Benefits and Co-pays

Below are links to the co-payment and benefit grids for Healthy Options (HO), Basic Health (BH), and General Assistance Unemployable (GA-U).

Major changes as of July 1, 2009 include:

• Oral nutrition therapy is no longer covered for members 21 years of age and older.
• Skin tags are no longer covered.
• The first sleep study is covered without diagnosis restriction each year. Any sleep study provided after the first requires a prior authorization.

To view any of the grids, click the appropriate link underneath. All grids are Adobe Acrobat (pdf) format. Download the free Acrobat Reader.

Healthy Options & CHIP benefit grid *

Basic Health benefit grid

GA-U benefit grid

* Healthy Options and CHIP do not have any copays.

Please Note: The benefit and co-payment information contained in the Community Health Plan website is provided only as a guide and is not a guarantee of coverage.

For details related to your benefits and co-payments, please call the customer service number on your Community Health Plan ID card.