CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield … Effective January 1, 2021 Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets … The cost for your visit varies based on your benefits. To choose the right plan for you and your family, you may want to consider the following: Compare the monthly cost of the HMO and PPO plans. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. However, it features a higher deductible and out-of-pocket maximum than a traditional PPO. Member Services The Blue Cross Blue Shield System is made up of 36 independent and locally operated companies. The BlueChoice Young Adult plan is available to individuals under the age of 30 at the time of their effective date. Variable, intermittent, infrequent or occasional schedule: • 28+ hours per week, and • 987 hours in a 12-month period • CareFirst … CareFirst BlueCross BlueShield EPO and PPO In general, all options under each type of plan (PPO or EPO) cover the same services. This plan is most similar to traditional group health insurance with low deductibles and predictable fixed costs for services like office visits and prescription drugs. “World’s Most Ethical Companies” and “Ethisphere” names and marks are registered trademarks of Ethisphere LLC. BlueCard PPO Network: Use this network when seeking in-network benefits outside of the DC/MD/Northern Viriginia area. CareFirst BlueChoice Advantage In-network Out-of-network *The amount that BCBS will pay for a given covered service is determined by the Plan Allowance for that service. A doctor, hospital or other healthcare entity enrolled in a network of designated PPO providers. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. What Impacts the Cost of Health Insurance? Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services. The CareFirst BlueCross BlueShield High Deductible Health Plan (HDHP) works much like a traditional preferred provider organization (PPO) plan – giving you the flexibility to use in-network or out-of-network providers. It is important to start the process as early as possible to ensure your breast pump arrives on time. Urgent Care Video Visits are available 24/7/365, and you also have the option to schedule visits with licensed professionals for other services. It’s a traditional indemnity plan administered by CareFirst BlueCross BlueShield. Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. CareFirst BlueCross BlueShield's Preferred Provider Organization (PPO) is offered to all active State of Maryland employees as well as all retirees, with or without Medicare, regardless of their place of residence. Plan names are found at the top of each benefit summary. Unlike an HMO, you are not limited to providers who are in-network, though your copay or out-of-pocket cost for out-of-network visits may be higher than for in-network providers. It is our goal to provide you with information and resources to help supplement your clinical decision-making and achieve the goals of improving quality and reducing costs of health care. We will handle the insurance paperwork for you and we also contact your physician to obtain a prescription to … Additionally, PPO plans offer more options for laboratory service providers. These are the differences between an HMO and a PPO. Catastrophic plans, like our BlueChoice HMO Young Adult plan, usually have … Find the latest information. Costs will be higher if you see a doctor who does not participate with a Blue Cross and Blue Shield plan. Doctors Community Hospital offers 3 plans through CareFirst BCBS HMO, POS, and PPO. At CareFirst BlueCross BlueShield, we’re building the future of healthcare with the widest coverage and the largest network for medical, dental and vision insurance in Maryland, Washington, D.C. and Northern Virginia. BluePreferred PPO Standard Bronze $4,500 Claim Forms. HMO plans offer the flexibility to see any of the 44,000 participating providers in the BlueChoice network. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). CareFirst BlueCross BlueShield's Preferred Provider Organization (PPO) is offered to all active State of Maryland employees as well as all retirees, with or without Medicare, regardless of their place of residence. Toggle navigation. To keep costs low, HMOs may require you to select a primary care physician (sometimes called a primary care provider or PCP), who can refer you to specialists when needed. HealthyBlue PPO Claim Forms. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. Benefits are paid for a family member who reaches the individual deductible amount before the family deductible amount is reached. If you need a lot of specialist care, say you are managing a rare or chronic condition, you may also prefer the ease of choosing specialists and seeing them right away that you get with a HMO plan. Lab Services for CareFirst HMO and PPO Members March 09, 2012 - We know how important it is to make proper care decisions and recommendations for your patients, our members. Costs will be higher if you see a doctor who does not participate with a Blue Cross and Blue Shield plan. Check out our Coronavirus Resource Center for information and resources to help you get the care you need and to protect yourself, your family and your community. Contact 866-773-2884 for authorization regarding treatment. CareFirst is closely monitoring the coronavirus situation and working in close partnership with state and local public health authorities. CareFirst BCBS BluePreferred PPO Health Insurance Virginia | VA. CareFirst Blue Cross / Blue Shield’s most comprehensive plan is Blue Preferred PPO. CareFirst offers a variety of plan types (HMO, POS, PPO). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The CareFirst BlueChoice Advantage (PPO) network offers even deeper discounts through network providers in MD/DC/VA, which means lower-out-of-pocket costs. I have the PPO plan through my employer. Medical Claim (MD, DC and Northern VA) For services received in the MD, DC and Northern Virginia CareFirst service area. CareFirst’s PPO/BlueChoice Advantage Network: When you see a physician who is a member of CareFirst’s national PPO network you pay less based on your physician’s negotiated fee. … A family member may not … Plan types refer to how plans provide coverage and from which network of providers you receive care. In exchange for a lower monthly payment, an HMO offers a narrower network of available doctors, hospitals, and specialists. CareFirst BlueCross BlueShield (CareFirst) Video Visit allows you to securely connect with a doctor whenever and wherever you want on your smartphone, tablet or computer. Carefirst BluePreferred PPO Plan Summary. BlueChoice HMO Standard Silver $4,000; Plan Type: HMO: Individual Deductible: $4,000: Individual Out-of-Pocket Maximum: … BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Learn … The company has a 75% market share in Maryland. Log In . Office Hours Monday to Friday, 8 am to 5 pm Connect With Us 1015 Half Street, SE, 9th Floor, Washington, DC 20003 There is no charge for preventative care and you can save money … BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. CareFirst BCBS PPO, deductible, and FFS. Medical Claim (Other Service Areas) For services received in areas other than the MD, DC and Northern … Preferred Provider Organization (PPO) PPO plans offer the most flexibility. This also means when you are traveling, you can receive care wherever you are. While CareFirst's HMO plans have especially wide networks compared to many other HMOs, the PPO plans still offer in-network coverage for more health care providers. Hi, My chosen FFS surgeon Dr. Jacob Kuperstock informed me last Wednesday that his office would submit later that day to Carefirst BCBS the preauthorization requests for me to have my FFS with him. I have about $1,200 before my … If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. First Care, Inc., CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. PPO plans typically require higher monthly payments in exchange for increased flexibility. To help keep yourself and your family safe, visit our resource center for the latest COVID-19 information. Care can be accessed from the PPO network of more than 47,000 providers locally and thousands nationally. Prevention is the best medicine, so CareFirst BlueCross BlueShield offers a wide range of services to help you and your family lead healthy and productive lives. Skip to main content Menu Main navigation . The monthly payment for an HMO plan is lower than for a PPO plan with a comparable deductible and out of pocket maximum. Carefirst BCBS breast pumps are covered any time during your pregnancy, meaning that you may receive your breast pump at anytime before or after the birth of your baby. PPO stands for Preferred Provider Organization. PPO outpatient services do not require Pre-Service Review. Outside of our network, only emergency medical services are covered. Please note, certain individuals age 30 or older may also apply for BlueChoice Young Adult if their policies were cancelled due to non-compliance with the Affordable Care Act or if they quality for a hardship exemption. Ambulance - elective air transport only (10.0.005) Artificial Cervical Disc … All plans include vision services, mental health services, and supplies. Skip to main content. Choosing between an HMO or a PPO health plan doesn't have to be complicated. Express Scripts administers the prescription drug portion of this plan. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). View the 2019 State of Maryland EPO Evidence of Coverage (PDF). BCBS Participating Network (BCBS provider): Members also have freedom of choice and out-of-pocket savings received through tradional medical coverage by using BCBS-participating providers. In cases where … Log In . CareFirst's PPO plans offer a wide network of providers. View the 2019 State of Maryland PPO Evidence of Coverage (PDF). Need an individual and family health insurance plan? Medical Claim (MD, DC and Northern VA) For services received in the MD, DC and Northern Virginia CareFirst service area. I also have a high deductible, which I haven't met yet. If you would like to keep your doctor, you can determine whether he or she is in-network under an HMO plan, a PPO plan or both. CareFirst Plan III is available to employees who meet the definition of limited-time faculty or staff or part-time instructors. Medical Claim (Other Service Areas) For services received in areas … HMO plans are generally less expensive than PPO plans, with lower monthly payments, making them ideal if your favorite doctors are already in the network, or if you receive most of your care close to home. To access your member services, please visit your BCBS company. Choosing the right health plan can give you peace of mind, knowing that your insurance plan has your health needs covered. The monthly payment for an HMO plan is lower than for a PPO plan with a comparable deductible and out of pocket maximum. An HMO plan will only pay for care from health care providers in the HMO network, except for emergency care, which may be covered out-of-network. Note: JHU does not contribute towards the cost of your coverage: Limited-time faculty and staff: Regular schedule: • 28+ hours per week, and • 987 hours in a 6-month period. CareFirst BlueCross BlueShield, with dual headquarters in Baltimore, Maryland and Washington, D.C., is a health insurance provider serving 3.3 million individuals and groups in Maryland and the Washington metropolitan area. If you need a lower monthly fee, consider an HMO plan. Catastrophic plans, like our BlueChoice HMO Young Adult plan, usually have lower premiums than a comprehensive plan, but have higher deductibles. First Care, Inc., CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association. Plan types (HMO, PPO) refer to how plans provide coverage and from which network of providers you receive care. We Stand Together Against Racial Injustice. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. It also … If you travel frequently and are more likely to need care while away from home, especially if you are living with a chronic condition, or enjoy high-risk hobbies such as certain sports, you may need a PPO to provide the best coverage for your needs. The main differences between the two are the size of the health care provider network, the flexibility of coverage or payment assistance for doctors in-network vs out-of-network, and the monthly payment. CareFirst BCBS Plans. You will be notified if you are eligible to enroll in this plan. Please refer to the criteria listed below for genetic testing. • CareFirst BCBS PPO Plan • EHP Classic POS Plan • Kaiser Permanente HMO. “World’s Most Ethical Companies” and “Ethisphere” names and marks are registered trademarks of Ethisphere LLC. It is a nonprofit organization and an independent licensee of the Blue Cross Blue Shield Association. * CareFirst BCBS PPO: When the type of coverage is family (3 or more persons), the family deductible amount is calculated by combining the amounts contributed by all the family members covered under the plan. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). Nondiscrimination Notice and Foreign Language Assistance, Summary of Preventive and Contraceptive Services. HMO stands for Health Maintenance Organization. To choose the right plan for you, consider the price and flexibility you need in a health plan. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. carefirst, bluecross, blueshield, health care, healthcare, health insurance, state of maryland, state md, md, employees . 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