About Enrollment and Working With Your Plan

 

Q. How do I become a member of Community Health Plan?

A. If you are a member of the State's Basic Health, Healthy Options, or Children's Health Insurance Program (CHIP) and you live in an area we serve, you can select Community Health Plan as your managed care health program.

If you are already a Basic Health member with another plan, you may select Community Health Plan during the open enrollment period. If you are a member of Healthy Options, you have an opportunity each month to select a new plan.

If you are a Disability Lifeline (GA-U) member, you were assigned to Community Health Plan.

If you are not enrolled in the Basic Health, Healthy Options, Children's Health Insurance Program, or Disability Lifeline (GA-U), you may qualify for one of these programs. To find out if you qualify, contact one of these state agencies:

  • For Basic Health, call toll free 1-800-660-9840. For hearing or speech impaired, call TTY 1-888-923-5622 (toll free). Information about eligibility and premiums is also available on the Washington State Basic Health website.
  • For Healthy Options, CHIP, or Disability Lifeline (GA-U), call DSHS toll free 1-800-562-3022 Monday through Friday from 8 am to 5 pm. If you are hearing or speech impaired, call TTY/TDD 1-800-848-5429 (toll free). Learn about eligibility on the DSHS website. You can also contact your local Department of Social and Health Services Community Service Office.

Q. Will I get an ID card from Community Health Plan?

A. Yes. As a member of Community Health Plan, you should have been issued a member ID card. Every family member enrolled in the plan should have his or her own ID card. If you haven't received your ID card(s) within one week of your effective date of enrollment with Community Health Plan, please contact Community Health Plan customer service at 1-800-440-1561.

Also, you can order a card online. Click here to order a card.

You will need your Community Health Plan ID card for all visits to the doctor, hospital, and pharmacist. If you're a member of Healthy Options, CHIP, or Disability Lifeline (GA-U), you will need to show both your Community Health Plan ID card and your DSHS Services card each time you get medical care or pick up a prescription.

Q. What if I lose my Community Health Plan ID card?

A. We will send you a new one.

Call 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 local 206-613-8875.

You can order a replacemenet card here. Click here to order a replacement card.

Q. What if I move?

A. First, call the state agency that oversees your insurance program and let them know your new address:

  • If you are a Healthy Options, CHIP, or Disability Lifeline (GA-U) member, call your DSHS Community Service Office (CSO). If you do not know the number for the CSO in your area, call DSHS toll free 1-877-501-2233Monday-Friday, 8 am – 5 pm. If you are hearing or speech impaired, call TTY/TDD 1-800-848-5429 (toll free).

    You can also find more information about Healthy Options or CHIP on the DSHS web site. You can find more information about Disability Lifeline (GA-U) on the DSHS website.
     
  • If you are a Basic Health member, call Basic Health so your records can be updated. Call toll free 1-800-660-9840. For hearing or speech impaired, call TTY 1-888-923-5622 (toll free). You can also find more information about the Basic Health on the Washington State Basic Health website.

After you update your records with the appropriate agency, call our customer service team at 1-800-440-1561 so we can help you choose a new primary care provider, if necessary.

Q. Where do I mail my premium?

A. You pay premiums only if you are a Basic Health member. If you are a Basic Health member, please send your premiums, on time, to the address on your monthy premium bill. For Basic Health, the address is: Basic Health, P.O. Box 34270, Seattle, WA 98124-1270. Do not mail your premiums to Community Health Plan.

Q. What is an Explanation of Benefits (EOB)?

A. After Basic Health members get health care, we mail you a written explanation of benefits, or EOB. It explains what services we paid for and show any amount you are responsible for paying.

Q. What do I do if I have a complaint?

A. Our members' complaints and concerns are important to us, and we want to hear about them. If you have a grievance, please call our customer service representatives toll free 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.

If a customer service representative can't resolve your grievance, or if you aren't happy with the response you get, please send your grievance in writing to:

Grievance Coordinator
Community Health Plan
720 Olive Way, Suite 300
Seattle, WA 98101-1830

In your letter, please include your name, address, subscriber ID numbers, the reason for your grievance, and any other information you think is important.

Our grievance coordinators will work with you to resolve your grievance. If you do not agree with the resolution of your grievance, you may appeal the Plan's decision. If you are not satisfied with the resolution of your appeal within Community Health Plan, you can ask for an external review. (Your options for external review depend upon which State program covers you.)

For more information about the grievance and appeal process, see:

If you have questions about grievances and appeals, please contact us. You can call our customer service representatives 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.