2025 Plan Highlights

Health Benefits. Putting the pieces together to improve your health.

Effective January 1, 2025

There are no changes to the CareFirst Plans (PPO & EPO) in 2025.
State of Maryland Healthcare Options Information (1/1/2024 - 12/31/2025)

Wellness Program Effective January 1, 2025 through December 31, 2026

CareFirst WellBeing is a wellness program designed to help you live a healthier life, reach your wellness goals and earn rewards like $0 PCP copays and reduced specialist copays for completing healthy activities. You have from January 1, 2025 through December 31, 2026 to complete the 2025-2026 healthy activities. For more information, log in to My Account.

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.

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.

Three rewards you can earn:

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.)
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.

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.

Vision Benefits

For all Plans

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.

In PPO Plan; SLEOLA PPO Plans and SLEOLA POS Plans

Benefits are covered in-network 100% of allowed amount; out-of-network: 70% of allowed amount after deductible.

In EPO Plans and SLEOLA EPO Plans

Benefits are 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:

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%

*Please see specific product type (PPO or EPO) for vision benefits based on your plan.