Welcome to BlueChoice HMO Individual and Family Plan by CareFirst BlueCross Blue Shield
$10 / $20 Copay Option.
This BlueChoice Option offers the lowest doctor copay in the series. $10 for your Primary care Doctor and $20 for Specialist. The drug deductible is also the lowest in this series of plans. With this plan you get very predictable medical care benefit costs, this in turn makes it much easier to budget your expenses without the concern of having to meet a huge deductible unexpectedly. We recommend this product.
Thoughts: A higher prescription benefit would make this a perfect plan.
BlueChoice Washington DC Quotes
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District of Columbia Medically Underwritten BlueChoice |
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BlueChoice HMO Washington DC $10/ $20 Plan |
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Services |
$10/$20 Copay Option |
General Information |
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Member Deductible |
$0 |
| Out-of-Pocket Maximum |
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| Individual |
$2,000 |
| Individual &Child(ren)*/ Individual & Adult** |
$4,000 |
| Family |
$6,000 |
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Lifetime Maximum |
No lifetime maximum |
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Outpatient Medical and Surgical Services |
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Physician Office Visit for Illness |
$10 PCP/$20 Specialist |
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Rehabilitative Services (Physical, Occupational and Speech Therapy) 30 visits each per calendar year |
$10 PCP/$20 Specialist |
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Surgical Services-Professional |
$10 PCP/$20 Specialist |
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Surgical Services-Hospital or
Other Facility |
$50 facility copayment plus
$10 PCP/ $20 Specialist copay
(if applicable) |
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Diagnostic Procedures |
$10 PCP/$20 Specialist |
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X-Rays and Lab Tests |
No copay |
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| Medically Underwritten BlueChoice |
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| Prescription Drug Benefits At A Glance |
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Services |
$10/$20 Option |
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Annual Deductible |
$50 |
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Generic copay |
$10 |
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Preferred Brand copay |
$25 |
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Non-Preferred Brand copay |
$40 |
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Annual Drug benefit maximum |
$1,000 |
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Services |
$10/$20 Option |
| Preventive Services and Office Visits |
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Well Child - Exams & Immunizations
through age 17 |
$10 PCP/$20 Specialist |
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Adult Routine Preventive Health |
$10 PCP/$20 Specialist |
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Routine Gynecological Visits
(No charge for Pap Smear) |
$10 PCP/$20 Specialist |
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Prostate Screening Visits
(No charge for PSA test) |
$10 PCP/$20 Specialist |
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Mammography Screening Visits |
No copay |
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Allergy Testing and Treatment |
$10 PCP/$20 Specialist |
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Annual Routine Eye Exam -at designated Davis Vision provider (optometrists or ophthalmologists) |
$10 |
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Hearing Screening |
$10 PCP/$20 Specialist |
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Inpatient Hospital Services |
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365 Days Room and Board (Semi-Private Room) |
$250 facility copay per admission |
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Medical and Surgical Services |
No copay |
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Prescription Drugs (Inpatient) |
No copay |
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Emergency or Urgent Care |
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Plan-Affiliated Urgent Care Facility |
$20 |
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Hospital Emergency Room or
Non-Plan Facility (Waived if Admitted) |
$50 |
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Ambulance (When Medically Necessary) |
No copay |
