Care First Blue Cross/Blue Shield of Washington DC serves all areas of DC, all areas of Maryland, and areas of Northern Virginia that are east of Route 123. This area includes the cities of Alexandria, Arlington, Springfield, Vienna, and parts of Fairfax. CareFirst recently introduced the new Healthy Blue 2.0 $1,500 deductible plan, featuring preventative care, primary care office visits, and generic prescription drugs at no charge, maternity benefits with no waiting period, and low co-payments for most services. You can also earn up to $400 each year in Healthy Rewards that can be used to pay for any healthcare expenses, and you receive valuable discounts on vision and dental services at no charge. There are no waiting periods for pre-existing conditions with the HealthyBlue plan.
**NOTE** This plan replaces the HealthyBlue Triple Option and Dual Option HSA plans, which are both no longer available.
HealthyBlue 2.0 allows you access to over 33,000 physicians and 60 hospitals in the local BlueChoice network, and the option to use either Blue Cross/Blue Shield PPO providers nationwide or non-participating providers with out-of-network benefits. Click here to download the brochure.
Deductibles– In Network – $1,500 individual, $3,000 family (one combined deductible for the family). Out of network – $2,500 individual, $5,000 family
Out of Pocket Maximums– In Network – $4,500 individual, $9,000 family. Out of Network – $5,900 individual, $11,800 family
Office Visits (Primary Care) – In Network – no charge. Out of Network – Deductible, then $40 co-pay
Office Visits (Specialist) – In Network – $40 co-pay. Out of Network – Deductible, then $40 co-pay
Lifetime Maximum – Unlimited
Preventative Care for Children – No charge
Preventative Care for Adults – No charge
Prescription Drugs – Tier 1 (generics) – No charge, no deductible. Tier 2 (Preferred Brand Name) – $400 drug deductible, then $45 co-pay. Tier 3 (Non-Preferred Brand Name) – $400 drug deductible, then up to $200 co-pay maximum. 90-day supply – $90 co-pay for Tier 2, $400 co-pay maximum for Tier 3. Unlimited benefit.
Diagnostic Services, X-rays, Lab Tests – In Network – No charge. Out of Network – Deductible applies, then no charge
Inpatient Services – In Network – Deductible applies, then $450/day co-pay. Out of Network – Deductible applies, then $700/day co-pay.
Outpatient Services– In Network – Deductible applies, then $40 co-pay. Out of Network – Deductible applies, then $125 co-pay.
Emergency Room Services – $200 co-pay (waived if admitted)
Urgent Care Center – $50 co-pay
Maternity Services– In Network – deductible applies, then $450/day co-pay for delivery room and board. Out of Network – deductible applies, then $700/day co-pay for delivery room and board. Upgrade to full maternity coverage including coverage for pre/post-natal office visits and hospital physician services for an additional $126/month.
Vision – $10 co-pay for annual eye exam, discounts on other services
Dental – Discount on services, upgraded dental insurance can be added for an additional cost
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