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You may contact Member Services by calling the telephone number on your card. Changes will not be processed unless received from your employer. Apply For This Plan. Phone Number. “World’s Most Ethical Companies” and “Ethisphere” names and marks are registered trademarks of Ethisphere LLC. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Your CareFirst BlueChoice provider should obtain any necessary admission authorizations for covered services. View Brochure Summary of Benefits Provider Directory. Plan Category. Important terms Allowed benefit is the dollar amount CareFirst BlueChoice, Inc. allows for the particular service in effect on the date that service is rendered. Insurance Type: ACA (Obamacare) Plan Name: BlueChoice HMO HSA Bronze $6,550: Plan ID: hhs-28137MD0370011: Plan Year: 2018: Insurance Provider: CareFirst BlueCross BlueShield: Metal … If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. With a BlueChoice HMO Open Access plan, your primary care provider (PCP) ... Home Care, please call Member Services at the phone number listed on your identification card. hŞb```b``Öe`e``Seàc@ >6v� The Blue Precision Gold HMO Plans are the most expensive plans, but also have the most comprehensive benefits. EPO HMO POS PPO. VA/CFBC/DB/HMO (1/17)-HIX 1 HMO OA-On Exchange CareFirst BlueChoice, Inc. 840 First Street, NE Washington, DC 20065 ... Richmond, VA 23218, or by phone at 1-800-552-7945 (toll-free within Virginia), 1-877-310-6560 (national toll-free number), or 804-371-9691. Blue Cross Blue Shield of Georgia 1-800-233-5765 TDD/1-800-368-4424 24/7 NurseLine For emergency room referral and for medical information from a registered nurse, 24-hours a day, seven days a week. BlueChoice HMO Gold $1,750. Name: Telephone Number: Title: Email Address: Type of Organization Sole Proprietorship Partnership Corporation Other _____ Nature of Business: Federal Tax Identification Number: EMPLOYER CONTRIBUTION . ВНИМАНИЕ:Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Insurance Type: ACA (Obamacare) Plan Name: BlueChoice HMO Value Silver $2,250: Plan ID: hhs-28137MD0370014: Plan Year: 2020: Insurance Provider: CareFirst BlueCross BlueShield: Metal … BlueChoice HMO Value Silver $2,250. TTY/TDD Service (For callers who are deaf or hard of hearing) Dial 711 and follow the prompts 24 hours a day, 365 days a year. Apply Filter. Find more phone numbers If you enroll in the BlueChoice HMO, all of your health care must be coordinated and approved by your primary care physician and received in-network. 613 0 obj <> endobj $370.31 /mo. Members may choose to take part in our Away From Home Care program which allows you to take your plan benefits with you if you’re in- or out-of-area for at least 90 days. Washington, DC 20065 . BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Members can use the claim forms for services rendered by in-area or out-of-area non-participating providers. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For Products Offered off of … An independent licensee of the Blue Cross and Blue Shield Association. EVIDENCE OF COVERAGE FOR A QUALIFIED HEALTH PLAN . Non-Grandfathered Maryland Small Groups . Employees may call the BlueChoice HMO Customer Service phone number 1-800-464-1367 for all questions. s®œ8´úâd†Õ=Vs(70 æåä�üVJÕIı½(Oj{Ìɨ¯ğÅ�bViq™Š§Í.Üİ7ibVøÆ>—Ÿ‡ÆSÕƒÛ¥r-=«ò ns€™h ¡jmŠƒ€}Â@ZˆÃÀJf1ğp?ddd@%9?ë,JSnVø¸HnCÇ~†ü@Y&æ ¾@íL–L–€l_&~ 8“71lğeØğ‰åÂG~ ›ÁRğ¢2‚¥à_扊€&ğ1\ ™ÃğA€‘S5€�KiF ş Ä^'8!|f íÃÀ®ú&ıR¢u»`ÈÍ¢•3íz-¯ÊÚ§İr�ö6Á¤éã¡4ÁäÅK«J¼®­K™¨-Úá¿À¦d¢óq^ �€‰Œ‡Y9x€ÁàÍÀpZHcUB n}׈uŒ ‰Otá Verify eligibility for BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina members by using My Insurance Manager, our secure online tool. Washington, DC 20065. With BlueChoice HMO Open Access-High Option, your primary care provider (PCP) provides routine care and coordinates specialty care. Washington, DC 20065. For the BlueChoice Select plans with a $1,000, $1,750, $2,500, or $5,000 individual deductible, the a prescription drug card benefit is subject to deductible and coinsurance. BlueChoice. For Products Offered off of the Maryland Health Benefits Exchange . Benefits of BlueChoice HMO Choose from more than 37,000 doctors, specialists and hospitals in Maryland, Washington, D.C. and … GROUP CONTRACT APPLICATION. Bronze Silver Gold Platinum Catastrophic. CareFirst BlueChoice, Inc. 840 First Street, NE . %%EOF Out-of-Pocket: $6,650 Copay: No Charge Eligible Locations County. endstream endobj 614 0 obj <. Owings Mills, Maryland 21117-5559. Gold Plans have a higher monthly premium and often lower out-of-pocket costs than Silver and Bronze plans. Plan Type. BlueChoice HMO Referral Silver 4000 Summary of Benefits Non-Integrated Deductible ... free phone number on the front of your CareFirst BlueChoice ID card for assistance in selecting a PCP or obtaining a printed copy of the CareFirst BlueChoice provider directory. Other Member Services contact numbers are also available. Our Rating: All Blue Precision HMO Plans offer the same set of essential health benefits, quality and amount of care. Note: The BlueChoice HMO plan is available only to bargaining unit members and current participants. carefirst.com for more information on behavioral health services. All. Звоните 1-844-662-2276. Contact number; HMO Gold, Green, Healthy Heart and Ruby plans: 1-800-275-4737: HMO Sapphire and HMO SNP plans: 1-800-431-9007: North East Medical Services (NEMS) - HMO Sapphire Premiere II: 1-833-502-8919: TTY (hearing and speech impaired) 711 Medical Claim : Membership Change Request If you buy insurance through your employer, please contact your employer to make changes. 644 0 obj <>/Filter/FlateDecode/ID[<3E7D0B0E630BD645A36328095085430E>]/Index[613 64]/Info 612 0 R/Length 96/Prev 63399/Root 614 0 R/Size 677/Type/XRef/W[1 2 1]>>stream and. Zip Code: 21215 (edit) Applicant: 12/6/1985 Male (edit) Benefits & Coverage. This Qualified Health Plan is being offered through the SHOP Exchange. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. BlueChoice HMO Open Access Summary of Benefits : istrict of Columia oernmentour Health Benet Options 15: CST4713-1P (11/19) DC 51+ Option 3: Services In-network You Pay: 1: HOSPITAL ALTERNATIVES: Home Health Care No charge* Hospice No charge* Skilled Nursing Facility $100 per admission: MATERNITY Preventive Prenatal and Postnatal Office : Visits No charge* Delivery and … Members should call the phone number on the back of their member​ identification card. 0 CareFirst BlueChoice reserves … Dependent Name Signature Email Address Cell Phone Number CareFirst BlueChoice, Inc. will not sell your email address or cell phone number to any third party and we do not share them with third parties except for CareFirst BlueChoice, Inc. vendors that perform functions on our behalf or to comply with the law. Non-Grandfathered Maryland Small Groups. CareFirst BlueCross BlueShield (CareFirst) 10455 Mill Run Circle. BlueChoice HMO HSA Bronze $6,550. Group Medical Plans. Participating providers are responsible for filing claims for their services. Apply Filter . Medical Products . Viewing and printing this document requires Adobe Acrobat Reader, which can be downloaded free from the Adobe site. This plan allows members to visit specialists directly without referrals. Dental Vision Health. BlueChoice HMO Coordinated Care with a Primary Care Provider With a BlueChoice HMO plan, your primary care provider (PCP) provides preventive care and coordinates specialty care using a large network of CareFirst BlueChoice specialists within a referral system. Check Provider Credentials & Certifications. BlueChoice Select $1,000, $1,750, $2,500, and $5,000 Plan Deductibles . N/A. All others may call 855-258-6518 and wait through the dialogue until prompted to push​ 0. Zip Code: 21215 (edit) Applicant: 11/30/1985 Male (edit) Benefits & Coverage. Plan Level. You have the right to get this information and​ assistance in your language at no cost. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Apply For This Plan. BlueChoice (HMO) Forms. Maintenance Organization (HMO) participating specialist for care. CareFirst BlueChoice, Inc. 840 First Street, NE. The BlueChoice HMO is a managed health care plan consisting of a network of physicians and other medical providers. Verify eligibility for out-of-state members by calling 800- 676-BLUE (2583). The discount is applied by the provider at the time of service for such programs. This means that you pay for prescriptions costs (at BCBS negotitated discount rates) until you reach your individual deductible. The member should not be instructed to call CareFirst BlueChoice for the referral. CareFirst BlueChoice, Inc. 840 First Street, NE Washington, DC 20065 202-479-8000 An independent licensee of the Blue Cross and Blue Shield Association . CFBC HMO. Toll-free: (866) PREAUTH (773-2884) Mental Health/Substance Abuse Care Call the telephone number on your member ID card under the Mental Health/ … Find out more about Carefirst Bluechoice Phone Number Carefirst Bluechoice Phone Number. 676 0 obj <>stream Visit the disease management section of provider. View Brochure Summary of Benefits Provider Directory. BlueChoice Network The BlueChoice network, one of the largest in Texas, is comprised of more than 500 hospitals and almost 35,000 physicians in all 254 Texas counties. Locate providers in the BlueChoice HMO network: You may call Blue Cross Blue Shield using the toll-free customer service number (1-800-424-8950) on the back of your health insurance card or use the instructions below to look up providers: CareFirst BlueChoice members who choose to see a non‑participating specialist still must contact CareFirst at 800‑245‑7013 to authorize services. Written correspondence is preferable so that a record of the inquiry is maintained. Name: Telephone Number: Title: Email Address: DC/CFBC/GCA/LG (R. 3/14) 2 BC(HMO), BCOO(OA), HB(HMO), HB2 Chief Executive Officer/President . Individual Deductible: N/A Individual Max. BlueChoice HMO Gold 1750 by CareFirst BlueChoice, Inc. 2021 Plan Details. An independent licensee of the Blue Cross and Blue Shield Association . endstream endobj startxref … Gold HMO Get a Quote. This number is listed on the front of the BlueChoice HMO membership card. CareFirst BlueChoice, Inc. 840 First Street, NE. Blue Cross Blue Shield of Georgia 1-877-724-2583 TDD/1-800-368-4424 Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. GROUP CONTRACT APPLICATION . %PDF-1.6 %âãÏÓ services by calling the number on the back of their member ID card. Claim forms should not be used for services rendered through any discount dental or vision program or for the options program for alternative therapies. $326.01 /mo. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. 202-479-8000. MD/CFBC/SE/HMO-BCOO/GCA (R. 1/16) 1 CFBC Small Group HMO . Not all services and procedures are covered by your benefits contract. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). SERVICES In-Network You Pay HOSPitAl AlternAtiveS8 Home Health Care No charge2 Hospice No charge2 Skilled Nursing Facility (limited to 100 days/year)5 No charge2 mAternity Prenatal and Postnatal Office Visits $20 per visit Delivery and Facility Services8 No charge2 Nursery Care of Newborn3 No charge2 Initial Office … hŞbbd``b`Œ?ADˆX $VÃXŒ«@ÜUpîj8wªb¸N.w/�`N â�`Zb­±l@¬V�b q^–�‰‘‰ d ãà#ş3ìz` µZ¸ 202-479-8000. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. 202-479-8000 . Employees who are currently members of the BlueChoice HMO plan and who have a Promina primary care physician will receive a letter from BlueChoice explaining the change, what it means to them and options they have. Apply Filter. 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