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Exclusive Provider Organization (EPO)

CareFirst BlueCross BlueShield's Exclusive Provider Organization (EPO) is offered to all active State of Maryland employees as well as all retirees, with or without Medicare, regardless of their place of residence.

Effective January 1, 2025

There are no benefit changes to the EPO plan in 2025.
State of Maryland Healthcare Options Information (1/1/2025 - 12/31/2025)

CloseKnit—24/7 Virtual-First Primary Care

CloseKnit, our leading virtual care practice, gives you 24/7 access to the support you deserve—from primary and urgent care to therapy and more* through your desktop or the convenient CloseKnit mobile app. Learn more and register at closeknithealth.com.

CloseKnit Offers:

  • Primary Care
    Full-service primary care from a dedicated care team.
    For adults age 18+.
  • Urgent Care
    The care you need to treat minor injuries and illnesses fast. Average wait time is 30 minutes or less.
    For adults and children (age 2+).
  • Behavioral Health Services
    Expert help, including therapy for depression, anxiety or other behavioral health diagnoses.
  • Lactation Support
    Assistance for nursing mothers with breastfeeding challenges.
  • Diet & Nutrition
    Guidance and support for healthy eating, weight loss and more.

Log in to My Account to access these wellness requirements. If a paper copy of the Health Assessment is needed, contact Customer Service at 800-225-0131.


Register with CareFirst WellBeing

If you have not already registered, log in to My Account. Click Explore Now in the wellness program pop-up message. You’ll need to enter your CareFirst My Account username and password and complete the one-time registration with CareFirst WellBeing.

Once you register, you can access your wellness program from the web or download the CareFirst WellBeing app from the App Store or Google Play.

Three rewards you can earn:

  1. Free PCP visits:
    • To earn free PCP visits, select a PCP, and
    • Complete the RealAge® test (an online health assessment that helps you determine the physical age of your body compared to your calendar age.)

  2. Receive up to two $5 reductions to your specialist copay by:

The $5 reduction to your specialist copay will be activated after CareFirst receives a verified paid claim. The claim must meet certain requirements including having gone through the CareFirst claims review process and have been paid. CareFirst will update the member's account to show the $5 copay reduction has been granted. The entire process may take up to 45 days.

To access the above activities, simply log in to your CareFirst WellBeing account, click Achieve, then Rewards. Next, click State of Maryland Wellness Program 2025. The sooner you complete your wellness plan activities, the sooner you start saving. If you require assistance with the wellness program or completing any activity, call CareFirst WellBeing at 877-260-3253.

*Sharecare, Inc. is an independent company that provides health improvement management services to CareFirst members. Sharecare, Inc. does not provide CareFirst BlueCross BlueShield products or services and is solely responsible for the health improvement management services it provides.

Medical Plan Benefits

By selecting the CareFirst EPO, you drive your own healthcare decisions by enjoying many hassle-free benefits with this plan.

Members selecting the EPO plan must select their providers from a National network and must stay in-network to receive coverage benefits.

  • No referrals needed. You have direct access to any specialist.
  • No primary care provider (PCP) needed.
  • No paperwork for you. Our participating physicians (within the PPO network) submit claims directly to us.
  • Vision benefits included with medical benefits.
  • No out-of-network coverage.
  • Unlimited lifetime maximum.
  • Advice Line – A 24-hour nurse-line, called FirstHelp, when all you need is a little advice.
  • Wellness Discount Program – As CareFirst members, you will also receive access to our Wellness Discount Program, which provides you with discounts on alternative therapies such as acupuncture, chiropractic services, yoga and much more.

Mental and Behavioral Health Benefits

Mental and Behavioral Health Services will be provided through CareFirst BlueCross BlueShield.

  • Members must seek services through a participating CareFirst EPO provider. There are no out-of-network mental health benefits in the EPO plan.
  • Inpatient treatment is covered at 100% of allowed benefit. Preauthorization is required through CareFirst.
  • Outpatient services are covered at 100% after a $15 copay.

Vision Benefits

Adult Vision Care—Benefits for Members 19 Years and Older

You have access to an expanded network of vision providers through Davis Vision* in addition to the BCBS PPO network. Present your CareFirst ID card to use your vision benefits with any participating provider in the expanded network.

Visit the State of Maryland Find a Doctor tool to view all vision providers that participate with your vision plan.

*CareFirst partners with Davis Vision to offer an extensive national network of optometrists, ophthalmologists and opticians. Davis Vision is an independent company that provides administrative services for vision care to CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. members. Davis Vision is solely responsible for the services it provides.

Covered in-network only at 100% of allowed amounts:*

Adult Vision Care—Benefits for Members 19 Years and Older

Routine Vision Exam (once per plan year)
Frames — $45 allowed (once per plan year)
Lenses (once per plan year):
  • Single Vision Lenses — $52 allowed
  • Bifocal Lenses — $82 allowed
  • Trifocal Lenses — $101 allowed
  • Lenticular Lenses — $181 allowed
Contact Lenses (in lieu of frames):
  • Contact Lenses — $97 allowed
  • Medically Necessary Contact Lenses — $285 allowed

Pediatric Vision Care—Benefits for Members through Age 18

Covered in-network only at 100% of allowed amounts:*

Pediatric Vision Care—Benefits for Members through Age 18

Routine Vision Exam (once per plan year)
Frames and lenses (once per plan year)
Frames — $70 allowed (once per plan year)
Lenses (Basic lenses are spectacle lenses with no "add-ons" such as glare resistant treatment, ultraviolet coating, progressive lenses, transitional lenses, etc.): (once per plan year)
  • Basic Single Vision — 100%
  • Basic Bifocal Lenses — 100%
  • Basic Trifocal Lenses — 100%
  • Basic Lenticular Lenses — 100%
Contact Lenses (in lieu of frames):
  • Contact Lenses — 100% of Annual Supply
  • Medically Necessary Contact Lenses — 100%

*This is an EPO Plan. Out-of-network: no benefit

Additional Resources