CareFirst Blue Cross Blue Shield of Maryland Review

CareFirst Blue Cross Blue Shield (BCBS)

CareFirst BCBS is the largest not-for-profit health insurer in the Mid-Atlantic, serving over 3.4 million members. With strong roots in Maryland, D.C., and Northern Virginia, it offers ACA, Medicare Advantage, Medigap, Medicaid, and employer coverage. In 2026, CareFirst continues to leverage its robust provider network and the Blue Cross Blue Shield national access while addressing ongoing member service concerns.

Coverage Area (2026)

United States

CareFirst serves individuals in Maryland, the District of Columbia, and Northern Virginia—including Alexandria, Arlington, Fairfax, and parts of Prince William County. Employer plans are also available throughout this regional footprint. ACA plans and public coverage options are detailed in state enrollment guides and federal health plan summaries.

International

CareFirst members receive emergency coverage worldwide via the BCBS network and maintain in-network access nationwide while traveling—providing peace of mind across borders.

Provider Network

Over 56,000 providers participate in CareFirst’s network, covering 99% of local and 91% of national providers. Plan and network details are accessible through their member portal and open enrollment materials.

Plan Types Offered (2026)

Under-65 (Individual & Family)

• ACA Marketplace Plans
  CareFirst offers Bronze, Silver, and Gold ACA plans using HMO and PPO structures in Maryland, D.C., and parts of Virginia. These plans are subsidy-eligible and include preventive care, wellness tools, and essential health benefits.
• Short-Term Medical (STM)
  Not a major offering for 2026, though temporary coverage may be available through partner brokers.
• Employer-Sponsored Plans
  Offered to both small and large businesses, employer plans include medical, dental, vision, and wellness coverage. Resources for HR teams and employees are available through CareFirst’s benefits overview.
• Student Health Plans
  Not separately marketed under the CareFirst label.
• Medicaid
  Medicaid services are delivered through CareFirst Community Health Plan Maryland, which has reported improved satisfaction and access outcomes.

Medicare (65+)

• Medicare Advantage (MA)
  CareFirst offers HMO and D-SNP Medicare Advantage options across MD and D.C. with $0 PCP copays, bundled dental/vision/hearing, SilverSneakers®, OTC coverage, and transportation.
• Medicare Supplement (Medigap)
  CareFirst provides a full suite of Medigap plans (A, B, G, High G, L, M, N) with discounts and broad access.
• Part D Prescription Drug Plans
  Integrated with most Medicare Advantage plans. The 2025 deductible increased to $590, as outlined in recent plan updates.
• Retiree Group Medicare
  Not prominently featured but may be available through employer group contracts, such as those covered in USPS retiree guides.

Recent Changes in Cost and Options (2026)

Premiums and Rate Changes

Maryland ACA premiums rose 6.2% in 2025. While 1332 waiver protections have kept costs low relative to national averages, potential subsidy expirations in 2026 may drive higher rates.

Out-of-Pocket Costs

Out-of-pocket costs have risen modestly, particularly in Medicare Advantage, where D-SNP monthly premiums increased from $28.20 to $40.30. Medicare Part D deductibles also rose in tandem with broader CMS policies.

Medicare Advantage Updates

Plans have added more generous benefits for 2026—especially in dental, vision, and fitness categories. Telehealth services, OTC perks, and transportation remain bundled.

Plan Enhancements

CareFirst has continued investing in digital health access, including provider portals, financial literacy tools, and care coordination through Patient-Centered Medical Homes.

Network Agreements

No major changes have been reported in 2026. Provider access remains stable across the MD/DC/VA service area with extensive integration through the national BCBS network.

Consumer Experience Snapshot

Complaint Index

CareFirst receives below-average scores from NAIC and BBB due to recurring complaints regarding claims denials and service delays.

Satisfaction Scores

No ACSI data available. Internal satisfaction improvements reported for Medicaid enrollees, but ACA and Medicare feedback remains mixed.

Methodology

Our Health Insurance Rating Methodology scores insurers across five main categories, each rated on a scale of 1 to 10. The overall score is the average of: Coverage Breadth and Accessibility, Plan Variety and Customization, Affordability and Value, Innovation and Care Quality, and Consumer Experience and Transparency. Categories assess provider reach, plan diversity, cost structure, care delivery, and member service experiences based on public data, filings, and expert analysis.

Bottom Line

CareFirst BCBS continues to lead the Mid-Atlantic health insurance market with strong ACA and Medicare options, broad provider networks, and affordable pricing (especially in Maryland). Despite these strengths, recurring service and transparency issues remain a concern. Residents in the CareFirst region benefit most from this insurer’s value—particularly if they prioritize in-network access and low ACA premiums.

Best for

Maryland, D.C., and Northern VA residents seeking broad provider access and affordable ACA or Medicare Advantage coverage.

Not ideal for

Those outside the Mid-Atlantic region or those prioritizing seamless customer support and low-deductible Medicare drug coverage.

Disclaimer

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc.