Provider Network

The CareFirst Group Advantage plan is a passive PPO, which means you can see doctors and other healthcare providers both in and out of our network and pay the same cost share. In-network providers include local providers in Maryland, Washington D.C. and northern Virginia who CareFirst has contracted with directly as well as nationwide providers who participate in the BlueCross BlueShield Medicare Advantage PPO network. You also have access to out-of-network providers that participate in Medicare and agree to bill CareFirst (or the local BlueCross BlueShield plan if outside Maryland, Washington D.C. or Northern Virginia).

What do I pay an in-network doctor?

You pay your copay or coinsurance according to your plan benefits. Your doctor or healthcare provider will bill CareFirst for the rest of the cost of your service(s).

How can I find a network provider?

Visit carefirst.com/findadocmappo and select the Medicare Advantage (PPO) network.

What is an out-of-network doctor?

An out-of-network doctor or healthcare provider does not have a contract with CareFirst.

Can I see any out-of-network doctor?

You can see any out-of-network doctor or healthcare provider that participates in Medicare and accepts the plan. Accepting the plan means the doctor is willing to treat you and bill your health insurance plan.

What if my doctor will not accept the plan?

We’ll be happy to talk to your doctor to explain how the plan works. Usually, that’s all that’s needed. You may also share this flier with your provider.