BlueChoice HMO Gold $1,750. 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 … This Qualified Health Plan is being offered through the SHOP Exchange. endstream endobj 614 0 obj <. 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 … Apply For This Plan. Non-Grandfathered Maryland Small Groups . Note: The BlueChoice HMO plan is available only to bargaining unit members and current participants. Apply Filter. CareFirst BlueChoice, Inc. 840 First Street, NE. Customer Service 1 (800) 997-1654 24 hours a day, 365 days a year. … endstream endobj startxref Verify eligibility for BlueCross BlueShield of South Carolina and BlueChoice HealthPlan of South Carolina members by using My Insurance Manager, our secure online tool. BlueChoice Select $1,000, $1,750, $2,500, and $5,000 Plan Deductibles . 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. Find more phone numbers 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 N/A. BlueChoice (HMO) Forms. Apply For This Plan. Washington, DC 20065. Employees may call the BlueChoice HMO Customer Service phone number 1-800-464-1367 for all questions. Members can use the claim forms for services rendered by in-area or out-of-area non-participating providers. hŞbbd``b`Œ?ADˆX $VÃXŒ«@ÜUpîj8wªb¸N.w/�`N â�`Zb­±l@¬V�b q^–�‰‘‰ d ãà#ş3ìz` µZ¸ Toll-free: (866) PREAUTH (773-2884) Mental Health/Substance Abuse Care Call the telephone number on your member ID card under the Mental Health/ … Phone Number. View Brochure Summary of Benefits Provider Directory. 202-479-8000 . Blue Precision HMO Plans. Plan Category. Visit the disease management section of provider. BlueChoice. You may contact Member Services by calling the telephone number on your card. CareFirst BlueCross BlueShield (CareFirst) 10455 Mill Run Circle. Gold HMO Get a Quote. Medical Products . BlueChoice HMO Gold 1750 by CareFirst BlueChoice, Inc. 2021 Plan Details. 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 If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. ВНИМАНИЕ:Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Our Rating: All Blue Precision HMO Plans offer the same set of essential health benefits, quality and amount of care. This plan allows members to visit specialists directly without referrals. An independent licensee of the Blue Cross and Blue Shield Association. Dental Vision Health. For Products Offered off of the Maryland Health Benefits Exchange . With BlueChoice HMO Open Access-High Option, your primary care provider (PCP) provides routine care and coordinates specialty care. Zip Code: 21215 (edit) Applicant: 12/6/1985 Male (edit) Benefits & Coverage. Apply Filter. Viewing and printing this document requires Adobe Acrobat Reader, which can be downloaded free from the Adobe site. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. Check Provider Credentials & Certifications. 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. 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 … CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. 613 0 obj <> endobj 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. Members should call the phone number on the back of their member​ identification card. Carefirst Bluechoice Phone Number search trends: Gallery. carefirst.com for more information on behavioral health services. Medical Claim : Membership Change Request If you buy insurance through your employer, please contact your employer to make changes. 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 … 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 . Benefits of BlueChoice HMO Choose from more than 37,000 doctors, specialists and hospitals in Maryland, Washington, D.C. and … Washington, DC 20065. services by calling the number on the back of their member ID card. The BlueChoice ... please Contact Us for the phone number of the regional sales office near you. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. Gold Plans have a higher monthly premium and often lower out-of-pocket costs than Silver and Bronze plans. %%EOF $370.31 /mo. All others may call 855-258-6518 and wait through the dialogue until prompted to push​ 0. Find out more about Carefirst Bluechoice Phone Number Carefirst Bluechoice Phone Number. Not all services and procedures are covered by your benefits contract. Owings Mills, Maryland 21117-5559. $326.01 /mo. CareFirst BlueChoice, Inc. 840 First Street, NE . The Blue Precision Gold HMO Plans are the most expensive plans, but also have the most comprehensive benefits. Apply Filter . Plan Type. View Brochure Summary of Benefits Provider Directory. 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. hŞb```b``Öe`e``Seàc@ >6v� EPO HMO POS PPO. Zip Code: 21215 (edit) Applicant: 11/30/1985 Male (edit) Benefits & Coverage. My Health Toolkit Access your digital ID card, check claims status, view plan details, and check your benefits. All. Zip Code* Apply Filter. Звоните 1-844-662-2276. 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: You have the right to get this information and​ assistance in your language at no cost. For Products Offered off of … 202-479-8000. 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. 202-479-8000. CareFirst BlueChoice members who choose to see a non‑participating specialist still must contact CareFirst at 800‑245‑7013 to authorize services. Your CareFirst BlueChoice provider should obtain any necessary admission authorizations for covered services. BlueChoice HMO Summary of Benefits Maryland Small Group Reform. Participating providers are responsible for filing claims for their services. GROUP CONTRACT APPLICATION. Plan Level. CareFirst BlueChoice reserves … Claim forms should not be used for services rendered through any discount dental or vision program or for the options program for alternative therapies. Non-Grandfathered Maryland Small Groups. The discount is applied by the provider at the time of service for such programs. 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. 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. EVIDENCE OF COVERAGE FOR A QUALIFIED HEALTH PLAN . In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. 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. Changes will not be processed unless received from your employer. CareFirst BlueChoice, Inc. 840 First Street, NE. Maintenance Organization (HMO) participating specialist for care. Individual Deductible: N/A Individual Max. GROUP CONTRACT APPLICATION . 0 This means that you pay for prescriptions costs (at BCBS negotitated discount rates) until you reach your individual deductible. 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. “World’s Most Ethical Companies” and “Ethisphere” names and marks are registered trademarks of Ethisphere LLC. Name: Telephone Number: Title: Email Address: Type of Organization Sole Proprietorship Partnership Corporation Other _____ Nature of Business: Federal Tax Identification Number: EMPLOYER CONTRIBUTION . Verify eligibility for out-of-state members by calling 800- 676-BLUE (2583). The member should not be instructed to call CareFirst BlueChoice for the referral. Group Medical Plans. CareFirst BlueChoice, Inc. 840 First Street, NE Washington, DC 20065 202-479-8000 An independent licensee of the Blue Cross and Blue Shield Association . Washington, DC 20065 . Written correspondence is preferable so that a record of the inquiry is maintained. BlueChoice ® PPO . A private not-for-profit health service plan incorporated under the laws of the State of Maryland. 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. An independent licensee of the Blue Cross and Blue Shield Association . %PDF-1.6 %âãÏÓ 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. and. MD/CFBC/SE/HMO-BCOO/GCA (R. 1/16) 1 CFBC Small Group HMO . In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). 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. BlueChoice HMO Value Silver $2,250. 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. BlueChoice HMO HSA Bronze $6,550. 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. Valid in these Zip Codes. Bronze Silver Gold Platinum Catastrophic. This number is listed on the front of the BlueChoice HMO membership card. 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. 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. Out-of-Pocket: $6,650 Copay: No Charge Eligible Locations County. 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 The BlueChoice HMO is a managed health care plan consisting of a network of physicians and other medical providers. CFBC HMO. Other Member Services contact numbers are also available. 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