Question & Answers

Questions and Answers

The following are some of the most frequently asked questions from brokers
regarding the CareFirst BlueChoice products.

For your convenience the questions are listed by category:

Products and Benefits
Retiree Issues
Network and Providers
Pricing
Out-of-State
Administrative

	Products and Benefits
	Q:	Can you combine a BlueChoice product with BluePreferred? How?
	Q:	Are there deductibles on the prescription card?
	Q:	What costs are applied to the out-of-pocket maximum?
	Q:	Once the out-of-pocket maximum is met, what costs are the member's responsibility?
	Q:	Since BlueChoice is not yet available on the Eastern Shore, what happens to a group on the Eastern Shore that is renewing 10/1?
	Q:	What is available in the Individual Product market now?
	Q:	When will information on the individual BlueChoice product be available?
	Q:	How does BlueChoice affect PHN?
	Q:	Is there a transplant rider? What is covered under the transplant rider?
	Q:	Will the CapitalCare Preferred Discount Dental program be available under BlueChoice? If so, will it be available throughout Maryland?
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	Retiree Issues
	Q:	Why is retiree coverage not available?
	Q:	What will happen to a current FreeState member who is a retiree at renewal if the group chooses BlueChoice?
	Q:	How do I cover retirees under age 65?
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	Network and Providers
	Q:	How do you credential providers for the BlueChoice (HMO) network?
	Q:	How do you measure the quality of physicians?
	Q:	Is the BlueChoice provider network regional?
	Q:	Is the BlueChoice provider network available on the Internet? How often will it be updated?
	Q:	Do you have a directory of providers?
	Q:	What are you doing with the MPOS and CareFirst of Maryland PPN (PPO) networks?
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	Pricing
	Q:	What happens at renewal -- will CareFirst use average age calculations?
	Q:	Are you still keeping the three-year age bands? What is average age based on?
	Q:	Does a 51+ group have to go through Underwriting?
	Q:	Is BlueChoice going to be available on the rating disk?
	Q:	Broker Express doesn't provide a price list - will it in the future?
	Q:	How do BlueChoice rates compare with the previous Capital Choice plan?
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	Out-of-State
	Q:	Does HMO-USA or "BlueCard" apply to BlueChoice?
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	Administrative
	Q:	Do new applications have to be completed for accounts moving to BlueChoice from other CareFirst products?