Colorado Child Health Plan Plus

Colorado’s Children’s Health Insurance Program, Child Health Plan Plus (CHP+) is available to children ages 0 to 18, and pregnant women age 19 and older. To qualify, you must be a resident of Colorado, and your household income must be less than or equal to 250 percent of the Federal Poverty Level (FPL). This program covers a variety of medical services for its members, including routine checkups, immunizations, prescriptions, and hospital care to name a few. Dental care is also covered by CHP+, including exams, cleanings and fillings.

CHP+ is free of charge for most families, though members with income over the specified limit will have to pay a small enrollment fee and copayments for services and medications. Coverage begins on the date your application was received if you are approved. Upon approval, you will receive your membership card and handbook in the mail and will be able to begin using your benefits immediately.

 

Colorado Child Health Plan Plus

 

CHP+ Eligibility

Eligibility depends largely on income and family size, refer to the chart below to see if you are able to qualify for CHP+. Uninsured Colorado residents under age 19 who are citizen of the U.S. or permanent legal residents who have had an Alien Registration number for a minimum of 5 years, or a refugee or asylee can apply for CHP+. Additionally, these applicants must not be eligible for Medicaid coverage.

If you have had health insurance through an employer group plan during the past three months prior to application where the employer paid at least 50 percent of premiums, you are unable to qualify. You also may not qualify if you are eligible for state employees’ health coverage. Residents of correctional or mental institutions are also ineligible.

Income Guidelines

 

Services & Providers

CHP+ covers routine exams, shots, medications, hospital care, eye glasses, hearing aids, and other medical services for its members. Dental care is also offered with a $600 limit per year including exams and cleanings, fillings, routine extractions, and even certain root canal therapies. Medical care is administered through various Health Maintenance Organizations (HMOs) in Colorado to ensure a high quality of service. Based on the provider network indicated by your chosen HMO as a CHP+ member, you can receive care from any doctor in your network for covered care.

The following HMOs throughout Colorado provide CHP+ care:

Click here for a map of service areas.

 

CHP+ Prenatal Care Program

The CHP+ Prenatal Care program provides coverage for pregnant women in Colorado who are age 19 and over with a household income at or below 250 percent of the Federal Poverty Level, or $3,153 per month. The same eligibility rules apply for residency and prior coverage for pregnant women as other applicants as mentioned above. It also covers the same services as CHP+ for children (except dental) including immunizations, regular physical exams, prescriptions, and hospitalization.

CHP+ Prenatal coverage lasts for at least 60 days after your pregnancy ends for those who are eligible. Coverage ends 60 days after the last day of the month following your childbirth. For example, if you gave birth on the 26th of June, your benefits would end on August 30th. Your newborn can also be enrolled in CHP+ once the office has been notified of the birth – call Customer Service to enroll at 800-359-1991. Their coverage will last for a full year from their date of birth.

Presumptive Eligibility (PE)

Immediate care is offered to pregnant women through the Presumptive Eligibility (PE) program. Without having to wait for your application to process, you can receive instant access to prenatal care by applying for PE. To enroll in PE, a brief review is required from a visit to a PE Site. Once you consult with the PE Site, they will let you know if you are eligible shortly thereafter. PE coverage lasts for up to 60 days while you wait to find out whether or not you qualify for CHP+ benefits.

 

Fees and Copayments

If your family size and household income are above the specified limits, you may be required to pay an Annual Enrollment Fee. Native Americans and Alaskan Natives do not have to pay a fee for yearly application, nor do adult pregnant women applying for the CHP+ Prenatal Care Program. If your income is over 205 percent of FPL, you will have to pay a $75 fee to enroll one child, and $105 to enroll two or more children in CHP+. Other families with lower income may be required to pay a $25 fee to enroll one child and $35 for two or more children.

Copays are also necessary when receiving CHP+ services, with the exception of preventive care (prenatal care, check ups, shots). Other services may be available for a small fee due at the time of the visit. Native Americans and Alaskan Natives are not required to pay copayments. Typical fees for services through CHP+ include the following:

  • $2 to $5 per doctor’s office visit
  • $2 to $5 for prescriptions
  • $3 to 15 for emergency room visits
  • $5 for most dental care visits

 

Resources

CHP+ Customer Service: (800) 359-1991

CHP+ Office
Monday—Friday 8:00 AM to 6:00 PM
4500 Cherry Creek S Dr Denver, CO 80246

Child Health Plan Plus

Application for CHP+