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 of Benefits and Coverage. 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.