CareFirst Blue Cross / Blue Shield has two HSA plans available in Washington DC – BluePreferred HSA PPO and BlueChoice HSA HMO.  The major differences between the two plans are network (PPO vs. HMO), maternity coverage, and benefits after deductible.  The BlueChoice plan includes coverage for maternity benefits with no waiting period, while the BluePreferred plan requires a 10-month waiting period.  Both plans have an additional charge of $126 per month to include maternity coverage.  Blue Choice also has fixed co-payments after deductible, while BluePreferred requires a percentage “co-insurance” instead.  Benefits for BlueChoice HSA HMO are as follows:

Deductible – $1,200 or $2,700 for individuals and $2,400 or $5,400 for families

Co-insurance – None

Annual out of pocket limit for individuals – $2,400 for the $1,200 deductible option and $5,250 for the $2,700 deductible option

Annual out of pocket limit for families – $4,800 for the $2,400 deductible option and $10,500 for the $5,400 deductible option

Lifetime Maximum – Unlimited

Office visits – After deductible, $30 for primary care, $40 for specialists

Preventative care – No charge

Prescriptions – After deductible, $5 co-pay for generics, $25 for brand name, $45 for non-formulary brand name (30-day supply).  If using mail order, up to a 90-day supply is $10 for generics, $50 for brand name, and $90 for non-formulary brand name.

Emergency Room – $100 co-pay after deductible, waived if admitted.  $60 co-pay for urgent care after deductible.

Outpatient Lab/X-ray – No charge after deductible

Outpatient Surgery – Office visit co-pay applies after deductible

Hospitalization – $600 co-pay after deductible per day

Maternity office visits – Office visit co-pay applies after deductible

Maternity hospital stay (labor & delivery) – $500 co-pay after deductible per admission

To get an instant quote for CareFirst BlueChoice HSA HMO and apply online, just click the banner at the top or bottom of the page to get started.  You can give us a call at 1-800-571-2980 if you have any questions from 9 AM to 9 PM or send us an e-mail at Info@terminsurancebrokers.com 24 hours a day.