March 11, 2010

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CareFirst – BluePreferred – MARYLAND

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

  Network Non-Network
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Network See Provider See Provider
Application BluePreferred Application BluePreferred Application
Brochure BluePreferred Brochure BluePreferred Brochure
Copay $25 N/A
Office Visit $25 (no deductible) Subject to deductible and coinsurance
Deductible Individual: $300, Family: $600 Individual: $600, Family: $1,200
Coinsurance 80% 60%
Coinsurance Limit BluePreferred BluePreferred
Out-of-Pocket Maximum Individual: $2,500, Family: $5,000 Individual: $5,000, Family: $10,000
Lifetime Maximum Unlimited Unlimited
Prescription Drugs
  • Separate Individual $100 deductible
  • Generic: $10
  • Preferred Brand: $25
  • Non-Preferred Brand: $45
  • $1,500 Annual Maximum
    		•  Subject to deductible and coinsurance
    Emergency Room $50 copay, subject to deductible and 80% coinsurance $50 copay, subject to deductible and 80% coinsurance
    Adult Preventative Care
  • Adult Preventive Physical Exams: $25 (no deductible)
  • Mammograms, PAP Tests and PSA's (cancer screenings): $0
    		•  Subject to deductible and coinsurance
    Child Preventative Care Well-Child Care (Up to age 18): $0 (No deductible) Subject to deductible and coinsurance
    Lab / X-Ray 80% coinsurance 80% coinsurance
    Maternity Optional Maternity and Prenatal Coverage Optional Maternity and Prenatal Coverage
    Physical Therapy Subject to deductible and coinsurance Subject to deductible and coinsurance
    Skilled Nursing 80% coinsurance (60 days per calendar year, in and out-of-network combined) 80% coinsurance (60 days per calendar year, in and out-of-network combined)
    Home Health Care 80% coinsurance (90 visits per episode of care, in and out-of-network combined) 80% coinsurance (90 visits per episode of care, in and out-of-network combined)
    Mental Health
  • Inpatient: 80% coinsurance
  • Outpatient: Visits 1-5 80% coinsurance, Visits 6-20: 50% coinsurance (per calendar year, in and out-of-network combined)
    		•
  • Inpatient: 80% coinsurance
  • Outpatient: Visits 1-5 80% coinsurance, Visits 6-20: 50% coinsurance (per calendar year, in and out-of-network combined)
    		•
    Hospital Care 80% coinsurance 80% coinsurance
    Optional Benefits Optional Maternity and Prenatal Coverage Optional Maternity and Prenatal Coverage