Initial Call

The CHAC enrollment process is simple.  We have specialized Enrollment Coordinators to take you through the process step-by-step.  All you need to do is contact local CHAC office.  A volunteer Enrollment Coordinator will take your call and briefly explain the CHAC program to you.  The Enrollment Coordinator will then schedule an  enrollment appointment for you, and inform you of the items you will need to bring to the appointment.

Enrollment Appointment

During your initial call , your Enrollment Coordinator will schedule your Enrollment Appointment.  When you arrive for your scheduled appointment:

1. You will be greeted by one of our friendly staff members or volunteers and introduced to your Enrollment Coordinator.
2. Your Enrollment Coordinator will take you to a confidential room to complete the enrollment process.
3. Your Enrollment Coordinator will explain the concept of the CHAC program and how the program will work for you.
4. Your Enrollment Coordinator will assist you with completing all enrollment forms.
5. A release of information will be completed.  This will allow CHAC to pass your hospital information and DHS forms along to the appropriate agency.  The release will also allow us to work with the volunteer physicians to assign you to a physician office or our volunteer clinic.
6. A Medicaid application will be completed.  If you have a letter from DHS stating that you are not eligible and the letter is less then 90 days old, a copy of the letter can be given to CHAC and you will not have to complete the DHS applications.
7. A list of your responsibilities will be read and explained to you.  You will need to sign the form and you will receive a copy to take with you.
8. You will be asked for a list of your prescriptions and the dosages.  Medications can be secured in three different ways:
9. At the end of the enrollment, we will review the coverage of the program and answer any questions you might have.  You will receive copies of the Summary of Benefits, the Authorization for Medical Treatment, and your Patient Responsibilities.
10. You can then expect to receive a letter in the mail from the CHAC office between 7 and 10 days after your enrollment appointment notifying you of your status in the program.

Give your local CHAC office a call today.  We will set up an appointment with one of our volunteers to complete the enrollment process.  We look forward to your call.