About Benefits and Services

 

Q. What types of services do the community health center clinics provide?

A. Most clinics offer a full range of services, including:

  • Preventive health care, including regular checkups for children and adults, routine lab tests, X-rays, and other basic medical services.
  • Access to medical advice by phone, even when the clinic is closed. If a plan member in your family becomes sick when the clinic is closed, call your clinic's after-hours number for assistance.
       Members can also call the free Nurse Advice Line to get health care information 24 hours a day, 7 days a week. To speak to a nurse, call toll free 1-866-418-1002 voice or 1-866-418-1006 TTY if you are speech or hearing impaired.
  • Referral to a medical specialist when you and your primary care provider decide you need one.
  • Access to hospital care, prescription medication, and other services, when deemed necessary.
  • Access to women's health care and family planning, including birth control drugs, devices, and counseling. How this is covered depends on whether you are a Basic Health, Healthy Options, CHIP, or Disability Lifeline (GA-U) member.

Q. How do I know if a service is covered?

A. To find out if a medical service is covered:

  • See your Community Health Plan Medical Benefits Summary. This information is available to all enrollees or potential enrollees who ask for it.
  • Contact the Community Health Plan customer service team at 1-800-440-1561 (toll free) or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or call local 206-613-8875.
  • See the benefits information for your program on this web site.
  • You can also check with the agency overseeing the health care program in which you are enrolled:
    • Basic Health members: See your Washington State Basic Health Member Handbook or call 1-800-660-9840.
    • Healthy Options, CHIP, or Disability Lifeline (GA-U) members: Call DSHS customer service at 1-800-562-3022, Monday through Friday, 8 am to 5 pm.

Q. What if I need an interpreter or I want materials in the language I speak or read?

A. We can provide you with an interpreter when you need to talk to us at Community Health Plan. If you'd like an interpreter, please call 1-800-440-1561 Monday through Friday, 8 am to 5 pm. Tell the customer service representative what language you speak, then please stay on hold until you are connected to someone who can help you.

At no charge, you may get our materials in the language you need, in larger print, or orally. Please call 1-800-440-1561. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875. (See the bottom of this page.)

Q. Do you have services for persons who are hearing or speech impaired?

A. Yes. To contact the Community Health Plan customer service team if you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.

To contact customer service by voice phone, call 1-800-440-1561 (toll free). You can also email us at customercare@chpw.org.

Q. How do I get Native American health care services?

A. If you are Native American, you can get covered services from the Indian Health Care System (IHCS). Call our customer service representatives at 1-800-440-1561 for information.

Q. What if I am pregnant?

A. Congratulations on your pregnancy!

Early prenatal care — the medical care you get while pregnant — is essential for your health and the health of your baby. Call your primary care provider for a checkup as soon as you know you are pregnant. During your pregnancy, tell your provider about any special needs, concerns, or questions you have.

It's best to choose a primary care provider for your baby while you are pregnant. If you don't choose one by the time your baby is born, we'll choose one for you. You can change your baby's PCP later if you wish.

Important note: Care for you during your pregnancy and delivery and for your baby right after birth is available from Healthy Options and Basic Health Plus. If you are on another plan, you might need to sign up for a special program to get your care. Ask your clinic staff to find out which programs you qualify for.

If you have questions about your pregnancy or health care benefits or need educational materials, please contact us. You can call our customer service team at 1-800-440-1561 (toll free) or email us at customercare@chpw.org.

Community Health Plan can help to support high-risk moms during pregnancy or postpartum recovery. If you need this extra support, case management will keep in touch with you by phone during the pregnancy and the 6-week postpartum recovery.

We also work with an in-home nursing service that can:

  • Help care for you if you have complications such as diabetes, pre-term labor, and hyperemesis.
  • Monitor high blood pressure related to your pregnancy.

First Steps Program

During your pregnancy, you may be eligible to receive the following services through Washington State First Steps program:

  • Nursing services
  • Social work services
  • Health education and counseling
  • Transportation for maternity appointments
  • Nutritional services


You can get more information about the First Steps program from your primary care provider or from a Department of Social and Health Services Community Service Office. Or call the Healthy Mothers, Healthy Babies Coalition of Washington at 1-800-322-2588.

Q. How can I get a free car seat for my newborn or a free backpack, booster seat, children’s books or bike helmet for my child?

A. Community Health Plan rewards moms for getting good care while pregnant and for getting your kids regular well child checkups and immunizations (shots). All you need to do is sign up for our Children First™ program and keep up with your care.

You can get a free car seat for your new baby. The Children First™ car seat reward is available only to eligible pregnant members of Community Health Plan. Children First is a program that rewards members who get comprehensive prenatal care.

You must:

Step 1. Be pregnant.

Step 2. See your prenatal services provider within the first three months of your pregnancy, and tell them you want to participate in the Children First program.
OR
if you are new to Community Health Plan, see your provider within 42 days of joining Community Health Plan.

Step 3. Remind your provider to complete and submit your Children First application form at your first appointment in the third trimester.

Your primary care provider (PCP) will submit your form to Community Health Plan. You will then get a car seat certificate in the mail!

Note: To help make sure your child is safe when he or she uses the car seat, carefully read the instruction manual and follow all directions for the correct and safe installation and use of the car seat. We'll also send you some additional information about car seat safety. The manufacturer's warranty is the only warranty for the car seat, and Community Health Plan makes no additional warranties for the product.

Once your baby is born, remember to schedule regular checkups with your provider. During these visits, your baby will get important shots and your provider will monitor your baby's growth and development. Don't forget to ask your provider any questions you might have as a new parent. Your provider is interested in helping your baby grow up to be a happy, healthy child.

For details, please contact us.You can phone Community Health Plan customer service at 1-800-440-1561 or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.

You can get a free backpack, booster seat, children’s books or bike helmet for your child. Preventing injuries and illness is one of the best ways to maintain the health of your child. During well child checkups, your provider will monitor the growth and development of your child, as well as keep his or her shots up to date.

The Children First program rewards eligible Community Health Plan members for getting their specific shots and well child checkups during the year. During your child’s appointment, ask your PCP for the Children First form. Based on your child’s age, select which free item you would like to get. Your PCP will then submit your form to Community Health Plan. In a few weeks, you will get a certificate in the mail for a bike helmet, booster seat, or backpack! If you selected children's books, Community Health Plan will send these directly to you.

Patient must be:

  • An eligible member of Community Health Plan and
  • 0 to 13 years of age.

To help make sure your child is safe when he or she uses the helmet or booster seat, carefully read the instruction manual and follow all directions for the correct and safe use of either item. The manufacturer's warranty is the only warranty for the bike helmet or booster seat, and Community Health Plan makes no additional warranties for the products.

If you have questions, please contact us.You can phone Community Health Plan customer service at 1-800-440-1561 or email us at customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.