CareFirst BCBS HDHP

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 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

* When the type of coverage is family (2 or more persons), the full family deductible must be satisfied before insurance will start.  The deductible may be met by 1 individual or the combined amount contributed by all members on the plan.