Care First Blue Cross/Blue Shield of Virginia serves areas of Northern Virginia that are east of Route 123. This area includes the cities of Alexandria, Arlington, Springfield, Vienna, and parts of Fairfax. One of the best plans from CareFirst is their new Healthy Blue Triple Option plan, featuring preventative care and primary care office visits at no charge, maternity benefits, a single deductible for the whole family, and no annual limit on prescription drugs.
HealthyBlue Triple Option allows you access to over 26,000 physicians and 60 hospitals in the BlueChoice network, and allows you to refer yourself to specialists instead of requiring your primary care doctor to make the referral. If you refer yourself, you pay higher deductibles, co-payments, and maximum out of pocket expenses. Option 1 requires primary care physician referrals, Option 2 does not. Option 3 describes out of network benefits (see brochure for out of network benefit details and information on balance billing). Download the product brochure here.
Deductibles – Option 1 – $1,500 individual, $3,000 for families (one single deductible). Option 2 – $2,000 for individuals, $4,000 for families. Option 3 – $2,500 for individuals, $5,000 for families.
Out of Pocket Maximums – Option 1 – $4,500 individual, $9,000 for families. Option 2 – $6,000 individual, $12,000 for families. Option 3 – $7,500 individual, $15,000 for families.
Office Visits – Option 1 – No charge for primary care visits, $20 co-pay for specialists. Option 2 – No charge for primary care visits, deductible applies for specialist visits, then $100 co-pay. Unlimited visits. Urgent care requires $50 co-pay.
Lifetime Maximum – Unlimited
Preventative Care for Children – No charge
Preventative Care for Adults – No charge
Prescription Drugs – No charge for HealthyBlue Select Generics (tier 1). After deductible, $4 co-pay for tier 1, $45 co-pay for tier 2, $65 co-pay for tier 3. 90-day supplies can be purchased for two times the listed co-pays. Unlimited benefit.
Diagnostic Services, X-rays, Lab Tests – No charge.
Inpatient Services – $300/day co-pay for up to 5 days after deductible for facilities. $20 co-pay after deductible for physician services.
Outpatient Services – $20 co-pay after deductible for facilities, $20 co-pay after deductible for physician services.
Emergency Room Services – $100 co-pay (waived if admitted)
Maternity – After deductible, $20 co-pay for office visits, $300/day co-pay up to 5 days for delivery and facility services.
Or to compare CareFirst HealthyBlue Triple Option with alternate plans available from Care First and other Virginia health insurance companies, please click here or follow the health quote link below. You can also e-mail us at Info@terminsurancebrokers.com 24 hours a day or call 1-800-571-2980 between the hours of 9 AM and 9 PM eastern time.