CareFirst BluePreferred HSA Bronze $3500 (Maryland)

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Company CareFirst BlueChoice
Plan Year 2014
State Maryland
Metal Tier Bronze
Plan Type PPO
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Cost Sharing Benefits (In Network)

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.

Deductible (Individual) $3,500
Deductible (Family) $7,000
Coinsurance 20%
Out of Pocket Maximum (Individual) $6,350
Out of Pocket Maximum (Family) $12,700

Doctors Visits

Primary Care Visit $30 copay
Specialist Visit $40 copay
In Patient Hospital Services 20% coinsurance
Emergency Room Services 20% coinsurance

Tests and Imaging

Imaging (CT/PET Scans, MRIs) 20% coinsurance
Laboratory Outpatient and Professional Services 20% coinsurance
X-ray and Diagnostic Imaging 20% coinsurance


Mental / Behavioral Health $30 copay
Rehabilitative Speech Therapy $40 copay
Rehabilitative Occupational & Physical Therapy $40 copay
Outpatient Facility 20% coinsurance
Outpatient Surgery 20% coinsurance

Prescription Drugs

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.

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