Child Health Plan Plus (CHP+) offers low-cost public health insurance designed for children and pregnant women in Colorado. Specifically, the Chp+ Prenatal Care Program is a vital resource for expectant mothers who earn too much to qualify for Health First Colorado (Colorado’s Medicaid program) but cannot afford private health insurance. This program ensures access to essential healthcare throughout pregnancy and beyond.
Managed Care Organizations Maternity Care Dental Care
Discover the Benefits of the CHP+ Prenatal Care Program
Who is Eligible for CHP+ Prenatal Care?
To access the comprehensive benefits of the CHP+ prenatal care program, applicants must meet specific criteria:
- Pregnant Individuals: The program is specifically designed for pregnant people.
- Age Requirement for Children: Children aged 18 and under are also eligible for CHP+ general coverage.
- Income Limits: Household income must be under 260% of the Federal Poverty Level (FPL). Refer to the income table below for detailed thresholds.
- Colorado Residency: Applicants must be legal residents of Colorado.
- Not Eligible for Health First Colorado: This program serves as a bridge for those who don’t qualify for Medicaid.
- No Other Health Insurance: Applicants should not have existing private health insurance coverage.
Approximate 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 Under CHP+
CHP+ provides a wide range of healthcare services, including a robust prenatal care program:
- Primary Care: Regular check-ups and preventative care for overall health maintenance.
- Emergency and Urgent Care: Access to immediate medical attention when needed.
- Hospital Services: Coverage for necessary hospital stays and procedures.
- Dental Care: Comprehensive dental services are also included under CHP+.
- Prescriptions: Assistance with the cost of prescribed medications.
- Immunizations: Coverage for recommended vaccines to prevent illnesses.
- Maternity Care (Prenatal, Delivery, and Postpartum Care): The cornerstone of this program, ensuring complete care throughout pregnancy, childbirth, and the postpartum period. This is the core of the CHP+ prenatal care program.
- Mental/Behavioral Health Care: Access to mental health services and support.
Understanding the Costs Associated with CHP+ Prenatal Care
Enrolling in CHP+ is free. Costs for services under CHP+, including the prenatal care program, are dependent on household size, income, and the chosen Managed Care Organization (MCO).
Co-pays and CHP+ Prenatal Care
While some CHP+ services may require small co-pays, prenatal care services are completely free, with no co-pays. This also extends to preventative care and regular check-ups, making essential healthcare accessible without financial barriers. It’s important to note that Native Americans and Alaskan Natives are exempt from all co-pays. For specific co-pay details related to other services, contact your Managed Care Organization (MCO).
Out-of-Pocket Limit Protection
To ensure financial predictability, CHP+ implements an annual out-of-pocket limit. This limit is capped at 5% of your annual income for all enrolled household members. For detailed information about your specific out-of-pocket limit, reach out to CHP+ customer service at 800-359-1991.
Applying for CHP+ and Accessing Prenatal Care
To begin your application process, visit the How To Apply page for comprehensive instructions and the application form.
For immediate healthcare needs, the Presumptive Eligibility (PE) program can provide temporary coverage. This program allows pregnant individuals and children to receive immediate care while their full CHP+ application is being processed. To apply for PE, visit a designated PE Site for a quick eligibility review. If deemed eligible, you can receive coverage for up to 60 days while awaiting your CHP+ determination. Find a PE Site in your area to access immediate support.
Focused Support: The CHP+ Maternity Care Program
The CHP+ prenatal care program, also known as the Maternity Care Program, emphasizes cost-free access to all pregnancy-related healthcare. There are no enrollment fees or co-pays for any maternity care services, including prenatal visits, labor and delivery, and postpartum check-ups.
Once deemed eligible for CHP+ during pregnancy, coverage extends for 12 months after the pregnancy concludes, specifically ending 365 days postpartum. It is crucial for members to report their pregnancy to ensure they receive the full spectrum of postpartum benefits.
To report a pregnancy and activate postpartum coverage, members can:
Upon notification of your baby’s birth, CHP+ automatically enrolls your newborn for a full year of coverage from their birth date. To complete your newborn’s enrollment, contact CHP+ Customer Service at 800-359-1991.
Comprehensive Dental Care Under CHP+
Dental health is an integral part of overall well-being, and CHP+ ensures access to dental services through DentaQuest. Enrolled CHP+ members are entitled to a wide range of dental benefits, encompassing preventive, diagnostic, restorative, endodontic, periodontic, prosthodontic, oral surgery, and limited orthodontic services. For in-depth information, visit the CHP+ Dental Care page.
For any inquiries regarding CHP+ dental benefits, contact DentaQuest directly at 1-888-307-6561, TTY 711.
The DentaQuest Member Access portal allows members to find dentists, review benefits, and download member ID cards after registration.
DentaQuest Contact Information:
DentaQuest Customer Relations: Toll free: 1-888-307-6561, TTY: 711 Member Portal
Claims and Appeals: DentaQuest Appeals PO Box 2906 Milwaukee, WI 53201
Complaints and Grievances: DentaQuest Complaints and Grievances PO Box 2906 Milwaukee, WI 53201
Navigating CHP+ Managed Care Organizations (MCOs)
CHP+ operates through Managed Care Organizations (MCOs). These networks consist of doctors, clinics, hospitals, pharmacies, and other healthcare providers collaborating to meet your healthcare needs effectively. Each CHP+ MCO has its own network of providers within specific counties.
Your county of residence determines the MCO you or your child will be enrolled in. If multiple MCOs are available in your county, a plan will be initially selected for you. However, you have the option to change MCOs within 90 days of qualifying for CHP+.
For any questions or to explore your options, 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 Assistance With:
- Benefit inquiries
- Membership card replacements
- Billing clarifications
- Doctor locator assistance
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