BlueChoice Advantage
Small Group Off-SHOP - Virginia

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.

BlueChoice Advantage

Plan Name Rx Plan Type Integration Status Medical Summary

BlueChoice Advantage Platinum 0 Med Ded 25 Dent Ded

$15/$50/$70/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7937

SUM7937-SPA

BlueChoice Advantage Platinum 500 Med Ded 25 Dent Ded

$0/$45/$65/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7938

SUM7938-SPA

BlueChoice Advantage Gold 0 Med Ded 25 Dent Ded

$20/$45/$70/$100/$150

Standard

Integrated OOP ONLY

 SUM7939

SUM7939-SPA

BlueChoice Advantage Gold 800 Med Ded 250 Drug Ded 25 Dent Ded

$15/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

Standard

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7940

SUM7940-SPA

BlueChoice Advantage Gold 1000 Med Ded 250 Drug Ded 25 Dent Ded

$15/D,$45/D,$70/D,50% (up to $100)/D,50% (up to $150)

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7941

SUM7941-SPA

BlueChoice Advantage Gold 3000 Med Ded 250 Drug Ded 25 Dent Ded

$10/D,$40/D,$70/D,$100/D,$150

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7942

SUM7942-SPA

BlueChoice Advantage Silver 5500 Med Ded 450 Drug Ded 25 Dent Ded

$20/D,$45/D,$75/D,$100/D,$150

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7943

SUM7943-SPA

BlueChoice Advantage Silver 6900 Med Ded 450 Drug Ded 25 Dent Ded

$20/D,$50/D,$75/D,$100/D,$150

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7944

SUM7944-SPA

BlueChoice Advantage Bronze 6000 Med Ded 25 Dent Ded

D,$20/D,$50/D,$70/D,$100/D,$150

HRA

Fully Integrated

 SUM7945

SUM7945-SPA

BlueChoice Advantage HSA/HRA Gold 1900 Med Ded 25 Dent Ded

D,$10/D,$45/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7946

SUM7946-SPA

BlueChoice Advantage HSA/HRA Silver 2800 Med Ded 25 Dent Ded

D,$15/D,$50/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7947

SUM7947-SPA

BlueChoice Advantage HSA/HRA Silver 3050 Med Ded 25 Dent Ded

D,$15/D,$45/D,$65/D,$100/D,$150

HSA/HRA/HDHP

Fully Integrated

 SUM7948

SUM7948-SPA

BlueChoice Advantage HSA/HRA Silver 3600 Med Ded 25 Dent Ded

D,$15/D,$50/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7949

SUM7949-SPA

BlueChoice Advantage HSA/HRA Bronze 6100 Med Ded 25 Dent Ded

D,$15/D,$45/D,$75/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7950

SUM7950-SPA