carefirst bluechoice advantage pos


̥Z��2/�J�|;�pH�yGVZ ��G������p�U�>�`)O/�u�^'��hx;��bz ����r8����o�$��i���_b. 2020 CareFirst BlueChoice, Inc. 3 Introduction/Plain Language/Advisory • Do not ask your doctor to make false entries on certificates, bills, or records in order to get us to pay for an item or service. No balance billing for out-of-network services by CareFirst BlueCross BlueShield participating providers. Log on to www.carefirst.com/georgetown to take advantage of member tools, videos, discounts, coaching and more! Women’s health coverage, such as routine mammograms and Pap tests, with no written referrals required for routine gynecological and obstetrical care, Men’s health coverage, including routine prostate cancer screening. When care is received inside the CareFirst service area members will experience the lowest out of pocket costs when they visit a BlueChoice provider. When you use a BlueChoice network or BCBS participating provider, that provider will submit your claim to CareFirst BluceChoice on your behalf. 2019 CareFirst BlueChoice, Inc. 4 Introduction/Plain Language/Advisory • Carefully review explanations of benefits (EOBs) that you receive from us. 1515 0 obj <>stream Find a participating network pharmacy using the CVS Caremark Pharmacy Locator. Participants in the CareFirst POS plan will also be enrolled in a prescription drug plan insured by CVS Caremark. CareFirst is closely monitoring the coronavirus situation and working in close partnership with state and local public health authorities. CareFirst will pay the provider as determined by plan rules and send you an Explanation of Benefits (EOB) which details for you the total amount billed by the provider, the amount that CareFirst paid, and the amount for which you are responsible. Find a General Practitioner who accepts CareFirst BlueChoice Advantage near you in Washington, DC. You can register with My Account using your social security number, or call Member Services at 877-691-5856 to get it. Health Advocate is there to help. There are two types of non-network providers:  ‘par’ and ‘non-par.’. Your provider will send you an invoice for the amount owed (if any). If you’re seeing lots of doctors every week, that can add up. See all General Practitioner office locations in Washington that accept CareFirst BlueChoice Advantage and doctor ratings. Holy crap, this insurance is much better. CFBC/POS-POE/ GCA/LG (11/18) Maryland – CFMI For MD groups headquartered in counties other than Prince George's and Montgomery. Georgetown University Retirement Plan (GURP), TAP Benefits for Children of Faculty & Staff, Dependent Care Support for Faculty & Staff during COVID-19. 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/$65/50% endstream endobj 1443 0 obj <>/Metadata 48 0 R/PageMode/UseThumbs/Pages 1440 0 R/StructTreeRoot 159 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1444 0 obj <>/MediaBox[0 0 792 612]/Parent 1440 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1445 0 obj <>stream h�b```b``Vd`e`P�[email protected] !�(��s�8���'����胳R������I�D�΃�\>���ܥy�}�gD�.M��,�P��h�E� b1�f���n Jج����,�� �� ��6^t0]� ����эU��f��C�C��n+�.f��Odd0>`|�����`.u�����@���Jl)5 ہ����2[z$��e`��f �� m��vqD5#@� �K>� Members still have the option to access a BlueCard PPO doctor, but will be subject to higher out of pocket expenses. 0 Vision: If you are interested in receiving a routine eye exam you must access care within the Davis Vision Network. The BlueChoice Young Adult plan is available to individuals under the age of 30 at the time of their effective date. The CareFirst BlueChoice Advantage plan allows members the flexibility to choose a health care provider when and where treatment is needed. You may also use this online directory to search for BlueCard PPO providers outside of the local area. You should then submit a copy of your invoice to CareFirst BlueChoice, along with a claim form. When care is received inside the CareFirst service area members will experience the lowest out of pocket costs when they visit a BlueChoice provider. BlueChoice Advantage HSA/HRA Gold 1500 90 Deductible: Individual/Family In-Network: $1,500 / $3,000 Out-Network: $3,000 / $6,000 Your cost for certain benefits is 10% coinsurance. CareFirst BlueChoice: HealthyBlue Advantage HDHP Coverage for: Self Only, Self Plus One or Self and Family | Plan Type: POS The Summary of Benefits and Coverage (SBC) … h�bbd```b``�"σH�&�)f���}@$�f�ʭ`�*��,�� ��b ��&� QYf'���@d�9 �d0� &��u �/s#�!H(6JB���^0 kV� 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 • Periodically review your claims history for accuracy to ensure we have not been billed for services you did not receive. FCPS developed the plan to help meet your health care needs. Follow the instructions above, then click on the link for providers outside the Metro area. Find a Endocrinologist who accepts CareFirst BlueChoice Advantage near you in Washington, DC. You can fill prescriptions at CVS retail locations or at the more than 68,000 network pharmacies including independent and chain locations. Except for emergency services, if you go outside of the BlueChoice network, your medical services will not be covered. 6 CareFirst BlueChoice MarylandAs a CareFirst BlueChoice member, you are encouraged to take advantage of the CareEssentials program, at no additional charge. 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. Need group health insurance? Find a Gastroenterologist who accepts CareFirst BlueChoice Advantage near you in Dunkirk, MD. With her insurance (carefirst) we have to pay additional for prescription and vision, however with mine (cigna) both are rolled in so cost is pretty much the same. Each specialist visit is a $40 a visit. Find a Internist who accepts CareFirst BlueChoice Advantage near you in Fairfax, VA. See all Internist office locations in Fairfax that accept CareFirst BlueChoice Advantage and doctor ratings. BlueChoice Advantage HSA/HRA Combined Rx Summary of Plan Options Options Features Medical Summary Rx Summary Option 1 In: $1,400 Ded. The CareFirst BlueChoice Advantage plan provides you with different ways to access care: The BlueChoice network is a local network of providers. 100%-70% SUM1677 Integrated Rx Options Option 2 In: $ These payments are established by CareFirst BlueChoice, Inc., however, in certain circumstances, an allowance may be established by law 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. %%EOF Participating pharmacies include CVS, Rite Aid, Walgreens, Safeway, Giant, Harris Teeter and many more. Find a Dentist who accepts CareFirst BlueChoice Advantage near you in Fort Washington, MD. Use this network when seeking in-network benefits outside of the DC/MD/Northern Viriginia area. The deductible and a 10% coinsurance applies to in-network Outpatient Surgery, Inpatient and Hospital services. 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. Learn more about BlueVision coverage here. endstream endobj startxref You will receive two ID cards – one for medical services from CareFirst and one for prescription drug coverage from CVS Caremark. Don’t know your member ID? CareFirst’s HMO plans use our BlueChoice network. You may also use this online directory to search for BlueCard PPO providers outside of the local area. BlueChoice Advantage Coverage for: Individual | Plan Type: POS The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 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 1442 0 obj <> endobj 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. Health Advocate is there to help. 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. 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. If  you recently elected CareFirst BlueChoice as your medical plan and have not yet received an ID card, you can access temporary ID cards online through their My Account feature on www.carefirst.com or call 1-877-691-5856. Need help resolving a claim or billing issue? CareFirst will reimburse you for any amount determined to be payable by the Plan. See all Ophthalmologist office locations in Potomac that accept CareFirst BlueChoice Advantage … See all Gastroenterologist office locations in Dunkirk that accept CareFirst BlueChoice Advantage … Find a Ophthalmologist who accepts CareFirst BlueChoice Advantage near you in Potomac, MD. 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. Check out our Coronavirus Resource Center for information and resources to help you get the Need help finding a doctor? CareFirst BlueChoice providers have agreed to accept as payment for covered services. The chronic conditions are essentially L. 111 To locate a medical provider, go to CareFirst’s online directory and look for providers in the “BlueChoice Advantage” network. More information about this plan is in the Employee Benefit Summary (PDF) and Evidence of Coverage (PDF) The CareFirst BlueChoice Advantage plan allows members the flexibility to choose a health care provider when and where treatment is needed. BlueChoice Advantage POS members will be receiving a new member ID card in late December. The SBC shows you how you and the plan would share the cost for CareFirst POS members will receive a new ID card for 2021. My monthly blood tests (costing $150) cost me $0. When you use a non-network provider, your provider may require you to pay the full bill at the time the service is rendered. When looking for participating doctors from www.carefirst.com, be sure to select “Vision” when conducting your search. Members will still have the option to opt-out of this network at a higher out of pocket expense. To locate a medical provider, go to CareFirst’s online directory and look for providers in the “BlueChoice Advantage” network. Non-par providers do not participate in BlueCross BlueShield. | Out: $2,800 Ded. With our flexible regional POS plans, your cost depends on which network you choose to receive services. BlueChoice Advantage - Small Group Off-SHOP Applications - Maryland Expand All | Collapse All BlueChoice Advantage (including HSA/HRA) GHMSI For MD groups headquartered in Prince George's or Montgomery counties. Now I have CareFirst BlueChoice Advantage POS. My ER visit cost only $100 for overnight stay. Copays (not deductible and coinsurance) apply to regular doctor visits, labs and diagnostic testing. 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. Find a Endocrinologist who accepts CareFirst BlueChoice Advantage near you in Fairfax, VA. See all Endocrinologist office locations in Fairfax that accept CareFirst BlueChoice Advantage and … You don’t need a physical ID card to seek services. In the CareFirst BlueChoice Advantage plan, you may also choose to access your care from a non-network provider. That’s okay too! The BlueChoice network is a local network of providers. Please note, certain individuals age 30 or older may also apply for BlueChoice Young Adult if their policies were Members receiving care outside the CareFirst Service area will experience the lowest out of pocket costs by accessing a national BlueCard PPO provider. CareFirst BlueChoice Advantage Rx Effective January 1, 2014, CareFirst is transitioning to a new Prescription Benefits Manager, CVS Caremark. Welcome to the CareFirst BlueChoice Advantage plan. See all Endocrinologist office locations in Washington that accept CareFirst BlueChoice Advantage and … Mental Health: To find a provider, visit CareFirst’s Provider Directory page and on “Behavioral Health”. CORONAVIRUS UPDATES FROM CAREFIRST (new window). 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. Subject: CareFirst BlueChoice Advantage POS Plan - mental health coverage Anonymous I have Carefirst. At a quick glance, it looks like Carefirst … CareFirst BlueCross BlueShield makes it easy to shop and manage benefits for businesses in Maryland, Washington D.C., & Northern Virginia. 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 … Whether you’re looking for health and wellness tips or support to You now have access to a customized website for your Georgetown University CareFirst medical plan. 4 HealthyBlue 2.0 Member Handbook Local CareFirst providers mail to: Mail Administrator PO Box 14116 (for claims)Lexington, KY 40512-4116 PO Box 14114 (for correspondence)Lexington, KY 40512-4114 CareFirst BlueChoice %PDF-1.6 %���� Par providers constitute approximately 80% of all doctors nationwide. 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