Medical Plan Options for Faculty and Staff

We offer a variety of medical plan options, including a high-deductible health plan (HDHP), two preferred provider organizations (PPOs), and a health maintenance organization (HMO), which is only available to current members. Your plan options depend on your employment status. JHU makes contributions toward the cost of coverage for all faculty and staff members except for part-time employees.

NEED HELP NAVIGATING YOUR 2024 HEALTHCARE BENEFITS?

Contact Quantum Health care coordinators at 844-460-2801, Monday-Friday 8:30 a.m. to 10 p.m.

Click here to access your Quantum Health member portal.

Employee Medical Plan Options
Full-time faculty and staff
Part-time faculty and staff
  • CareFirst BCBS Core PPO Plan
  • CareFirst BCBS Enhanced PPO Plan
  • CareFirst BCBS High Deductible Health Plan (HDHP)
  • Kaiser Permanente HMO Plan (closed to new enrollees)
Limited-time faculty and staff and part-time instructors
  • CareFirst BCBS Limited PPO Plan

If you don’t have medical coverage elsewhere, you must select one of JHU’s medical plans. If you don’t select a medical plan, you’ll be enrolled automatically with individual coverage in the CareFirst BCBS Core PPO Plan.

If you’re covered under another plan, you may waive medical coverage by submitting a medical waiver, available on the myChoices Health & Life portal. Anyone waiving medical coverage is eligible to receive a credit for either $800 (if your annual salary is $40,000 or less) or $500 (if your annual salary is more than $40,000).

Selecting a Medical Plan

Before you choose a medical plan, it’s important to understand how each plan works.

Overview of Services

Our CareFirst medical plans offer:

  • The same national network of providers
  • 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 management through Capital Rx
  • Telehealth visits available through MDLive, with a $20 copay per visit (including behavioral health). Register here to access care 24/7.

As the administrator for the medical plans, CareFirst will process your medical claims. Capital Rx will process your prescription drug claims. You’ll receive one medical ID card with information about both your medical and pharmacy benefits, which will include contact info for Quantum Health and Capital Rx. Quantum Health can answer questions about both your medical and pharmacy benefits.

Medical Plan Options

Your options may include:

  • A choice of preferred provider organization (PPO) plans with different premium and out-of-pocket cost structures or
  • A high-deductible health plan (HDHP)

The CareFirst BlueCross BlueShield PPO Plan is a Preferred Provider Organization plan. This means that you may see any provider, in-network or out-of-network, but you will generally pay more for out-of-network care. With this plan, you pay your deductible first, and then you pay a portion of the cost (your coinsurance amount) each time you use medical services.

The CareFirst HDHP offers the lowest monthly premiums and the CareFirst BCBS Enhanced PPO Plan has the highest. However, you’ll pay more for out-of-pocket expenses with the CareFirst HDHP compared to the CareFirst BCBS Core and Enhanced PPO Plans. That’s why the CareFirst HDHP comes with a tax-advantaged Health Savings Account that’s designed to help you set aside funds on a pretax basis to help pay your out-of-pocket health care expenses.

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 and specialist)
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 - 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
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
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
Telemedicine – MD Live
$20 copay
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)
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)
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.
* 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.

All prescription drug managers (including JHU's new 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.
Need help deciding which medical plan is right for you? Just ask ALEX! Our decision-support tool will help you compare options. You can also add your spouse or partner’s medical plan options for a fuller picture when choosing your coverage.
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.

2024 Faculty and Staff Premiums