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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).

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

HO:

Benefit grid

BH:

Benefit grid

GA-U: Benefit Grid

Note: HO and CHIP do not have any co-pays

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.