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The following BlueFund and Compatible HSA & HRA Plans are BlueChoice Opt-Out Plus (Open Access) based. Whether you choose an option as a BlueFund or Compatible plan, there is no difference in cost.
| NOTES: |
BlueFund Plans integrate with our fund administrator (FlexAmerica). |
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Compatible Plans do not integrate with a CareFirst fund administrator |
* HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan.
Please select from the following:
| MSGR BlueChoice Opt-Out Plus HSA Plans |
| Option |
Features |
Integrated Rx Plan |
Brochure Number |
| Option 1 |
$1,200 80%-20% |
$0/$25/$45 |
CUT6954 |
| Option 2 |
$2,000 80%-20%
|
$0/$25/$45 |
CUT6955 |
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| Non-MSGR 1-50 BlueChoice Opt-Out Plus Open Access HSA/HRA Plans |
| Option |
Features |
Rx Copay |
Brochure Number |
| Option 1 |
In: $1,200 Ded; 80% | Out: $1,800 Ded; 20% |
$0/$25/$45 |
CUT6956 |
| Option 2 |
In: $2,500 Ded; 80% | Out: $3,750 Ded; 20% |
$0/$25/$45 |
CUT6957 |
| Option 3 |
In: $4,000 Ded; 80% | Out: $6,000 Ded; 20%
|
$0/$25/$45 |
CUT6958 |
| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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| Non-MSGR 51-199 BlueChoice Opt-Out Plus Open Access HSA/HRA Plans |
| Option |
Features |
Brochure Number |
| Option 1 |
In: $1,200 Ded; 80% | Out: $1,800 Ded; 20% |
CUT6956 |
| Option 2 |
In: $2,500 Ded; 80% | Out: $3,750 Ded; 20% |
CUT6957 |
| Option 3 |
In: $4,000 Ded; 80% | Out: $6,000 Ded; 20%
|
CUT6958 |
| Option 4 |
In: $1,500 Ded; 80% | Out: $2,250 Ded; 20% |
CUT6959 |
| Option 5 |
In: $5,000 Ded; 80% | Out: $7,500 Ded; 20% |
CUT6960 |
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| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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| DC 1-50 BlueChoice Opt-Out Plus HSA/HRA Plans* |
| Option |
Features |
Brochure Number |
| Option 1 |
In: $1,200 Ded. | Out: $1,800 Ded. 80%- 20% |
CUT6973 |
| Option 2 |
In: $2,500 Ded. | Out: $3,750 Ded. 80%- 20% |
CUT6974 |
| Option 3 |
In: $4,000 Ded. | Out: $6,000 Ded. 80%- 20%
|
CUT6975 |
|
| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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| DC 51-199 BlueChoice Opt-Out Plus HSA/HRA Plans* |
| Option |
Features |
Brochure Number |
| Option 1 |
In: $1,200 Ded. | Out: $1,800 Ded. 80%- 20% |
CUT6973 |
| Option 2 |
In: $2,500 Ded. | Out: $3,750 Ded. 80%- 20% |
CUT6974 |
| Option 3 |
In: $4,000 Ded. | Out: $6,000 Ded. 80%- 20%
|
CUT6975 |
| Option 4 |
In: $1,500 Ded. | Out: $2,250 Ded. 80%- 20% |
CUT6976 |
| Option 5 |
In: $5,000 Ded. | Out: $7,500 Ded. 80%- 20% |
CUT6977 |
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| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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| VA 1-50 BlueChoice Opt-Out Plus HSA/HRA Plans |
| Option |
Features |
Brochure Number |
| Option 1 |
In: $1,200 Ded. | Out: $1,800 Ded. 80%- 20% |
BRC6551 |
| Option 2 |
In: $2,500 Ded. | Out: $3,750 Ded. 80%- 20% |
BRC6552 |
| Option 3 |
In: $4,000 Ded. | Out: $6,000 Ded. 80%- 20%
|
BRC6553 |
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| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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| VA 51-199 BlueChoice Opt-Out Plus HSA/HRA Plans |
| Option |
Features |
Brochure Number |
| Option 1 |
In: $1,200 Ded. | Out: $1,800 Ded. 80%- 20% |
BRC6551 |
| Option 2 |
In: $2,500 Ded. | Out: $3,750 Ded. 80%- 20% |
BRC6552 |
| Option 3 |
In: $4,000 Ded. | Out: $6,000 Ded. 80%- 20%
|
BRC6553 |
| Option 4 |
In: $1,500 Ded. | Out: $2,250 Ded. 80%- 20% |
BRC6554 |
| Option 5 |
In: $5,000 Ded. | Out: $7,500 Ded. 80%- 20% |
BRC6555 |
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| * HSA plans require a combined medical and Rx plan. HRA plans can be combined or can be purchased with a standard Rx plan. |
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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 BlueChoice, Inc., an affiliate company, also offers health benefit products and services on this site.
CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.
® Registered trademark of the Blue Cross and Blue Shield Association. ®' Registered trademark of CareFirst of Maryland, Inc. |
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