The CareFirst BlueCross BlueShield High Deductible Health Plan (HDHP) works much like a traditional preferred provider organization (PPO) plan – giving you the flexibility to use in-network or out-of-network providers. However, it features a higher deductible and out-of-pocket maximum than a traditional PPO. While the employee premium is lower, you have to pay more health care – and prescription drug costs – yourself (your deductible) before the plan starts to pay its share. What makes this type of plan unique is that it is teamed with a triple tax-advantaged Health Savings Account (HSA) to help fund your out-of-pocket health care costs.
Here are highlights of how your benefits compare in-network vs. out-of-network. For more information, refer to the 2023 Medical Plan Coverage Comparison Chart and Summary Plan Description. You can also Ask ALEX, our new, interactive decision support tool. ALEX acts as a virtual benefits counselor to help you learn more about your benefit options, so you can choose what’s best for you.
Plan Benefits |
In-Network | Out-of-Network |
|---|---|---|
| You Pay… | ||
| Annual Deductible (includes prescription) | $1,750 per person $3,500 per 2 or more persons * |
$3,500 per person $7,000 per 2 or more persons * |
| Physician Services (office visits) | 20% after deductible | 40% after deductible |
| Physician Services (medical and surgical) | 20% after deductible | 40% after deductible |
| Preventive care (physical exams and well baby) | $0; 100% JHU covered | 40% no deductible |
| Emergency care | Facility: 20% after deductible Physician: 20% after deductible |
Facility: 20% after deductible Physician: 20% after deductible |
| Urgent care | 20% after deductible | 40% after deductible |
| Hospital copay per inpatient admission | No copay | No copay |
| Hospital service benefits | 20% after deductible | 40% after deductible |
| Outpatient surgery | 20% after deductible | 40% after deductible |
| Vision Care | Not covered | Not Covered |
| Plan Year Maximums | ||
| In-Network | Out-of-Network | |
| Annual Maximum Benefit | None | |
| Annual Out-of-Pocket Maximum (includes deductibles, copays & coinsurance Medical and Rx combined) | $3,500 per person
$7,000 per 2 or more persons |
$7,000 per person
$14,000 per 2 or more persons |