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Before you receive care — understand your options!

HealthyBlue Triple Option gives you the freedom to visit any doctor, regardless of whether they participate in the BlueChoice network or CareFirst's Preferred Provider Organization (PPO). However, greater flexibility comes with higher costs to you, so be sure you understand the difference between a BlueChoice provider, a CareFirst PPO provider and an out-of-network doctor, since the cost difference can be significant.

In-Network (Options 1 and 2)
Out-of-Network (Option 3)
Laboratory and Hospital Information

CareFirst BlueChoice Provider Networks

Save the most money when you visit your personal PCP and get the referrals for any specialty care.
If you choose to visit a specialist without a referral, you'll receive Option 2 benefits and pay higher out-of-pocket costs.

CareFirst Preferred Provider Organization (PPO) Network

PPO providers have agreed to accept CareFirst's negotiated rates.
- You have a higher annual deductible than in Option 1 and 2.
- You will likely pay more out-of-pocket costs.
Non-Participating Providers
- You may have to pay the doctor's actual charges at the time you receive care (not the CareFirst negotiate rate).
- You may have to file a claim for reimbursement.
- You will have a higher deductible and/or copay.
- You could be billed for the difference between CareFirst's rate and the provider's actual charges.

Laboratory and Hospital Information

There are networks for laboratory services and hospital visits, just like you have with doctors. These networks have contracted with CareFirst BlueChoice to help reduce costs while offering convenient and necessary services.

Laboratory Services

To ensure you receive the maximum laboratory benefit from HealthyBlue, you must use a LabCorp® facility for any in-network laboratory services. Services performed at any facility other than LabCorp will be charged at the out-of-network cost and will be subject to the deductible.
Also, any lab work performed in an outpatient hospital setting will require a prior authorization from your personal PCP in Option 1, but not in Options 2 or 3. But remember, you may have higher out-of-pocket costs in Options 2 and 3 depending on you particular plan, so be sure to check the benefit summary.
LabCorp has approximately 70 locations throughout Maryland, D.C. and Northern Virginia. To locate the LabCorp patient service center near you, call (888) LAB-CORP or visit www.labcorp.com.

Hospital Authorization

In-network providers will obtain all needed authorizations for you for covered services.
For services and hospital admissions provided by out-of-network providers members are responsible for making sure all preauthorizations are received. For information, call toll free at 1-866-PREAUTH.