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Medical Plan Options

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CareFirst BlueChoice Advantage Plan

  • In-network: Blue Choice and BluePreferred PPO providers locally; BlueCard PPO providers nationally
  • Primary Care Provider not required
  • Prescription drug benefits are provided through Express Scripts
  • CareFirst Video Visits provide an alternative when your Primary Care Provider (PCP) is not available. You can securely connect with a doctor over your mobile device or computer who will provide consultation, diagnosis, and prescriptions (when appropriate) for uncomplicated, non-emergency health concerns for the cost of a PCP sick office visit.
CareFirst Plan Overview
Plan Provision CareFirst
  In-Network Out-of-Network
Deductible
Individual
Individual plus one/Family
$400
$800
$1,000
$2,000
Copay
Primary Care Physician (PCP)
Specialist
$20
$40
N/A
Coinsurance paid by Plan, where applicable 90% 65%
Emergency Room 90% coverage - after $100 copayment* 90% of plan allowance - after $100 copayment*
Inpatient Hospital 90% coverage - after $250 copayment* 65% of plan allowance*
Out-of-Pocket Max
Individual
Family
$2,750
$5,500
$4,000
$8,000
2018 Monthly Employee Cost
Individual under $35,000
Individual over $35,000
Individual plus one
Family
$33.84
$135.34
$473.26
$686.08
2019 Monthly Employee Cost
Individual under $35,000
Individual over $35,000
Individual plus one
Family
$36.54
$146.17
$511.12
$740.96

*Subject to annual deductible.

The amount that BCBS will pay for a given covered service is determined by the Plan Allowance for that service. The Plan Allowance for covered services is determined by the contracted rate or fee schedule that participating providers have agreed to accept for that service or rate or fee that is established by law.

CareFirst and Kaiser Medical Plan Comparison

  1. Go to www.carefirst.com
  2. Search "Find a Doctor"
  3. Select BlueChoice Advantage as your plan
  1. Go to www.bcbs.com
  2. Follow the instructions to Find a Doctor
  3. Enter the first three letters of your Member ID number on your insurance card in the "Select a Plan" field

For behavioral health inpatient pre-certification and emergencies 24 hours/day, 7 days/week, contact Magellan directly at:

  • Magellan Behavioral Health
    (800) 245-7013
    Monday through Friday
    8 a.m. - 6 p.m.
    After hours available for inpatient pre-certification and emergencies 24 hours/day, 7 days/week

You are covered while traveling outside the U.S. For more information, go to the following links:

Some restrictions apply. Not all countries are covered.

  • CareFirst Discount Dental
  • CareFirst Discount Vision (administered by Davis Vision)
    (800) 783-5602
  • CareFirst Video Visit

Important Plan Information

Group Number: 5801532-DC10
Customer Service: (800) 628-8549
Monday through Friday, 8 a.m. - 9 p.m.

First Help: (800) 535-9700
24 hours/day, 7 days/week
www.carefirst.com

To set up an account at CareFirst Online go to www.carefirst.com.

Mobile website: m.carefirst.com
CareFirst apps are available for iPhone® or Android™ smartphones.

On the CareFirst site, you can:

  • View and print your member ID card
  • Find a provider
  • Find a nearby Urgent Care Center
  • Submit and view claims and deductibles
  • Check your coverage
  • Use the Treatment Cost Estimator tool