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Explore our career opportunities to find your place with one of the world's most ethical companies. Search Jobs. Have a question for us? If you are looking to buy or renew a CareFirst plan, please contact us at Have a question about individual or family plans?
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Shop Insurance Plans. Employer Solutions. Insurance Basics New. Introducing CloseKnit A new patient-centric, virtual-first primary care practice. About Us. Receive Hassle-Free Care Whether you are visiting a provider or simply calling our dedicated Customer Service representatives, you can be assured you are receiving quality care and service. National vs. Regional Plans National and regional plans offer you choices of different cost-sharing arrangements, premiums and networks.
National plans have access to a large network of providers throughout the country see the "General Information" row in each summary for specifics.
These plans are the best option if you or your family members live outside Washington, D. Regional plans use the BlueChoice network of participating doctors, specialists and hospitals available only in Washington, D.
These plans are not recommended if you or your family live outside this area.
Need Insurance? Log In or Register. Choosing a health plan for yourself—or your family—is an important decision. Whether you know what coverage you need or want to explore your options, CareFirst offers a range of plans for Maryland residents. Plans offer core health benefits and preventive services, including: Prescription drugs Preventive care Vaccinations Hospital and emergency services As a Maryland resident, you can apply for your health insurance plan directly through CareFirst.
Get a Quote. Interested in individual or family health insurance? Dental Insurance Plans of Maryland We offer several affordable dental care plans to help protect your smile, health and budget.
Our dental plans cover a comprehensive range of dental services at no charge including: Oral exams Cleanings X-rays. Get a Dental Quote. In addition, many members have a right to an independent external review of any final appeal or grievance decision. Refer to your Evidence of Coverage for more specific information regarding initiating an external review, a final appeal determination or a complaint. If you need language assistance or have questions, call the Member Services telephone number on the back of your member ID card.
Get a Quote. Skip Navigation. Login Register. Have questions about health insurance? Explore our Insurance Basics pages. Need Insurance? Log In or Register. Insurance Basics. We know healthcare can be complicated. To learn more, choose a topic from the list below.
Expand All Collapse All Covered benefits. All of our plans include core health benefits, including: Office visits Maternity and newborn care Prescription drugs Laboratory tests and X-rays Preventive and wellness care Dental and vision for children under age 19 Emergency services Hospitalization Behavioral health and substance use disorder Physical, speech and occupational therapy.
Common non-covered benefits. Finding a primary care provider. Finding a specialist, behavioral health or hospital resource. After office hours or emergency care. Out-of-area care and benefit coverage. How to submit a claim. You can submit your claim one of two ways: Mail your claim form To print and mail your claim form, log in to My Account, select the My Documents tab, choose Forms. Choose the form for your type of claim and fill in the required information. Then, mail the form using the directions included.
If you do not have internet access, you may request a paper claim form by calling Member Services at the telephone number on the back of your member ID card. Submit your claim form online CareFirst also offers online claims submission for medical, dental and behavioral health claims. From your computer or mobile device, log in to My Account and select Claims. Enter the requested information, upload the required documents and submit.
Understanding the review process. The medical review process includes, but is not limited to: Preservice review The preservice review serves as a check to assure that members receive the right service in the right setting at the right time. Requests for review include high-cost, complex inpatient, experimental, cosmetic, and outpatient services.
The preservice review also helps ensure services are provided by in-network providers. Your doctor must initiate your authorization request. All admissions are reviewed and categorized by severity level.
The urgent review process continues until the member is approved to go home. Concurrent review decisions are made within 24 hours.
Post-service review Members may be eligible for a post-service review. CareFirst collaborates with facility administrators, medical clinicians and members to determine needs based on medical criteria and member benefits. Decisions must be made within 30 calendar days of the initial request.
Pharmacy procedures. Generics are dispensed when available unless your provider determines that a brand-name drug is necessary for your overall health. There may be cost-sharing implications for choosing non-preferred brand medications when generics are available. You should always check with your doctor to make sure a generic alternative is right for you. Prior authorization from CareFirst is required before you fill prescriptions for certain drugs.
Your doctor may need to provide some of your medical history or laboratory tests to determine if these medications are appropriate. Without prior authorization from CareFirst, your drugs may not be covered.
Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. Group Hospitalization . CareFirst offers HMO and PPO plans with deductibles and monthly costs to meet your budget. Plans offer core health benefits and preventive services, including: Prescription drugs; . You will still receive quality care through the CareFirst CHPMD benefits and provider network. And we will continue to help you get the care you need. If you have any additional questions, .