How do I enroll in a plan?
There are a few ways you can enroll in the Together with CCHP product:
How do I know if I qualify for a tax credit?
Consumers within certain income ranges are eligible for tax credits to reduce the cost of their health insurance. To see if you are eligible visit the healthcare.gov saving on health coverage section, enter in your household size and income.
Who do I call about benefit, claims, billing, and general health insurance questions?
If you have a question or concern, please reach out to our Together with CCHP Customer Service team at 844-201-4672
How do I pay my bill?
Members have many payment options to keep their coverage. Members are able to pay their premium monthly by the following options:
- Log in to CCHP Connect - Together
- Pay by credit or debit card
- Pay from your checking or savings account
- Set up recurring payments
- Mail a check or money order to:
Children’s Community Health Plan
PO Box 360190
Pittsburgh, PA 15251-6190
- Call Customer Service at 844-201-4672 to pay by credit, checking or savings account, or debit card.
How do I make a payment and what is my grace period – different for on and off exchange?
Except for your first premium, any premium not paid to us by the due date is in default. However, there is a grace period beginning with the first day of the payment period during which you fail to pay the premium. Your grace period is 30 days from the due date, unless you are receiving an advanced premium tax credit from the Federal Government, in which case you will have a 3-month grace period. If you are receiving an advanced premium tax credit from the Federal Government, we reserve the right to pend payment of all applicable claims that occur in the second and third month of the grace period. If claims were paid during the grace period, and coverage is terminated, CCHP will recoup payments from the provider and the provider will bill you for any outstanding balances on your account. It will be your financial responsibility to pay for these services.
Who do I call to make a change to my application?
On-exchange: If you purchased your health insurance coverage and received a subsidy or tax credit (on-exchange), you will need to contact the Health Insurance Marketplace to make any changes to your application. This can be done online at healthcare.gov or by calling 800-318-2596.
Off-exchange: If you purchased your coverage without a subsidy or tax credit (off-exchange), and it is before your policy has begun, contact the CCHP Sales team at 844-708-3837. After your policy has begun, you can log into your member portal to make changes or call the CCHP sales team for assistance.
How can I find a provider?
To find a provider in the Together with CCHP, please browse our Provider Directory or contact our Customer Service team at 844-201-4672.
What services require Prior Authorization?
Please see your the Prior Authorization Quick List or contact our Customer Service team at 844-201-4672.
What is not covered?
For a list of exclusions within your plan, please reference the Together with CCHP Evidence of Coverage (EOC) or contact our Customer Service team at 844-201-4672
Where can I find more information on what prescriptions are covered with my plan?
You can speak with a Customer Service team member at 844-201-4672 or refer to the Together with CCHP Pharmacy Benefit Guide.
How do I order a new ID cards, member packet, etc.?
By signing up for CCHP Connect - Together, you will be able to print a new ID card and have access to all your plan documents. If you don't already have access to CCHP Connect, call Customer Service at 844-201-4672 to request member materials.
What is the benefit of working with an Agent?
Agents are licensed experts in the field who can help explain the differences between the health insurance plans/carriers in a way that is easy for the member to understand. They are better prepared to help the customer choose a plan that is going to be the best fit for themselves and their family.
Agents are advocates for the customer; helping them to navigate a complex explanation of benefits (EOB), premium bill, service issue, complaint, exc.
How do I file an appeal?
You have the right to complain about services offered through Children’s Community Health Plan or the practitioners and providers in our network, or any other issue. You also have the right to file an appeal when you are unhappy with a decision that has been made by us. At any time during the course of the complaint and appeal process, you may choose to designate an authorized representative to participate in the complaint and appeal process on your behalf.
To learn more about filing an appeal, visit your Evidence of Coverage (EOC).
The Appeals process is as follows:
- You have the right to file an appeal to us within three years of the date of the decision regarding a complaint or any Adverse Benefit Determination. To file a formal appeal, you or your Authorized Representative should write down your concerns and mail your written appeal (in any form) along with copies of any supporting documents to us.
- Submit your written appeal to:
Children’s Community Health Plan
P.O. Box 1997, MS 6280
Milwaukee, WI 53201-1997
- We will send you a letter within five business days notifying you that the appeal was received. Depending on the type of appeal, either our appeals committee or specialist will review the appeal, investigate and provide you with a decision within 30 calendar days of receiving the appeal.
What is a SEP?
A Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period (November 1-January 31) when you can sign up for health insurance. You qualify for a SEP if you’ve experienced a qualifying event like losing health coverage, moving, getting married, having a baby, or adopting a child. If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply. You may have to provide documentation showing you are eligible for a SEP.
To learn more about if you qualify for a special enrollment period, please visit healthcare.gov.
I would like to make a complaint. How would I go about doing this?
Contact Customer Service 844-201-4672. Customer Service representatives are available Monday through Friday, 8:00A-6:00P and Saturday 8:00A-2:00P. After we receive your complaint, we will notify you of our decision within 30 days.