CareFirst Blue Cross Blue Shield Health Insurance Quotes for Washington DC Families, Individuals and Self Employed

DC Blue Cross Blue Shield Health Insurance Quotes For Families and Individuals & Business Groups
 
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With BlueChoice Open Enrollment, members will need to choose a Primary Care Physician (PCP) that will coordinate all health care needs.
Benefits of this plan include:
- No medical deductible
-$10/$20 medical office visit copay
- Preventive care including routine physicals, screenings and pediatric care Hospital services for one facility copay per admission
- Three tier prescription drug coverage with low deductible Dental and Vision are included

Please note: Benefits for maternity pre-natal care, post-natal care and inpatient physician services during delivery are not covered
.

The CareFirst BlueChoice HMO Open Enrollment Individual & Family Health Insurance Plan for Washington DC Residentsoffers you and your family a medical plan that also provides prescription drug, dental and vision coverage, all in one plan.
To qualify for this plan you must be a District of Columbia resident under the age of 65, or over the age of 65 and not receiving Medicare benefits, you can obtain coverage regardless of your health condition. Because this is an Open Enrollment plan, you are not required to answer any medical questions. Your coverage is guaranteed.*
By offering a wide range of preventive care benefits including well-child and pediatric care, annual physicals, mammograms, PAP tests, prostate screenings and immunizations, BlueChoice Open Enrollment helps to keep you and your family healthy.

■ Choose from over 26,000 doctors, specialists and 68 hospitals in Maryland, the District of Columbia and Northern Virginia.
■ No medical deductible to meet before you can start using your medical benefits.
■ Predictable copays for primary ($10) and specialists ($20) office visits.
■ Hospital services for one facility copay per admission.
■ Prescription drug coverage with predictable copays once you meet your prescription drug deductible.
■ Around the clock advice with a 24 hour per day, 7 day a week health care advice line, FirstHelpTM, staffed by registered nurses.
■ Dental and Vision care benefits included to enhance your health care plan.

Enrollment in this plan will be capped at 2,500 contracts (calculated by total enrollment by DC residents in the previous BluePreferred Open Enrollment plan and the new BlueChoice Open Enrollment plan combined).

 
 
BlueChoice Open Enrollment - Benefits At-a-Glance

Services

You Pay

General InformatIon
Member Deductible


$0

 

Out-of-Pocket Maximum

- Individual


$2,500


-
Individual & Child(ren)*/Individual & Adult**

$5,000

-
Family

$5,000
Lifetime Maximum
No lifetime maximum
   





PREVENTIVE SERVICES & OFFICE VISITS  
Well-Child - Exams & Immunizations through age 17 $10 PCP/$20 Specialist

Adult Routine Preventive Health

$10 PCP/$20 Specialist

Routine Gynecological Visits (No Charge for Pap Smear)

$10 PCP/$20 Specialist

Mammography Screenings

No copay

Prostate Screening Visits (No Charge for PSA test)

$10 PCP/$20 Specialist

Colorectal Cancer Screening (in accordance with the most current American Cancer Society guidelines)

No copay

Allergy Testing and Treatment

$10 PCP/$20 Specialist

Annual Routine Eye Exam at designated Davis Vision provider (optometrists or ophthalmologists)

$10

Hearing Screening $10 PCP/$20 Specialist
   

OUTPATIENT MEDICAL & SURGICAL SERVICES

Physician Office Visit for Illness



$10
PCP/$20 Specialist

Spinal Manipulation

$10 PCP/$20 Specialist

Surgical Services-Professional

$10 PCP/$20 Specialist

Surgical Services-Hospital or Other Facility

$50 facility copay

Diagnostic Procedures

$10 PCP/$20 Specialist

X-rays and Lab Tests at Plan Facilities No copay
   

INPATIENT HOSPITAL SERVICES

365 Days Room and Board (Semi-Private Room)



$500
facility copay per admission

Medical and Surgical Services

No copay

Prescription Drugs (Inpatient) No copay
   

EMERGENCY OR URGENT CARE

Plan-Affiliated Urgent Care Facility



$20

Hospital Emergency Room or Non-Plan Facility (waived if admitted)

$50

Ambulance

No copay

Services

You Pay

Mental Health and Substance Abuse
Outpatient services


Visits 1-40: 25% of the Allowed Benefit
Visits 41+: 40% of the Allowed Benefit

Inpatient Facility Services
(Limited to 60 days per benefit period)

$500 facility copay per admission

Inpatient Professional Services
(Limited to one visit per day during a covered admission)

No copay

Maternity Services
Prenatal and Postnatal Care

Not covered

Room and Board

$500 facility copay per admission

In-Patient Physician Services

Not covered

Nursery Care of Newborn

No copay

PRESCRIPTION DRUGS

Annual Deductible

$100 Individual, $200 Individual & Adult,
Individual & Child(ren), Family

Tier 1 – Generic copay

$10

Tier 2 – Preferred Brand copay

$60

Tier 3 – Non-Preferred Brand copay

$80

Annual drug benefit maximum

$1,500 per member per benefit period

 
 
 
 
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