Welcome to BlueChoice HMO Individual and Family Plan by CareFirst BlueCross Blue Shield $15/ $25 Copay Option
This is a very affordable comprehensive health Insurance plan offered in DC by CareFirst Blue Cross Blue Shield. This plan has no medical deductible and labwork is performed with no copay, making it a very practical and well rounded plan with reasonable doctor Copays. We recommend this plan for families with children that are looking for a plan that will provide more predictable medical costs. The BlueChoice $15/ $25 Plan also works well for students on a budget because the coverage is great just as the price is.
BlueChoice Washington DC Quotes
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District of Columbia Medically Underwritten BlueChoice |
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BlueChoice HMO Washington DC $15 / $25 Copay Plan |
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Services |
$15/$25 Copay Option |
General Information |
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Member Deductible |
$0 |
| Out-of-Pocket Maximum |
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| Individual |
$3,000 |
| Individual &Child(ren)*/ Individual & Adult** |
$6,000 |
| Family |
$9,000 |
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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 |
$15 PCP/$25 Specialist |
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Rehabilitative Services (Physical, Occupational and Speech Therapy) 30 visits each per calendar year |
$15 PCP/$25 Specialist |
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Surgical Services-Professional |
$15 PCP/$25 Specialist |
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Surgical Services-Hospital or
Other Facility |
$50 facility copayment plus
$15 PCP/ $25 Specialist copay (if applicable) |
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Diagnostic Procedures |
$15 PCP/$25 Specialist |
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X-Rays and Lab Tests |
No copay |
| Prescription Drug Benefits At A Glance |
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Services |
$15/$25 Option |
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Annual Deductible |
$100 |
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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 |
$15/$25 Option |
| Preventive Services and Office Visits |
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Well Child - Exams & Immunizations
through age 17 |
$15 PCP/$25 Specialist |
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Adult Routine Preventive Health |
$15 PCP/$25 Specialist |
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Routine Gynecological Visits
(No charge for Pap Smear) |
$15 PCP/$25 Specialist |
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Prostate Screening Visits
(No charge for PSA test) |
$15 PCP/$25 Specialist |
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Mammography Screening Visits |
No copay |
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Allergy Testing and Treatment |
$15 PCP/$25 Specialist |
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Annual Routine Eye Exam -at designated Davis Vision provider (optometrists or ophthalmologists) |
$10 |
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Hearing Screening |
$15 PCP/$25 Specialist |
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Inpatient Hospital Services |
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365 Days Room and Board (Semi-Private Room) |
$500 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 |
$25 |
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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 |
