-800-359-1991.

Where do I go to pay my annual enrollment fee?

  • Pay online at Colorado.gov/PEAK. This is the fastest way to pay your enrollment fee.
  • Mail your payment to P.O. Box 17548, Denver, CO 80217.You can make your check out to "Child Health Plan Plus" or "CHP+".
  • Drop off your payment in person at 655 Bannock Street, Denver, CO80204.

What if I'm pregnant now?

You may qualify for the CHP+ Prenatal Program. See the CHP+ Prenatal Program information below for more details. Visit the How To Apply page for more information about applying.

CHP+ Prenatal Program Details

Who Qualifies?

  • Women age 19 years or older
  • Applicants with household income under 260% of the Federal Poverty Level (FPL). See the CHP+ Income Chart for details.
  • Colorado residents
  • Lawfully residing pregnant women with no five year waiting period
  • Applicants not eligible for Health First Colorado
  • Applicants who do not have other health insurance

How much does the CHP+ Prenatal Care Program cost?

It is free to enroll in the CHP+ Prenatal Care Program and you do not have co-pays. All pregnancy care is free, including prenatal care, labor and delivery, and visits after you deliver.

How long does CHP+ Prenatal Care Program coverage last?

If you are found eligible, your coverage will last for at least 60 days after your pregnancy ends. Coverage will end 60 days after the last day of the month when your pregnancy ended. For example, if you give birth on June 26th, your coverage will last until August 31st.

Will my newborn be enrolled in CHP+?

Once CHP+ is notified of your baby's birth, your baby will be given CHP+ coverage for a full year from their date of birth. To enroll your newborn, call CHP+ Customer Service at (800) 359-1991.

What if I need immediate care for my pregnancy?

If you are pregnant, you may qualify for a program called Presumptive Eligibility (PE). PE is a way for pregnant women to receive prenatal care right away without having to wait to see if you are eligible. To apply, you must visit a PE Site and they will do a quick review. If found eligible you will get enrolled for up to 60 days while you wait to see if you qualify. Find a PE Site in your area.

Can I apply for CHP+ for my children and for the CHP+ Prenatal Care Program for myself?

Yes. Fill out one application. CHP+ will see if your children qualify for CHP+ and if you qualify for the CHP+ Prenatal Care Program. Visit the How To Apply page for more information about applying.

Which doctors can I visit?

CHP+ works with Managed Care Organizations (MCOs) to provide health care to you or your child. Each MCO has their own network of doctors that you or your child can see on CHP+. The county you live in will determine which MCO you or your child enrolls with.

Your CHP+ MCO can help you find a doctor for you or your child.

CHP+ Managed Care Organizations (MCOs)

CHP+ members are enrolled into a Managed Care Organization (MCO). An MCO is a group of doctors, clinics, hospitals, pharmacies, and other providers who work together to help meet your health care needs. Each CHP+ MCO uses its own group of hospitals, pharmacies and doctors for the counties it serves.

There are five CHP+ MCOs in Colorado: Colorado Access, Kaiser Permanente, Rocky Mountain Health Plans, Friday Health Plans, and Denver Health. The county you live in will determine which MCO you or your child enrolls with. If more than one MCO is available in your county, a health plan will be selected for you, but you can change MCOs for up to 90 days after you qualify for CHP+.

If you have any questions, please contact your MCO or visit their website:

How do I get dental benefits?

DentaQuest provides dental benefits to all eligible and enrolled CHP+ child members and to pregnant women. These benefits include preventive and diagnostic services, restorative services, endodontic, periodontic, prosthodontic, oral surgery, and limited orthodontic services. There will be a maximum allowable of $1000.00 per member per calendar year (January 1 - December 31). As with all CHP+ benefits, higher income families may be required to pay a small fee or co-payment when they receive services. CHP+ Prenatal women will not be charged co-payments for dental services. If you have any questions about CHP+ dental benefits call DentaQuest at 1-888-307-6561, TTY 711.

Please visit the DentaQuest Member Access page. After registration, you will be able to search for a dentist, check your benefits, and download your member ID card.

Other DentaQuest Contact Information

DentaQuest Customer Relations:
Toll free: 1-888-307-6561, TTY: 711
Email: memberaccess.dentaquest.com

Claims and Appeals:
DentaQuest Appeals
PO Box 2906
Milwaukee, WI 53201

Complaints and Grievances:
DentaQuest Complaints and Grievances
PO Box 2906
Milwaukee, WI 53201

Who do I call if I have questions about my benefits?

Your CHP+ Managed Care Organizations (MCO) can help you understand your CHP+ benefits.

What if I need a new membership card?

To get a new membership card, contact your CHP+ Managed Care Organizations (MCO).

How long does CHP+ coverage last?

  • For children, CHP+ coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage lasts at least 12 months.
  • For pregnant women, CHP+ Prenatal Care Program coverage begins the date the application is received at the CHP+ office, an Application Assistance Site, or a county office. Coverage will last for at least 60 days after your pregnancy ends.

How do I renew CHP+ coverage?

  • Children enrolled in CHP+ must reapply every year. CHP+ will send you a packet about 3 months before your child's coverage ends. Complete this and return it to CHP+ as soon as possible. If you do not receive a renewal packet, call CHP+ Customer Service at (800) 359-1991 to ask for one.
  • Clients who have an active PEAK account will also have the ability to pay enrollment fees and update their information at any time.
  • Pregnant women enrolled in the CHP+ Prenatal Care Program cannot renew coverage after their pregnancy ends. If you do become pregnant again, however, you can apply again.

Can I enroll my newborn baby?

Call CHP+ Customer Service at (800) 359-1991 to see if your baby qualifies for CHP+.

What if I move?

Call us and tell us your new address as soon as you move. CHP+ sends letters to families letting them know about their benefits, so it is very important that we have a correct address. If you move out of state, you no longer qualify for CHP+ benefits. To find programs in other states, visit insurekidsnow.gov.

What if I get a bill from the doctor?

Your CHP+ Managed Care Organizations (MCO) can help you get medical bills paid.

How can I apply?

Visit the How To Apply page for more information.

When will I find out if I qualify?

If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify.

What if I need immediate care?

You may qualify for a program called Presumptive Eligibility (PE). PE is a way for children and pregnant women to receive care right away without having to wait to see if you are eligible. To apply, you must visit a PE Site and they will do a quick review. If found eligible you will get enrolled for up to 60 days while you wait to see if you qualify. Find a PE Site in your area.

What if I have other questions?

See our Child Health Plan Plus Frequently Asked Questions.

How can I get more help?

  • You can call CHP+ Customer Service at 1-800-359-1991. CHP+ Customer Service is available Monday through Friday, 8 a.m. to 6 p.m. (se habla Español).
  • The CHP+ mailing address is: Department of Health Care Policy & Financing, P.O. Box 17548, Denver CO 80217.
 
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