Are you seeking affordable health coverage for your children or expecting a baby? The Child Health Plan Plus (CHP+), often referred to as a Care Health Plus Program, provides low-cost public health insurance designed for families who earn too much to qualify for Health First Colorado (Colorado’s Medicaid program) but still find private health insurance out of reach. This comprehensive program ensures that children and pregnant women in Colorado have access to essential medical services.
Managed Care Organizations Maternity Care Dental Care
Understanding the Child Health Plan Plus Program
Is CHP+ Right for You? Eligibility Criteria
To be eligible for the care health plus program (CHP+), applicants must meet specific criteria:
- Age and Status: Children aged 18 and under and pregnant individuals are eligible.
- Income Limits: Household income must be under 260% of the Federal Poverty Level (FPL). Refer to the income table below for detailed thresholds.
- Residency: Applicants must be residents of Colorado.
- Medicaid Ineligibility: Applicants should not qualify for Health First Colorado.
- Lack of Other Health Insurance: Applicants must not have existing private health insurance coverage.
Estimated Monthly Income Limits for CHP+ Eligibility
| Family Size | Monthly Income |
|---|---|
| 1 | up to $3263 |
| 2 | up to $4429 |
| 3 | up to $5595 |
| 4 | up to $6760 |
Effective April 1, 2024
Comprehensive Benefits and Services Covered by CHP+
The care health plus program offers a wide range of benefits, ensuring comprehensive healthcare coverage:
- Primary Care: Regular check-ups and doctor visits.
- Emergency and Urgent Care: Access to necessary care for unexpected health issues.
- Hospital Services: Coverage for inpatient and outpatient hospital care.
- Dental Care: Essential dental services to maintain oral health.
- Prescription Medications: Coverage for prescribed medications.
- Vaccinations: Routine immunizations to protect against preventable diseases.
- Maternity Care: Complete care for pregnant women, including prenatal, delivery, and postpartum services.
- Mental and Behavioral Health Care: Access to mental health services and support.
Understanding the Costs Associated with CHP+
Enrolling in the care health plus program is free. However, to ensure affordable access to healthcare, some services may require small co-pays. The costs are structured based on household size, income, and the chosen Managed Care Organization (MCO).
Co-pay Information
While preventative care services like prenatal care and routine check-ups are co-pay free, other services might have minimal co-pays depending on your income bracket. It’s important to note that Native Americans and Alaskan Natives are exempt from co-pays. For specific co-pay amounts, please contact your Managed Care Organization (MCO).
Out-of-Pocket Expense Limit
To further protect families from high healthcare costs, the care health plus program includes an annual out-of-pocket limit. This limit is capped at 5% of your annual household income for all enrolled CHP+ members in your household. For detailed information regarding your specific out-of-pocket limit, please reach out to CHP+ customer service at 800-359-1991.
Applying for the Care Health Plus Program
To begin your application process for the care health plus program, visit the How To Apply page for detailed guidance and application instructions.
For urgent healthcare needs, the Presumptive Eligibility (PE) program offers immediate access to care while your CHP+ application is being processed. This program allows eligible children and pregnant individuals to receive temporary coverage for up to 60 days. To apply for PE, visit a designated PE Site for a quick eligibility review. Find a PE Site near you.
Dedicated Maternity Care within CHP+
The care health plus program prioritizes maternal health by providing comprehensive and free maternity care. This includes all essential services throughout your pregnancy journey: prenatal care, labor and delivery, and postpartum check-ups.
If you are deemed eligible for CHP+ during pregnancy, your coverage extends for 12 months after your pregnancy ends, ensuring continuous support for new mothers. To activate postpartum coverage, members must inform CHP+ about their pregnancy. Coverage will automatically terminate 365 days following the end of the pregnancy.
Upon notification of your baby’s birth, the care health plus program automatically enrolls your newborn into CHP+ for a full year from their birth date, ensuring your child receives continuous healthcare from day one. To complete your newborn’s enrollment, contact CHP+ Customer Service at 800-359-1991.
Comprehensive Dental Care Benefits with CHP+
Dental health is a crucial part of overall well-being, and the care health plus program ensures access to quality dental services through DentaQuest. CHP+ members are entitled to a wide array of dental benefits, including: preventive care, diagnostic services, restorative procedures, endodontics, periodontics, prosthodontics, oral surgery, and specific orthodontic services. For more in-depth information, please visit our dedicated CHP+ Dental Care page.
For any inquiries regarding CHP+ dental benefits, contact DentaQuest directly at 1-888-307-6561 (TTY 711).
Visit the DentaQuest Member Access portal to register and easily find a dentist, review your benefits, and download your member ID card.
DentaQuest Contact Details
For Customer Relations: Toll-free: 1-888-307-6561, TTY: 711 Member Portal
For Claims and Appeals: DentaQuest Appeals PO Box 2906 Milwaukee, WI 53201
For Complaints and Grievances: DentaQuest Complaints and Grievances PO Box 2906 Milwaukee, WI 53201
Managed Care Organizations (MCOs) within the CHP+ Network
Participants in the care health plus program are enrolled in a Managed Care Organization (MCO). MCOs are networks of healthcare providers, including doctors, clinics, hospitals, and pharmacies, collaborating to address your healthcare needs effectively. Each CHP+ MCO has its own network of providers within specific counties.
Your county of residence determines your assigned MCO. In counties with multiple MCO options, a plan will be initially selected for you. However, you have the flexibility to change your MCO within the first 90 days of your CHP+ qualification.
For any questions or further clarification, please contact your assigned MCO or visit their website:
| Managed Care Organization | Phone Number | Counties Served |
|---|---|---|
| Colorado Access | 800-511-5010 | Adams, Alamosa, Arapahoe, Baca, Bent, Boulder, Broomfield, Chaffee, Cheyenne, Clear Creek, Conejos, Costilla, Crowley, Custer, Delta, Denver, Douglas, Eagle, El Paso, Elbert, Fremont, Gilpin, Huerfano, Jefferson, Kit Carson, Kiowa, Larimer, Las Animas, Lincoln, Logan, Mineral, Morgan, Otero, Park, Phillips, Prowers, Pueblo, Rio Grande, Sedgwick, Saguache, Summit, Teller, Washington, Weld, Yuma |
| Denver Health Medical Plan | 303-602-2100 | Adams, Arapahoe, Denver, Jefferson |
| Kaiser Permanente | 303-338-3800 | Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson |
| Rocky Mountain Health Plans | 877-668-5947 | Archuleta, Delta, Dolores, Eagle, Garfield, Grand, Gunnison, Hinsdale, Jackson, La Plata, Lake, Mesa, Moffat, Montezuma, Montrose, Ouray, Pitkin, Rio Blanco, Routt, San Juan, San Miguel, Summit |
Contact Your MCO For:
- Benefit inquiries
- Requesting a new membership card
- Billing questions
- Assistance in finding a healthcare provider
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