Manage Your Money and Health
Your health care. Your wellness. Your costs.
Most people believe that the sole purpose of an insurance company is to process paperwork and file medical claims on their members. While those items are important, we also are here to help you — help you understand health insurance, stay healthy and lower your health care costs.
The links below will point you in the right direction as you explore great ways manage your coverage, stay healthy and save money.
Understanding Your Coverage Options
A change in your insurance coverage may leave you a little lost, trying to understand what individual and family options are available to you. You probably will have a lot of questions, and we want to be here to help you find answers to those questions — quickly and easily.
There are many reasons your employer/group coverage may change or end:
- Work status change - from full-time to part-time
- Loss of job
- Age out of parent’s insurance plan
- High premium costs – looking to explore other less costly options
- Retirement
In any of these situations you can begin exploring coverage options by looking into what is offered and asking yourself:
- What is covered under each insurance plan option I am considering?
- What is the cost of the coverage (premium, deductibles, out-of-pocket expenses)?
- How does my medical history affect costs and coverage? (Medical Underwriting)
- What does COBRA cover and what is the cost? (if losing employer/group coverage)
While looking into plan options, it is important to understand the main types of plans available to you, and the coverage and/or cost savings benefit each type of plan provides.
Option Types:
- A high deductible plan - allowing you to pay only for coverage you and your family actually need
- A comprehensive HMO plan for your children - offering appropriate coverage for children who typically require more doctor visits
- Point of Service and Opt-Out Plan (POS) - providing all of the benefits of a HMO with access to out-of-network providers
- Preferred Provider Organization (PPO) – offering you more flexibility with the physicians you choose and out of area services
- COBRA – allowing you to continue your employer’s health plan coverage for a specified period of time (some restrictions may apply)
Losing Employer/Group Coverage
Your employer/group coverage is ending or you have reached an age where you can no longer be covered under your parents insurance policy. Now, you are faced with exploring and selecting an individual insurance plan that meets your needs, and those of your family, while staying within your budget.
Knowing what to consider when researching plan options can give you the confidence you need to choose an appropriate plan for you.
- Decide on a Plan - information, resources and frequently asked questions to help you compare, explore and understand insurance plans, their coverage and costs
- Compare Plans - information to help you summarize the cost and coverage benefits for each type of plan coverage
- What is Medical Underwriting - details to help you know what role Medical Underwriting plays when applying for individual and family coverage
Understanding plan options and costs will help you select coverage to meet your health and financial needs.
- Need to Buy Insurance - details on plan options and pricing, helping you select the right plan for you and your family
- Call: Contact a CareFirst product specialist at 410-356-8000 in Baltimore or toll-free at 1-800-544-8703
- Ask Blue - information and pricing on Blues Plans across the United States
- Coverage Advisor – a resource to help estimate your annual health care costs
Ensuring your doctors and specialists are covered under the plan you are considering will give you peace of mind.
- Find a Doctor – check to sse if your doctor or specialist is covered under the plan you are considering by using Find a Doctor
Exploring COBRA and its cost will help you understand all options available to you.
- COBRA – the Consolidated Omnibus Budget Reconciliation Act allows employees to continue their group coverage for a specified period of time
Coverage Options for Retirees
You may be nearing the age for retirement and looking forward to enjoying this time. The last thing you want to worry about is your health care coverage. We are here to help you with a variety of resources providing you the information you need to select an insurance plan that is right for you..
MediGap - health coverage that fills in the "gaps" to standard Medicare, helping pay for medical expenses not covered by Medicare.
- How Medicare and Medigap plans work?
- How to choose a Medigap policy
- Explore types of CareFirst MediGap plans and costs (no obligation to purchase)
MediCare- a fee-for-service plan managed by the Federal Government
- Medi-CareFirst.com - provides plan information, costs and tips for effective plan management
- The government's medicare site - great resource to explore federal medicare information and policies
- Medicare and You - informational brochure created by the Centers for Medicare & Medicaid Services
Part D Plans- Medicare prescription drug coverage
- Details about Part D plans - offered by Medi-CareFirst
Other Individual & Family Plan Options
- Need to Buy Insurance? - details on plan options and pricing, helping you select the right plan for you and your family
- Call: Contact a CareFirst product specialist at 410-356-8000 in Baltimore or toll-free at 1-800-544-8703
- Ask Blue - information and pricing on Blues Plans across the United States
What is COBRA?
COBRA (Consolidated Omnibus Budget Reconciliation Act) gives workers and their families who lose their health benefits (due to voluntary/involuntary job loss, death/divorce of a spouse) the right to choose to continue their group health benefits for a specified period of time.
Knowing where to find answers regarding COBRA will help you understand all available coverage options.
- COBRA & CareFirst Coverage Options - Read about CareFirst coverage options, common COBRA questions and general information, and calculate your subsidized COBRA premium
- Contact a representative from your employer’s Human Resources Department to learn about COBRA through your employer
Managing Your Health Care Costs
Right now, everyone can use a little more money in their pockets. As a member, you have access to simple ways to reduce your health care costs.
Comparing hospital & treatment costs can save you money.
- Hospital Comparison Tool - Provides a side-by-side comparison of the hospitals in your area, based on the number of procedures completed, the rate of complications, the average length of stay and more. Access is available to members through My Account.
- Treatment Cost Tool - CareFirst members with certain health plans (including some CDH plans and the Federal BlueChoice HMO plan), have access to medical cost information and number of days for treatment for 22 major health categories. Access is available to qualifying members through My Account.
Researching your prescription costs may help you plan your medical spending.
- Drug Pricing Tool - Allows members with most prescription plans to check prescription costs. Using this tool is simple. You need to know the drug name, prescribed dosage and a pharmacy near you. In seconds, you will know how much you have to pay. You may access the Drug Pricing Tool through My Account.
Note: If you have not reached your deductible, your cost will be the CareFirst discounted drug cost. If you are in a managed care plan or have already met your deductible, you will receive your copay amount.
Understanding when to use generic drugs may save you 20%-80% on your prescription costs.
- Generic Drug Information - We have detailed information on the cost differences between brand name and generic drugs, facts about generic drugs, and what we are doing as in insurance copy to reduce prescription costs for you.
Using in-network physicians can save you from high out-of-pocket expenses.
- Find a Doctor - Knowing which doctors are covered by our plan can save you money. In-networks physicians cost you less out-of-pocket.
Maintaining Your Health and Wellness
Members can explore our wellness discount opportunities, health related information and tips offered to enhance your overall well-being and save you some money.
Maintain your wellness. Stay informed. Live healthier. Enjoy savings.
Health resources, tools, tips and information to help you maintain mind, body and spirit.
- My Care First is a wellness Web site that offers an online library full of information on a large selection of health topics, health risk assessments, wellness tools, healthy recipes and much more. These great resources are available to help you and your family lead healthier lifestyles.
Health service and program discounts — keeping you at the top of your game, while saving you money.>
- Options - Our regional health and wellness discount program for members provides savings on a broad range of programs and services in your community. There are no claim forms, referrals or paperwork to fill out – all you need to do is show your CareFirst BlueCross BlueShield ID card!
- Blue365 - Offers CareFirst members discounts on national services, programs and alternative therapies. All you need to enjoy these discounts is your CareFirst ID card.
Health assessments for CareFirst members with certain plan coverage.
- My HealthProfile - Members with individual insurance plans, as well as some members with group coverage (if the employer group has selected this option), will be able to access this health risk assessment option as part of their benefits package.
My HealthProfile provides a personalized health report that alerts you to possible health risks and offers recommendations on how to stay healthy.