The CareFirst Limited PPO Plan is available to limited-time faculty and staff members, as well as part-time instructors. If you are eligible for this plan, you will be notified by email of your options for enrollment.
CareFirst Limited PPO Plan
The CareFirst Limited PPO Plan for limited-time faculty, staff, and part-time instructors, is administered by Quantum Health. The medical portion of the plan is on the BlueChoice Advantage PPO Network from CareFirst, and prescription drug coverage is managed by Capital Rx.
|
In-Network Benefits |
CareFirst Limited PPO Plan |
|---|---|
| Annual Deductible | $3,000 individual $6,000 family |
| Medical Out-of-Pocket Maximum | $5,000 individual $10,000 family |
| Physician Services (medical and surgical) | Deductible, then 50% |
| Preventive care | $0 |
| Emergency Room | Deductible, then 50% |
| Outpatient Hospital | Deductible, then 50% |
| Inpatient Hospital | Deductible, then 50% |
|
In-Network Benefits |
Prescription Drug (managed by Capital Rx) |
| Prescription Deductible | Integrated with medical |
| Prescription Out-of-Pocket Maximum |
Integrated with medical |
| Prescription Drugs: retail
(up to 30-day supply) |
Generic: Deductible, then $10 Formulary brand: Deductible, then $30 Non-formulary brand: Deductible, then $60 |
| Prescription Drugs: mail order
(up to 90-day supply) |
Generic: Deductible, then $25 Formulary Brand: Deductible, then 20%, $120 max Non-formulary brand: Deductible, then 25%, $250 max |
Additional information for this plan can be found in the Summary of Benefits and Coverages.