Frequently Asked Questions

Welcome to the FAQ section for the State of Maryland. These Frequently Asked Questions provide general information, but do not contain a full description of your benefits. Please refer to your Certificate of Coverage for a full benefit explanation or call Member Services at the number on your ID card.

Select the plan you have questions about from one of the tabs below.

The Frequently Asked Questions below refer to the Exclusive Provider Organization (EPO) health plan. If this is not your plan, please select one of the other tabs above.

Enrollment

Q: How often can I change benefit plans?

A: You can only change your benefit plans during your open enrollment period, unless you have a qualifying "life event." Life events include but are not limited to, births, deaths, adoption, and divorce. Please notify your State of Maryland Employee Benefits Coordinator of the change in coverage. For more information, please refer to your Employee Benefit booklet.


General Information

Q: What happens to my coverage if I move out of the area?

A: Even though the EPO product only provides benefits for in-network services, it utilizes a large national network of PPO providers. So, even if you move out of the area, you will still be covered as long as you continue to seek services through in-network PPO providers. (See the About BlueCard section below for more information).

Q: How can I find out if I have a particular benefit?

A: You may contact Member Services at 410-581-3601 or 800-225-0131 for detailed benefit information for medical or vision services.

Q: Is my dependent covered while in college (in- or out-of-state)?

A: Even though the EPO product only provides benefits for in-network services, it utilizes a large national network of PPO providers. So, even if you have dependents that go to school out of the area, they will still be covered as long as they seek services from in-network PPO providers. (See the About BlueCard section below for more information).


ID Cards

Q: How do I order additional ID cards?

A: You may order a new ID card or additional ID cards by logging into My Account and clicking on "Request ID Card."

Q: What is my ID card for?

A: Your card is important to getting the most out of your health plan. You will present your card when you receive care. Always carry your membership card with you.

Q: Do I need to carry my ID card with me at all times?

A: Always carry your ID card with you and present it wherever you receive care. Our Member Services telephone number is on the front of your card. The back of the card lists other important telephone numbers to help you in accessing care.


ID Number Conversion to Non-SSN

Q: Will CareFirst still use my Social Security number?

A: Yes, CareFirst will still continue to use your Social Security number internally. CareFirst has adopted and enforces a strict Privacy Policy intended to safeguard the confidentiality of information that is necessary to operate our business.

Q: Does my doctor know to use the new number when submitting my claims?

A: Doctors and other health care providers were notified that we changed members' ID numbers and they should submit the new ID number on claims. It is important that you always show your ID card to your doctor or health care provider at every visit to ensure claims are submitted to the correct ID number.

Q: If I submit my own claims, what number should I use?

A: Include the ID number on your ID card to ensure the claim is filed accurately and to minimize claim payment delays.

Q: Should I show my new ID card to my doctor?

A: Yes, show your new ID card to your doctor and other health care providers at your next visit. The information on the card will enable the provider to file the claim accurately and minimize claim payment delays.


Member Services

Q: How do I get a provider directory?

A: The Preferred Provider Directory is available online.


Physicians and Other Providers

Q: Can I go to an out-of-network provider?

A: Benefits are available when obtained by an in-network PPO/PPN provider or BlueCard only. No out-of-network services are available through the EPO.

Q: How do I find an in-network provider?

A: To determine if a provider participates with the Preferred Provider network, you may search the online Provider Directory, which contains the most up-to-date provider listing available.


Travel Coverage

Q: What do I do if I need coverage while traveling?

A: Even though the EPO product only provides benefits for in-network services, it utilizes a large national network of PPO providers. So, even if you are travelling, you will still be covered as long as you seek services from in-network PPO providers. (See the About BlueCard section below for more information).


Emergency Coverage

Q: What happens if I have an emergency and the providers who treat me are not in the PPO network?

A: We recognize that in emergency situations you may not always have control or the ability to look for participating providers; therefore, claims for true medical emergencies will process at the in-network level even if the provider is not a preferred provider.


About BlueCard

Q: What is BlueCard?

A: The BlueCard Program offers the same advantages provided to members who live, work or travel outside the CareFirst service area of MD, DC and Northern Va. The BlueCard Program allows members to utilize the BlueCross BlueShield national network of PPO providers. With BlueCard, if you obtain services through a preferred provider, you will receive benefits at the in-network level. Call BlueCard at 1-800-810-BLUE to obtain names of in-network participating providers or you can search for participating providers on the CareFirst website.


Flu Shots

Q: Do I have coverage for a flu shot?

A: Flu shots are covered at 100% with no copayment when seeing an in-network provider. There are no out-of-network benefits with this plan. Additionally, members can now choose to get a flu shot at Target Clinics or CVS Minute Clinics at the same in-network level.