Welcome to BlueChoice HMO Individual and Family Plan by CareFirst BlueCross Blue Shield
These are some of the most sensible and affordable plans in DC and thus this series of plans has become the National Capitol's most popular individual and family plan. The BlueChoice DC plan feature no annual deductible for medical, along with very reasonable doctor copays. The CareFirst HMO network is very expansive with most top doctors in the area participating in it. CareFirst places heavy emphasis on Preventative care and the benefit loaded preventative package in these plans make that evident. To make it better No referrals are needed for OB/GYN visits. Maternity and a discount dental plan are optional.
BlueChoice Washington DC Quotes
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| District of Columbia Medically Underwritten BlueChoice Options |
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BlueChoice HMO Washington DC Plans |
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Services |
$20/$30 Copay Option |
$15/$25 Copay Option |
$10/$20 Copay Option |
General Information |
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Member Deductible |
$0 |
$0 |
$0 |
| Out-of-Pocket Maximum |
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| Individual |
$3,600 |
$3,000 |
$2,000 |
| Individual &Child(ren)*/ Individual & Adult** |
$7,200 |
$6,000 |
$4,000 |
| Family |
$11,000 |
$9,000 |
$6,000 |
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Lifetime Maximum |
No lifetime maximum |
No lifetime maximum |
No lifetime maximum |
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Outpatient Medical and Surgical Services |
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Physician Office Visit for Illness |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Rehabilitative Services (Physical, Occupational and Speech Therapy) 30 visits each per calendar year |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Surgical Services-Professional |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Surgical Services-Hospital or
Other Facility |
$50 facility copayment plus
$20 PCP/ $30 Specialist copay (if applicable) |
$50 facility copayment plus
$15 PCP/ $25 Specialist copay (if applicable) |
$50 facility copayment plus
$10 PCP/ $20 Specialist copay
(if applicable) |
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Diagnostic Procedures |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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X-Rays and Lab Tests |
No copay |
No copay |
No copay |
| District of Columbia Medically Underwritten BlueChoice Options |
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Prescription Drug Benefits At A Glance |
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Services |
$20/$30 Option |
$15/$25 Option |
$10/$20 Option |
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Annual Deductible |
$150 |
$100 |
$50 |
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Generic copay |
$10 |
$10 |
$10 |
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Preferred Brand copay |
$25 |
$25 |
$25 |
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Non-Preferred Brand copay |
$40 |
$40 |
$40 |
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Annual Drug benefit maximum |
$500 |
$1,000 |
$1,000 |
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Services |
$20/$30 Option |
$15/$25 Option |
$10/$20 Option |
| Preventive Services and Office Visits |
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Well Child - Exams & Immunizations
through age 17 |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Adult Routine Preventive Health |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Routine Gynecological Visits
(No charge for Pap Smear) |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Prostate Screening Visits
(No charge for PSA test) |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Mammography Screening Visits |
No copay |
No copay |
No copay |
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Allergy Testing and Treatment |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Annual Routine Eye Exam -at designated Davis Vision provider (optometrists or ophthalmologists) |
$10 |
$10 |
$10 |
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Hearing Screening |
$20 PCP/$30 Specialist |
$15 PCP/$25 Specialist |
$10 PCP/$20 Specialist |
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Inpatient Hospital Services |
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365 Days Room and Board (Semi-Private Room) |
$700 facility copay per admission |
$500 facility copay per admission |
$250 facility copay per admission |
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Medical and Surgical Services |
No copay |
No copay |
No copay |
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Prescription Drugs (Inpatient) |
No copay |
No copay |
No copay |
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Emergency or Urgent Care |
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Plan-Affiliated Urgent Care Facility |
$30 |
$25 |
$20 |
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Hospital Emergency Room or
Non-Plan Facility (Waived if Admitted) |
$50 |
$50 |
$50 |
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Ambulance (When Medically Necessary) |
No copay |
No copay |
No copay |
