CareFirst BluePreferred HSA Bronze $3500 MD

Plan Information
Company CareFirst BlueChoice
State MD
Metal Tier Bronze
Plan Type PPO

Cost Sharing Benefits

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,500 Data Not Available
Deductible (Family) $7,000 Data Not Available
Coinsurance 20% 40%
Out of Pocket Maximum (Individual) $6,350 Data Not Available
Out of Pocket Maximum (Family) $12,700 Data Not Available
Services In Network Out of Network
Primary Care Visit $30 copay 40% coinsurance
Specialist Visit $40 copay 40% coinsurance
In Patient Hospital Services 20% coinsurance 40% coinsurance
Emergency Room Services 20% coinsurance 20% coinsurance
Mental / Behavioral Health $30 copay 40% coinsurance
Imaging (CT/PET Scans, MRIs) 20% coinsurance 40% coinsurance
Rehabilitative Speech Therapy $40 copay 40% coinsurance
Rehabilitative Occupational & Physical Therapy $40 copay 40% coinsurance
Preventative Care $0 40% coinsurance
Laboratory Outpatient and Professional Services 20% coinsurance 40% coinsurance
X-ray and Diagnostic Imaging 20% coinsurance 40% coinsurance
Outpatient Facility 20% coinsurance 40% coinsurance
Outpatient Surgery 20% coinsurance 40% coinsurance
Prescription Drugs In Network Out of Network
Generic Rx 20% coinsurance
Preferred Brand Rx 30% coinsurance
Non Preferred Brand Rx 50% coinsurance
Specialty Drugs 0.5

Other Plans

Other plans that are available in the state.

Plan Name
BlueChoice HSA Bronze $6000
BlueChoice HSA Bronze $4000
BlueChoice Plus Bronze $5500
BluePreferred HSA Bronze $3500
BlueChoice Silver $2000
BlueChoice Plus Silver $2500
BlueChoice Gold $1000
BlueChoice Gold $0
BCBS Preferred 500, a Multi-State Plan
HealthyBlue Gold $1500
HealthyBlue Platinum $0
BluePreferred Platinum $0
BlueChoice HSA Silver $1300
BCBS Preferred 1500, a Multi-State Plan
BlueChoice Gold $0 Ltd CSR
BlueChoice HSA Bronze $4000 Ltd CSR
BlueChoice HSA Bronze $6000 Ltd
BlueChoice HSA Bronze $6000 $0CSR
BlueChoice HSA Silver $1300 73% CSR
BlueChoice HSA Silver $1300 87% CSR
BlueChoice HSA Silver $1300 94% CSR
BlueChoice HSA Silver Ltd CSR
BlueChoice Plus Bronze Ltd CSR
BlueChoice Plus Bronze $5500 $0 CSR
BlueChoice Young Adult $6350
BluePreferred HSA Bronze $3500 Ltd CSR
BluePreferred HSA Bronze $0 CSR
BluePreferred Platinum $0 Ltd CSR
HealthyBlue Gold $1500 Ltd CSR
HealthyBlue Platinum $0 Ltd CSR
BlueChoice Plus Silver 73% CSR
BlueChoice Plus Silver 87% CSR
BlueChoice Plus Silver 94% CSR
BlueChoice Plus Silver Ltd CSR
BlueChoice Silver 73% CSR
BlueChoice Silver 87% CSR
BlueChoice Silver 94% CSR
BlueChoice Silver Ltd CSR
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