CareFirst Plan III
CareFirst Plan III is available to employees who meet the definition of limited-time faculty or staff or part-time instructors. You will be notified if you are eligible to enroll in this plan. It’s a traditional indemnity plan administered by CareFirst BlueCross BlueShield. Express Scripts administers the prescription drug portion of this plan. With this plan, you must meet a deductible first, and then you pay a portion of the cost (your coinsurance/copay) when you access non-preventive care and prescription drugs. The medical plan uses CareFirst’s PPO Network; however you can always visit providers outside of the plan network.
| CareFirst Plan III | ||
|---|---|---|
| Plan Benefits | In-Network | Out-of-Network |
| You Pay… | ||
| Annual Deductible | $3,000 per person $6,000 per 2 or more persons |
$6,000 per person $12,000 per 2 or more persons |
| Medical Out-of-Pocket Maximum | $5,000 per person $10,000 per 2 or more persons |
N/A |
| Physician Services (medical and surgical) | Deductible, then 50% | Deductible, then 50% |
| Preventive care | $0 | 50% |
| Emergency Room | Deductible, then 50% | Deductible, then 50% |
| Outpatient Hospital | Deductible, then 50% | Deductible, then 50% |
| Inpatient Hospital | Deductible, then 50% | Deductible, then 50% |
| Prescription Drugs – Express Scripts | ||
| Prescription Deductible | $600 per person
$1,200 for 2 or more persons |
N/A |
| Prescription Out-of-Pocket Maximum |
$1,600 per person
$3,200 for 2 or more persons |
N/A |
| Retail Prescription – Generic – Formulary – Non-Formulary |
Deductible, then $10 Deductible, then $30 Deductible, then $60 |
N/A |
| Mail Order Prescription – Generic – Formulary – Non-Formulary |
Deductible, then $25 Deductible, then $75 Deductible, then $150 |
N/A |