Preferred Provider Organization (PPO)

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:
   
   • To receive a $5 reduction in your specialist copay, complete one of the recommended screenings listed in the State of Maryland Wellness Plan Activities (PDF).
   • To receive a $5 reduction in your specialist copay, complete an annual eye exam

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 CareFirst's PPO, you have the freedom to choose your own doctor or specialist, every time you need care.

• No referrals needed. You have direct access to any specialist.
• No primary care physician needed.
• Vision included with medical benefits.
• Unlimited lifetime maximum.
• Office visits are covered for minimal copay.
• In-network well child visits, physicals, and annual GYN exams are covered at 100% with no copay.
• No paperwork for you. Our PPO physicians submit claims directly to us.
• Out-of-Area Coverage – You will receive one of the most widely recognized and accepted healthcare identification cards in the United States – BlueCard. So now, you can take your health care benefits with you – across the country and around the world.
• 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.

• In order to maximize benefits, members should seek services through a participating CareFirst
  PPO provider.
• 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 100% of allowed amount; out-of-network: 70% of allowed amount after deductible:

Pediatric Vision Care—Benefits for Members through Age 18

Covered in-network 100% of allowed amount; out-of-network: 70% of allowed amount after deductible: