hey is any one there

Carefirst Bluechoice is better if you need fertility coverage. Pretty sure they are the only Federal plan that fully covers IUI plus meds.

Anonymous wrote:

Anonymous wrote:I currently have CareFirst blue choice high and have been happy with it, but as PP said, the premium is going up a lot. I plan to switch to the standard plan next year. There is a deductible but it does not apply to doctor visits or prescriptions and you can get the deductible reduced by having a physical done.

The FEHB CareFirst plans do not require referrals for specialists and I haven't found a doctor I wanted to see who was not in-network.

Forgot to mention that I had MD IPA in the past. MD IPA had some visions and dental coverage included which was nice, but I found the referral and pre-certifiaction process for things like MRIs, etc. cumbersome. Carefirst seems much less HMO-like in that respect.

I also looked at BCBS Basic for next year but after running the numbers, for our family, it looked like we would come out better cost-wise with CareFirst standard (even though the premiums are a bit more, the doctor, prescription and imaging co-pays are less).

I keep hitting enter too soon

The 30 percent co-insurance for agencts and drugs in conjunction with treatment for BCBS refers to things like if you have an MRI and they use contrast dye or you have a cortisone injection as part of a orthoepdic visit, etc. I can see how that could potentially really add up if you have a hospitalization. BCBS basic also has a higher catastrophic maximum than CareFirst standard.

Anonymous wrote:I currently have CareFirst blue choice high and have been happy with it, but as PP said, the premium is going up a lot. I plan to switch to the standard plan next year. There is a deductible but it does not apply to doctor visits or prescriptions and you can get the deductible reduced by having a physical done.

The FEHB CareFirst plans do not require referrals for specialists and I haven't found a doctor I wanted to see who was not in-network.

Forgot to mention that I had MD IPA in the past. MD IPA had some visions and dental coverage included which was nice, but I found the referral and pre-certifiaction process for things like MRIs, etc. cumbersome. Carefirst seems much less HMO-like in that respect.

I also looked at BCBS Basic for next year but after running the numbers, for our family, it looked like we would come out better cost-wise with CareFirst standard (even though the premiums are a bit more, the doctor, prescription and imaging co-pays are less).

I currently have CareFirst blue choice high and have been happy with it, but as PP said, the premium is going up a lot. I plan to switch to the standard plan next year. There is a deductible but it does not apply to doctor visits or prescriptions and you can get the deductible reduced by having a physical done.

The FEHB CareFirst plans do not require referrals for specialists and I haven't found a doctor I wanted to see who was not in-network.

I started a similar thread a week or so ago, and there was a lot of confusion.

First of all, this is just for the FEDERAL plans (FEHB).

The Carefirst plans are regional options (only MD, DC and VA).

The Carefirst High is an HMO, but it looks like they don't require referrals for everything. However, the premiums seem high. You have to use an in-network provider.

The Carefirst Standard option is a POS. There is a deductible. But there are also options (it appears) to use out-of-network providers at higher cost.

I haven't looked into the High Deductible Carefirst option. That's a completely different animal entirely.

The BCBS options are national plans.

The BCBS Standard has options for out-of-network providers, but it also has a percentage co-insurance (which always makes me nervous) and higher premiums.

The BCBS Basic plan does not cover anything out-of-network. It has lower premiums. It does have some weird language about a 30 percent co-insurance for "agents, drugs" et cetera used in conjunction with treatments. I have no idea what this means, and people who have the coverage don't seem to be aware of it.

I have been on MDIPA, a regional HMO, for years. I think the coverage is very good, but the referral process is cumbersome and there are some weird radiology location restrictions. AND the premiums are going up significantly.

I have been debating whether or not to switch to either BCBS Basic (national plan) or Carefirst Standard (the regional POS). Both of them have lower premiums, but I am nervous about switching.

If anyone can weigh in, that would be great. The BCBS Standard PPO and the Carefirst High HMO are both around the same premium-wise as my current plan, so I'm not interested in those.

I'm not OP, but look forward to information!

BlueChoice is the HMO product offered by CareFirst. If you don't want HMO, then do not choose BlueChoice!

Yeah-with a PPO or fee for service, you can see any doctor, no referrals, and you will get reimbursed by insurance. Your reimbursement will be lower than if it was an in network doctor, and the level if reimbursement varies between basic and standard.

With an HMO, if the doctor is not in network, you won't get reimbursed for much. There are some exceptions. BCBS has a pretty large network in the DC region, so this may not be much of an issue. HMOs also have a reputation of being more resistant to covering extra tests, etc.

I'm sure there are other small coverage differences.

Yes, for the Feds, the Blue Cross Blue Shield plans are national, and fee for service. CareFirst is the Maryland DC product. CareFirst has the huge BCBS provider network. You wouldn't see much difference there. Pick the high option HMO under CareFirst and you are not required to get referrals any where.

The CareFirst regional plans are HMOs.

Carefirst is a company that provides BCBS insurance.

On the opm.gov site, I see these 5 plans..

- Blue Cross and Blue Shield Service Benefit Plan -Basic- Nationwide
- Blue Cross and Blue Shield Service Benefit Plan -Std- Nationwide
- CareFirst BlueChoice -HDHP- All of Maryland
- CareFirst BlueChoice -High- All of Maryland
- CareFirst BlueChoice -Std- All of Maryland

What is the difference between CareFirst and Blue Cross Blue Shield? I thought Carefirst _was_ Blue Cross Blue Shield?

I did notice that the CareFirst plans seem to have a significantly lower Overall Plan Satisfaction score. Anybody know why this is?

Thanks a bunch.