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BlueChoice Advantage
Mid / Large Group Benefit Summaries - Maryland
Benefit summaries are now available for the health plans listed below. Please check the site frequently for summary updates.
Please note: Not all services and procedures are covered by your benefits contract. Benefit summaries are for comparison purposes only and does not create rights not given through the benefit plan.
NOTE: Employers can consult with a CareFirst account executive to explore other plan options that fit their organization's benefit needs.
| Options | Features | Medical Summary | Rx Summary |
|---|---|---|---|
| Option 4 | In: $0 Ded. | Out: $500 Ded. 100%-70% |
CUT7037 | Non-Integrated Rx Options |
| Option 6 | In: $0 Ded. | Out: $500 Ded. 100%-70% |
SUM1031 | Non-Integrated Rx Options |
| Option 7 | In: $250 Ded. | Out: $1,000 Ded. 90%-60% |
SUM1032 | Non-Integrated Rx Options |
| Option 8 | In: $250 Ded. | Out: $1,000 Ded. 80%-50% |
SUM1033 | Non-Integrated Rx Options |
| Option Q | In: $1,000 Ded. | Out: $2,000 Ded. 100%-80% |
SUM5455 | Non-Integrated Rx Options |
| Option 10 | In: $1,000 Ded. | Out: $2,000 Ded. 80%-60% |
SUM4590 | Non-Integrated Rx Options |
| Option 11 | In: $1,500 Ded. | Out: $3,000 Ded. 80%-60% |
SUM4591 | Non-Integrated Rx Options |
| Option 12 | In: $2,000 Ded. | Out: $4,000 Ded. 80%-60% |
SUM4592 | Non-Integrated Rx Options |
| Option 13 | In: $500 Ded. | Out: $1,000 Ded. 90%-70% |
SUM4593 | Non-Integrated Rx Options |
| Option 15 | In: $0 Ded. | Out: $500 Ded. 100%-80% |
SUM5768 | Non-Integrated Rx Options |
| Option 16 | In: $500 Ded. | Out: $1,000 Ded. 100%-80% |
SUM5769 | Non-Integrated Rx Options |
| Option 17 | In: $1,000 Ded. | Out: $2,000 Ded. 100%-80% |
SUM5770 | Non-Integrated Rx Options |
| Option 18 | In: $1,500 Ded. | Out: $3,000 Ded. 100%-80% |
SUM5771 | Non-Integrated Rx Options |
| Option 19 | In: $2,000 Ded. | Out: $4,000 Ded. 100%-80% |
SUM5772 | Non-Integrated Rx Options |
| Option 20 | In: $2,500 Ded. | Out: $5,000 Ded. 100%/80% |
SUM5773 | Non-Integrated Rx Options |
All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.
| Options | Features | Medical Summary | Rx Summary |
|---|---|---|---|
| Option 1-S | $0 Deductible | SUM3267 | Non-Integrated Rx Options |
| Option 2-S | $500 Deductible | SUM3268 | Non-Integrated Rx Options |
| Option 3-S | $1,000 Deductible | SUM3269 | Non-Integrated Rx Options |
| Option 4-S | $2,000 Deductible | SUM3270 | Non-Integrated Rx Options |
All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.
| Options | Features | Medical Summary | Rx Summary |
|---|---|---|---|
| BlueChoice Advantage Option MV 1 |
$5,000 Deductible | SUM2693 | Non-Integrated Minimum Value (MV) Rx Options |
| BlueChoice Advantage Option MV 3 |
$3,000 Deductible | SUM5075 | Non-Integrated Minimum Value (MV) Rx Options |
| BlueChoice Advantage Option MV 4 |
$5,000 Deductible | SUM5076 | Non-Integrated Minimum Value (MV) Rx Options |
| BlueChoice Advantage Option MV 5 |
$7,000 Deductible | SUM5077 | Non-Integrated Minimum Value (MV) Rx Options |
| BlueChoice Advantage Option MV 6 |
$3,000 Deductible | SUM6893 | Non-Integrated Minimum Value (MV) Rx Options |
All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.