We offer a variety of medical plan options, including a high-deductible health plan (HDHP) and two preferred provider organizations (PPOs). JHU makes contributions toward the cost of coverage for all full-time faculty and staff members.
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Medical Plan Options for Faculty and Staff
NEED HELP NAVIGATING YOUR HEALTHCARE BENEFITS?
Contact Quantum Health care coordinators at 844-460-2801, Monday-Friday 8:30 a.m. to 10 p.m. Access the Quantum Health member portal
Selecting Your JHU Medical Plan
Medical Plan Options
JHU supports your health journey with a selection of medical plans available through CareFirst Administrators, which offers access to BlueCross BlueShield’s BlueChoice Advantage PPO network of doctors and specialists.
Eligibility
| Full-time and part-time faculty and staff | You and your eligible dependents are eligible to enroll in these JHU medical plans:
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| Limited-time faculty and staff and part-time instructors | You and your eligible dependents are eligible to enroll in the CareFirst Limited PPO Plan |
Important note: If you’re covered under another medical plan, such as through your spouse’s employer, you must formally waive the medical coverage available to you through JHU. To do so, you will need to submit a medical waiver form that requires you to provide proof of coverage elsewhere. This form is available on the myChoices Health & Life portal.
If you don’t have medical coverage elsewhere, you must select one of JHU’s medical plans. If you don’t select one, you’ll be enrolled automatically with individual coverage in the CareFirst Core PPO Plan.
How the Plans Work
All our medical plans feature comprehensive, high-quality coverage at an affordable cost—plus access to a national preferred provider network and other resources that make accessing care and staying healthy easier.
CareFirst High Deductible Health Plan (HDHP)
The CareFirst HDHP medical plan offers lower monthly premiums than the CareFirst Core and Enhanced PPO Plans. However, you’ll pay a higher deductible and more for out-of-pocket expenses with the CareFirst HDHP compared to the CareFirst Core and Enhanced PPO Plans.
To help manage these higher costs, the CareFirst HDHP offers access to a separate tax-advantaged Health Savings Account that allows you to set aside funds on a pretax basis to help pay certain out-of-pocket health care expenses.
CareFirst PPO Plans
JHU also offers a choice of two Preferred Provider Organization (PPO) plans available through CareFirst. Each plan offers different monthly premiums and out-of-pocket costs for services:
- CareFirst PPO Plan
- CareFirst Enhanced Plan
Both plans allow you to see any provider, in-network or out-of-network, but you will generally pay more for out-of-network care. Both plans require that you pay a deductible first. Then you’ll pay a portion of the cost for care—called coinsurance—each time you use medical services.
How the Plans Are the Same
All three of our CareFirst medical plans offer:
- The same national network of providers through BlueCross BlueShield’s BlueChoice Advantage PPO network
- Coverage for the same broad range of services, including eligible preventive care covered at 100%
- Health care advocacy and navigation support through Quantum Health, your go-to guide and front door for all medical questions, big and small
- Prescription drug benefits managed through Capital Rx
- Telehealth visits available through MDLIVE for medicaland behavioral health needs, with a $20 copay per visit. Register to access care 24/7. Find out how to create your MDLIVE account
- A plan ID card that provides contact information for your JHU medical and pharmacy benefits—including Quantum Health, which can answer questions about both. You’ll receive your ID card when you first enroll in a JHU medical plan; JHU does not issue new ID cards every year
Tax-advantaged spending and savings accounts
JHU offers spending and savings accounts that allow you to deduct tax-free dollars from your pay to help cover certain medical and other health care expenses you incur throughout the year.
- If you enroll in either of the CareFirst PPO medical plans, you can participate in the Health Care Flexible Spending Account (HCFSA) to pay for such qualified expenses as copays and coinsurance, contact lenses, prescriptions, and over-the-counter medications.
- If you enroll in the CareFirst High Deductible Health Plan (HDHP), you can contribute to a Health Savings Account (HSA) on a pretax basis to pay for eligible medical, prescription, dental, vision, and other health care expenses that you incur today or later in life. Unlike the HCFSA, the funds you save through an HSA roll over from year to year. You own the funds forever and decide when you want to use them.
- Due to IRS guidelines, you cannot participate in the HCFSA if you enroll in the CareFirst HDHP with an HSA, but you can enroll in a Limited Purpose FSA to set aside funds to pay for qualifying dental and vision expenses.
- All of JHU’s flexible spending accounts offer several options for managing your FSA expenses and reimbursement. When you first enroll, you’ll receive a benefits debit card you can use to pay your doctor or other provider expenses directly, and to pay for eligible health care expenses at qualified merchants. You’ll only receive a new debit card if your current card is about to expire.
Adult vision exams
You and your eligible dependents age 18 and older are eligible for a free eye exam every two years by a selected School of Medicine Wilmer Eye Institute provider in the Baltimore area. The comprehensive visit will consist of a routine eye exam and complete visual system exam. Call 410-955-5080 to schedule an appointment with Wilmer.
Please note: Eyeglasses and fitting or dispensing new contact lenses are not included in the routine eye exam and are not covered by JHU’s medical plans. However, you may enroll in the EyeMed Vision Plan available to you through JHU.
Medical Plan Comparison Chart
Here’s a summary of some key plan features for the three CareFirst medical plans. For more information about these plans, as well as the Kaiser Permanente HMO Plan and CareFirst BCBS Limited PPO Plan, refer to the plan’s Summary of Benefits and Coverage or Summary Plan Description.
| In-Network Benefits (unless otherwise labeled)* | CareFirst High Deductible Health Plan (HDHP) | CareFirst Core PPO Plan | CareFirst Enhanced PPO Plan |
|---|---|---|---|
| Provider network | BlueChoice Advantage PPO network (through CareFirst) | BlueChoice Advantage PPO network (through CareFirst) | BlueChoice Advantage PPO network (through CareFirst) |
| Access to Quantum Health advocacy service | Yes | Yes | Yes |
| Annual deductible (what you pay for medical and mental health services before the plan pays benefits) |
In-network: $1,750 individual $3,500 family** Out-of-network: $3,500 individual $7,000 family |
In-network: $500 individual $1,500 family Out-of-network: $1,000 individual $3,000 family |
In-network: $250 individual $750 family Out-of-network: $500 individual $1,500 family |
| Out-of-pocket maximum (the most you'll pay in a year for medical, mental health, and prescription drugs) |
In-network: $3,500 individual $7,000 family Out-of-network: $7,000 individual $14,000 family |
In-network: $2,000 individual $6,000 family Out-of-network: $4,000 individual $8,000 family |
In-network: $1,000 individual $3,000 family Out-of-network: $2,000 individual $6,000 family |
| Coinsurance (what you pay for most services after the deductible is met) |
In-network: 20% Out-of-network: 40% |
In-network: 20% Out-of-network: 30% |
In-network: 10% Out-of-network: 30% |
| Health Savings Account (HSA) eligible | Yes | No | No |
| JHU Health Savings Account (HSA) contribution (contribution amount depends on salary band) |
Salary band $40,000 or less: $500 individual $1,000 family Salary band $40,001–$60,000: $250 individual $500 family |
Not applicable | Not applicable |
| Flexible Spending Account (FSA) eligible | No; eligible for Limited Purpose FSA (for eligible dental and vision care expenses only) | Yes | Yes |
| Prescription drugs managed by | Capital Rx | Capital Rx | Capital Rx |
| Prescription drugs | After meeting the plan's medical deductible, you pay a copay or coinsurance amount per prescription | No deductible; you pay copay or coinsurance depending on the type of drug | No deductible; you pay copay or coinsurance depending on the type of drug |
| Preventive care | 100% covered, no deductible | 100% covered, no deductible | 100% covered, no deductible |
| Office visit (primary, specialist, mental health, & substance abuse) |
You pay 20% of the cost after deductible is met | You pay 20% of the cost after deductible is met | You pay 10% of the cost after deductible is met |
| Diagnostic, X-ray, MRI, CAT scan | You pay 20% of the cost after deductible is met | You pay 20% of the cost after deductible is met | You pay 10% of the cost after deductible is met |
| Urgent care | You pay 20% of the cost after deductible is met | $50 copay | $40 copay |
| Emergency room | You pay 20% of the cost after deductible is met | $150 copay (waived if admitted) | $100 copay (waived if admitted) |
| Outpatient surgery (medical and mental health services) |
You pay 20% of the cost after deductible is met | You pay 20% of cost after deductible is met | You pay 10% of cost after deductible is met |
| Hospitalization (medical and mental health services) |
You pay 20% of the cost after deductible is met | $250 copay + you pay 20% of the cost after deductible is met | $250 copay + you pay 10% of the cost after deductible is met |
| Mental Health & Substance Abuse - telemedicine | You pay $0 after deductible is met | 100% covered, no deductible | 100% covered, no deductible |
| Mental Health & Substance Abuse - outpatient | You pay 20% of the cost after deductible is met | You pay 20% of cost after deductible is met | You pay 10% of cost after deductible is met |
| Mental Health & Substance Abuse - inpatient | You pay 20% of the cost after deductible is met | $250 copay + you pay 20% of the cost after deductible is met | $250 copay + you pay 10% of the cost after deductible is met |
| Occupation/Physical/Speech Therapy (limited to a combined 90 days per illness or injury per calendar year) | You pay 20% of the cost after deductible is met | You pay 20% of cost after deductible is met | You pay 10% of cost after deductible is met |
| Pre- and Post-Natal Care- routine | 100% covered, no deductible | 100% covered, no deductible | 100% covered, no deductible |
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Artificial Insemination (AI) and Intra-Uterine Insemination (IUI)
limited to six (6) attempts per live birth and up to a lifetime maximum benefit of $100,000 combined with IVF and Prescription Drugs. |
You pay 20% of the cost after deductible is met | You pay 20% of cost after deductible is met | You pay 10% of cost after deductible is met |
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In-Vitro Fertilization (IVF)
limited to three (3) attempts per live birth; and a lifetime maximum of $100,000 combined with AI/IUI and Prescription Drugs. |
You pay 20% of the cost after deductible is met | You pay 20% of cost after deductible is met | You pay 10% of cost after deductible is met |
| Gender Affirming Care | Benefits are available to the same extent as benefits provided for other inpatient and outpatient services. Click here for an overview. | ||
| Vision Care |
Adult biennial eye exam covered 100% through Wilmer; must call 410-955- 5080 to schedule
Eyeglasses, new contact lenses, and dispensing of contact lenses not included |
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| Telemedicine – In-Network Provider (excluding mental health & substance abuse) | You pay $0 after deductible is met | $20 copay | $20 copay |
| Telemedicine – MD Live |
$20 copay
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| Prescription drugs: retail (up to 30-day supply) |
Generic: $10 copay after deductible Formulary brand name: You pay 20% of the cost after deductible is met Non-formulary brand: You pay 25% of the cost after deductible is met |
Generic: $10 copay Formulary brand name: You pay 20% of the cost (max $60) Non-formulary brand: You pay 25% of the cost (max $125) |
Generic: $10 copay Formulary brand name: You pay 10% of the cost (max $30) Non-formulary brand: You pay 10% of the cost (max $75) |
| Prescription drugs: mail order (up to 90-day supply) (applies to Johns Hopkins Outpatient Pharmacies**) |
Generic: $25 after deductible Formulary brand name: You pay 20% of the cost after deductible is met Non-formulary brand: You pay 25% of the cost after deductible is met |
Generic: $20 copay Formulary brand name: You pay 20% of the cost (max $120) Non-formulary brand: You pay 25% of the cost (max $250) |
Generic: $20 copay Formulary brand name: You pay 10% of the cost (max $60) Non-formulary brand: You pay 10% of the cost (max $150) |
| Methadone Maintenance | You pay 20% of the cost after deductible is met | You pay 20% of the cost after deductible is met | You pay 10% of the cost after deductible is met |
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Family includes two or more individuals.
*You have the option to use out-of-network providers. However, the plan pays less for out-of-network services, and there is a separate deductible and out-of-pocket maximum. Certain services may not be covered. See the Summary of Benefits and Coverage for details. **The full family deductible must be met before you begin paying coinsurance. The deductible may be met by one individual or the combined amount contributed by all members covered by your insurance. |
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*You have the option to use out-of-network providers. However, the plan pays less for out-of-network
services, and there is a separate deductible and out-of-pocket maximum. Certain services may not be
covered. See the Summary of Benefits and Coverage for details.
**You also can fill prescriptions through one of the Johns Hopkins Outpatient Pharmacies or use their mail-order services. All prescription drug managers (including JHU’s pharmacy benefits manager, Capital Rx) have a formulary—a list of drugs covered by the plan. JHU’s plan covers both formulary and non-formulary drugs. However, you’ll pay more for non-formulary drugs. |
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Prescription Drug Benefits
| CareFirst High Deductible Health Plan (HDHP) | CareFirst Core PPO Plan | CareFirst Enhanced PPO Plan | |
|
Out-of-pocket costs |
After meeting the plan’s medical deductible, you pay a copay or coinsurance amount per prescription | No deductible; you pay a copay or coinsurance depending on the type of drug | No deductible; you pay a copay or coinsurance depending on the type of drug |
| Prescription drugs: retail (up to 30-day supply) |
Generic: $10 copay after deductible
Formulary brand name: You pay 20% after deductible Non-formulary brand: You pay 25% after deductible |
Generic: $10 copay
Formulary brand name: You pay 20% (max $60) Non-formulary brand: You pay 25% (max $125) |
Generic: $10 copay
Formulary brand name: You pay 10% (max $30) Non-formulary brand: You pay 10% (max $75) |
| Prescription drugs: mail order (up to 90-day supply) |
Generic: $25 after deductible
Formulary brand name: You pay 20% after deductible Non-formulary brand: You pay 25% after deductible |
Generic: $20 copay
Formulary brand name: You pay 20% (max $120) Non-formulary brand: You pay 25% (max $250) |
Generic: $20 copay
Formulary brand name: You pay 10% (max $60) Non-formulary brand: You pay 10% (max $150) |
All prescription drug managers (including JHU’s pharmacy benefits manager, Capital Rx) have a formulary—a list of drugs covered by the plan. JHU’s plan covers both formulary and non-formulary drugs. However, you’ll pay more for non-formulary drugs.
Find Providers
Click on the link below to search for in-network CareFirst providers. You’ll need to enter the prefix: JHU.
Provider Search (Prefix: JHU)
Cost of Coverage
Your semimonthly per-paycheck deductions for medical coverage depend on your employment status with the University and your salary tier.
2025 Faculty and Staff Premiums 2026 Faculty and Staff Premiums
2025 Johns Hopkins Police Department Premiums 2026 Johns Hopkins Police Department Premiums
Decision Support
Use ALEX for benefits decision support. Looking for expert advice about choosing your medical plans and other benefits? ALEX is available 24/7 to help you pick the best plan options for you. Once you answer a few questions about your preferences and health care needs, ALEX can narrow down the plan options to determine which one will give you the best coverage for the lowest cost. You can also add your spouse or partner’s medical plan options for a fuller picture when choosing your coverage.
Questions? Quantum Health has answers. Quantum Health is your full-time health care benefits resource and advocate. Experienced care coordinators can answer questions about all your JHU health benefits, including how to select and make the most of your medical and prescription benefits all year long. Contact Quantum Health at 844-460-2801 or access the member portal.