No referrals needed to see a plan specialist (some exceptions may apply), Pharmacy benefits provided through CVS Caremark, Freedom to choose any doctor, specialist or hospital – anytime you wish, No claims to file when visiting a plan provider. The CareFirst BlueChoice Advantage plan allows members the flexibility to choose a health care provider when and where treatment is needed. 100%-70% SUM1677 Integrated Rx Options Option 2 In: $ To locate a medical provider, go to CareFirst’s online directory and look for providers in the “BlueChoice Advantage” network. You can fill prescriptions at CVS retail locations or at the more than 68,000 network pharmacies including independent and chain locations. Members can see a provider who is not in the Blue Cross Blue Shield network, but may pay a higher out-of-pocket cost and members typically must file their own claims. See all Ophthalmologist office locations in Potomac that accept CareFirst BlueChoice Advantage … CareFirst will reimburse you for any amount determined to be payable by the Plan. See all Gastroenterologist office locations in Dunkirk that accept CareFirst BlueChoice Advantage … Use the mobile app to get your member information on the go, or log in to the My Account section of CareFirst.com to print a verification of coverage. • Periodically review your claims history for accuracy to ensure we have not been billed for services you did not receive. Learn more about BlueVision coverage here. HealthyBlue Advantage Group and Member Applications - Maryland Notes below are applicable to group contracts effective 4/1/04 and after: Non-MSGR MD Groups: If a group chooses BlueChoice medical coverage (HealthyBlue, BlueChoice, BlueChoice Open Access, BlueChoice Opt-Out Open Access, or BlueChoice Opt-Out Plus Open Access ) and indemnity dental coverage (Traditional or … CareFirst BlueChoice Advantage POS This plan offers in- and out-of-network benefits and has the added advantage of access to both local and national networks without referral. CareFirst BlueChoice, Inc. 840 First Street, NE Washington, DC 20065 202-479-8000 An independent licensee of the Blue Cross and Blue Shield Associationmeans the Patient Protection and Affordable Care Act of 2010 (Pub. When looking for participating doctors from www.carefirst.com, be sure to select “Vision” when conducting your search. A ‘par’ provider does not participate in the local BlueChoice network, however, they do participate in the “Traditional/Indemnity” or national BlueCross Blue Shield (BCBS) participating provider, or ‘par,’ network. h�bbd```b``�"σH�&�)f���}@$�f�ʭ`�*��,�� ��b ��&� QYf'���@d�9 �d0� &��u �/s#�!H(6JB���^0 kV� The BlueChoice network is a local network of providers. When you use a BlueChoice network or BCBS participating provider, that provider will submit your claim to CareFirst BluceChoice on your behalf. BlueChoice Advantage POS members will be receiving a new member ID card in late December. Need help finding a doctor? | Out: $2,800 Ded. Plan Name Rx Plan Type Integration Status Medical Summary BlueChoice Advantage Platinum 0 $10/$45/$65/50% up to $100 max/50% up to $150 max Non-Integrated SUM3820 BlueChoice Advantage Gold 500 $10/$45/$65/50% That’s okay too! %%EOF endstream endobj 1443 0 obj <>/Metadata 48 0 R/PageMode/UseThumbs/Pages 1440 0 R/StructTreeRoot 159 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1444 0 obj <>/MediaBox[0 0 792 612]/Parent 1440 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1445 0 obj <>stream CareFirst is closely monitoring the coronavirus situation and working in close partnership with state and local public health authorities. Participants in the CareFirst POS plan will also be enrolled in a prescription drug plan insured by CVS Caremark. Your provider will send you an invoice for the amount owed (if any). More information about this plan is in the Employee Benefit Summary (PDF) and Evidence of Coverage (PDF) 1468 0 obj <>/Filter/FlateDecode/ID[<11AF4F4EEDCBAE4EAC358CC98321C8B0><880FA2FDB163564F9C95AAD72B63378D>]/Index[1442 74]/Info 1441 0 R/Length 121/Prev 447468/Root 1443 0 R/Size 1516/Type/XRef/W[1 3 1]>>stream Members still have the option to access a BlueCard PPO doctor, but will be subject to higher out of pocket expenses. Participating pharmacies include CVS, Rite Aid, Walgreens, Safeway, Giant, Harris Teeter and many more. My ER visit cost only $100 for overnight stay. Non-par providers do not participate in BlueCross BlueShield. In-Network (BlueChoice) versus BCBS “Participating ” or “Traditional” ProvidersIn order to access ‘in-network’ care, and receive the greatest benefit with the lowest out-of-pocket expense, visit a BlueChoice network provider when seeking care in DC/MD/Northern VA, and a BlueCard PPO provider outside of the metro area. CareFirst BlueChoice providers have agreed to accept as payment for covered services. When you use a non-network provider, your provider may require you to pay the full bill at the time the service is rendered. This means that although you’ll pay more than you would when seeking care from a BlueChoice doctor, you’ll pay less than you would by going completely out of the BCBS network and you’ll avoid balance billing. Find a participating network pharmacy using the CVS Caremark Pharmacy Locator. Health Advocate is there to help. You will receive two ID cards – one for medical services from CareFirst and one for prescription drug coverage from CVS Caremark. Par providers constitute approximately 80% of all doctors nationwide. The deductible and a 10% coinsurance applies to in-network Outpatient Surgery, Inpatient and Hospital services. h�b```b``Vd`e`P�bb@ !�(��s�8���'����胳R������I�D�΃�\>���ܥy�}�gD�.M��,�P��h�E� b1�f���n Jج����,�� �� ��6^t0]� ����эU��f��C�C��n+�.f��Odd0>`|�����`.u�����@���Jl)5 ہ����2[z$��e`��f �� m��vqD5#@� �K>� Find a General Practitioner who accepts CareFirst BlueChoice Advantage near you in Washington, DC. If you’re seeing lots of doctors every week, that can add up. Vision: If you are interested in receiving a routine eye exam you must access care within the Davis Vision Network. There are two types of non-network providers:  ‘par’ and ‘non-par.’. Welcome to the CareFirst BlueChoice Advantage plan. Use this network when seeking in-network benefits outside of the DC/MD/Northern Viriginia area. Except for emergency services, if you go outside of the BlueChoice network, your medical services will not be covered. Find a Gastroenterologist who accepts CareFirst BlueChoice Advantage near you in Dunkirk, MD. h��Yko۸�+���&�Xȣ�h{�$�Y����$Bmː����{��?����l��0d��!yfxf���q)L�/)I�L��Ō�$h�%�0 �R��[�>����c`�jMn}�>$`|�I�)ei�2�F �)'�3�ax��(y���9B`Z�8rʴ��7�R�#�Lۈ=UL���jf���aF�Q��h%cU�� ;ҔY�����d�R��bV�ت�5“d�u4��9E��1�C���9�I Members receiving care outside the CareFirst Service area will experience the lowest out of pocket costs by accessing a national BlueCard PPO provider. Now I have CareFirst BlueChoice Advantage POS. Professional vision services including routine eye examinations, eyeglasses and contact lenses offered by CareFirst BlueCross BlueShield through the Davis Vision, Inc. national network of providers. Don’t know your member ID? Each specialist visit is a $40 a visit. 1442 0 obj <> endobj Whether you’re looking for health and wellness tips or support to FCPS developed the plan to help meet your health care needs. The CareFirst BlueChoice Advantage plan provides you with different ways to access care: The BlueChoice network is a local network of providers. BlueChoice Advantage HSA/HRA Gold 1500 90 Deductible: Individual/Family In-Network: $1,500 / $3,000 Out-Network: $3,000 / $6,000 Your cost for certain benefits is 10% coinsurance. Need group health insurance? CareFirst BlueChoice Advantage Rx Effective January 1, 2014, CareFirst is transitioning to a new Prescription Benefits Manager, CVS Caremark. In the CareFirst BlueChoice Advantage plan, you may also choose to access your care from a non-network provider. At a quick glance, it looks like Carefirst … Holy crap, this insurance is much better. 2019 CareFirst BlueChoice, Inc. 4 Introduction/Plain Language/Advisory • Carefully review explanations of benefits (EOBs) that you receive from us. Plan is available to individuals under the age of 30 at the more than network. 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