March 20, 2010

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CareFirst – BluePreferred Saver – DISTRICT OF COLUMBIA

A comparison of the BluePreferred Saver offered by CareFirst is detailed out below for both Network and Non-Network coverage.

  Network Non-Network
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Application BluePreferred Saver Application BluePreferred Saver Application
Brochure BluePreferred Saver Brochure BluePreferred Saver Brochure
Copay Office Visits (excluding preventive care) 1-2: $30 per visit (no deductible) Subject to deductible and coinsurance
Office Visit
  • Office Visits (excluding preventive care) 1-2: $30 per visit (no deductible)
  • 3+ visits: subject to deductible and coinsurance
  • Subject to deductible and coinsurance
    Deductible Individual: $10,000, Family: $20,000 Individual: $12,500, Family: $25,000
    Coinsurance 100% 80%
    Coinsurance Limit BluePreferred Saver BluePreferred Saver
    Out-of-Pocket Maximum Individual: $10,000, Family: $20,000 Individual: $15,000, Family: $27,500
    Lifetime Maximum $3,000,000 $3,000,000
    Prescription Drugs
  • Separate Individual $150 deductible
  • $15 Generic copay
  • Discount of Preferred and Non-Preferred Brands
  • $1,500 Annual Benefit Maximum Per Person (Generic Drugs)
  • Subject to deductible and coinsurance
    Emergency Room Subject to deductible and coinsurance Subject to deductible and coinsurance
    Adult Preventative Care
  • Routine Adult Physical: $30 per visit (no deductible)
  • Routine OB/GYN Visits: $30 per visit (no deductible)
  • PAP test, Mammograms, Prostate Screening & Colorectal Screening- No charge
  • Subject to deductible and coinsurance
    Child Preventative Care
  • Well-Child Care Including Exams and Immunizations: Covered in full through age 18 (no deductible)
  • Subject to deductible and coinsurance
    Lab / X-Ray Subject to deductible and coinsurance Subject to deductible and coinsurance
    Maternity Optional Extended Maternity Services Optional Extended Maternity Services
    Physical Therapy BluePreferred Saver BluePreferred Saver
    Skilled Nursing BluePreferred Saver BluePreferred Saver
    Home Health Care BluePreferred Saver BluePreferred Saver
    Mental Health BluePreferred Saver BluePreferred Saver
    Hospital Care Subject to deductible and coinsurance Subject to deductible and coinsurance
    Optional Benefits BluePreferred Saver BluePreferred Saver