Benefit overview & plan comparison
Benefit |
BlueChoice Advantage HDHP |
Blue Value Plus |
Standard BlueChoice |
|---|---|---|---|
| Wellness Program & Blue Rewards | |||
| You have access to a comprehensive wellness program as part of your medical plan. You also have Blue Rewards, an incentive program where you can get rewarded for completing certain activities. With Blue Rewards, you can earn up to $400 EACH for you and spouse. | |||
| Annual Deductible | |||
| Self Only | $1,650** | $0 | $0 |
| Self + One, Self and Family | $3,300*** | $0 | $0 |
| Annual Out-of-Pocket Maximum | |||
| Self Only | $5,500 | $6,500 | $5,500 |
| Self + One, Self and Family | $11,000 | $13,000 | $11,000 |
| Preventive Services | |||
| Well-Child Care Visit / Adult Physical Examination, Routine GYN | $0 | $0 | $0 |
| Breast, Prostate, Colorectal Screening | $0 | $0 | $0 |
| Outpatient Services (Per Visit or Procedure) | |||
| Primary Care Office Visit | Deductible, $0 | $15 | $25 |
| Specialist Visit | Deductible, $35 | $50 | $50 |
| Physical, Speech & Occupational Therapy | Deductible, $35 | $50 | $50 |
| Acupuncture & Chiropractic Services | Deductible, $35 | $50 | $50 |
| Urgent & Emergency Care | |||
| Urgent Care (per visit) | Deductible, $50 | $50 | $50 |
| Emergency Room Facility (waived if admitted) | Deductible, $300 | $275 | $200 |
| Ambulance | Deductible, $100 | $200 | $100 |
| Diagnostic Services (Non-hospital/Freestanding facility) | |||
| Labs | Deductible, $0 | $30 | $0 |
| X-rays | Deductible, $35 | $50 | $40 |
| Specialty Imaging (i.e., MRI, CAT Scan) | Deductible, $75 | $100 | $75 |
| Hospitalization (Physician fees are listed in section 5(b) of CareFirst Inc. Brochure) | |||
| Outpatient Hospital Non-Surgical Services | Deductible, $200 | $150 | $100 |
| Outpatient Hospital Surgical Services | Deductible, $300 | $200 | $150 |
| Inpatient Hospital Services | Deductible, 20% | 25% | 20% |
| Maternity | Deductible, 20% | 25% | 20% |
| Mental Health and Substance Use Disorder | |||
| Office/Outpatient Professional | Deductible, then $0 | $15 | $0 |
* This summary is for comparison purposes only & does not create rights not given through the benefit plan. Please refer to your 2024 FEHBP BlueChoice Contract for specific plan details.
** The $75 monthly pass through amount is added directly to your Health Savings Account.
*** The $150 monthly pass through amount is added directly to your Health Savings Account.