What You Need to Know
CareFirst BCBS Maryland offers medical, vision, dental, and prescription drug coverage.
It provides coverage to individuals and to companies of varying sizes.
There are plans for students as well as for Medicare members.
Who Is CareFirst BCBS Maryland?
CareFirst Blue Cross Blue Shield of Maryland is an independent licensee of the Blue Cross Blue Shield Association and has been offering health insurance options on the East Coast since 1934. It began as Group Hospitalization Inc. in Washington, D.C., then joined a group of 15 hospitals in the Baltimore area in 1937 and started using the Blue Cross service mark.1
Now serving more than 3.4 million individuals and employers in Maryland, the District of Columbia and North Virginia, CareFirst BCBS Maryland is a not-for-profit healthcare company that provides a variety of services. CareFirst BCBS Maryland has over 56,000 primary care physicians and specialists in-network to meet your needs.2
What Health Insurance Does CareFirst BCBS Maryland Offer?
CareFirst BCBS Maryland provides medical, dental and vision coverage to students and adults, as well as Medicare and Medicaid plans. All of their individual medical plans meet Affordable Care Act (ACA) requirements, which means you might qualify for subsidies that lower your monthly payments.
CareFirst BCBS Maryland also offers employer group plans for locally owned and national companies, covering groups of small (2-50), mid-sized (51-99) and large (100+) employees.3
What Are Member Benefits With CareFirst BCBS Maryland?
In addition to medical, dental, vision and prescription drug coverage, CareFirst BCBS Maryland offers wellness programs to help you stop smoking, manage your weight and even manage your finances. Its Patient-Centered Medical Home program helps your primary care doctor coordinate with specialists and oversee all your care.
You can access your account and ID card from your smartphone, and the CareFirst website offers personalized information about your health, your benefits, your deductibles and other costs, as well as where to find providers.
Help Paying for Coverage
If you qualify, you can get an ACA subsidy to lower the cost of your plan.
How Do You Enroll in Coverage With CareFirst BCBS Maryland?
You have several options for enrolling in a plan with CareFirst BCBS Maryland. If you live in Maryland and are eligible for subsidies based on income and household size, you can apply through Maryland’s Health Insurance Exchange, Maryland Health Connection. That way, you can apply for tax credits to lower your premium.
If you don’t qualify for a subsidized plan, you can enroll directly with CareFirst BCBS Maryland through its website. You can compare plan options, check if your doctor is in-network and review coverage before signing up for a plan.
If you’d rather work with a live person, call CareFirst BCBS Maryland at (800) 544-8703 to talk to a representative. You can also reach out to a licensed insurance agent who can sort through plans with you.
How to Access Your Plan
With CareFirst BCBS Maryland, you can access plan information and your ID card with your smartphone.
How Do You File Claims With CareFirst BCBS Maryland?
When you use a doctor or medical facility that has contracted to be part of CareFirst BCBS Maryland’s provider network, that provider will electronically submit your claim for you. If you visit an out-of-network provider, you’ll need to submit the claim yourself.
You can submit claims online through your account. Some claims, like out-of-network pharmacy and vision services, will need to be printed and mailed. CareFirst BCBS Maryland processes 99% of claims within 30 days of receipt.4
How is CareFirst BCBS Maryland Rated?
CareFirst BCBS Maryland says on its website that it has revenues of $9.6 billion. However, the insurer hasn’t received a rating from either AM Best or Standard & Poor’s.
CareFirst BCBS Maryland isn’t accredited with the Better Business Bureau, but the BBB website gives it an A- for customer satisfaction. Online comments appear to show that the insurer responds to complaints and resolves most issues.5
Consumer Affairs, with 67 reviews, shows an overall score of just over 1 star.6 Most complaints seem to be focused on customer service response to claims questions.
What Are Strengths of CareFirst BCBS Maryland?
If you live in Maryland, northern Virginia or Washington, D.C., you have five to 12 plan options to choose from with CareFirst BCBS Maryland. If you’re eligible, you can get an ACA subsidy to help pay for coverage.
If you’re eligible for Medicare, CareFirst BCBS Maryland offers Medicare Advantage or Medicare Supplement plans.
If you’re a student attending a college or university that offers CareFirst BCBS Maryland coverage, you can get healthcare coverage nationally and in over 200 countries.7
For the past nine years, CareFirst BCBS Maryland has been named one of the world’s most ethical companies by the Ethisphere Institute, a for-profit company focused on corporate ethical standards.8
What Are Weaknesses of CareFirst BCBS Maryland?
CareFirst BCBS Maryland plans offer limited coverage in some areas. Search by ZIP code or county to make sure there are plans available where you live.
CareFirst BCBS Maryland appears to be a solid health insurance company with some customer service issues, based upon complaints submitted.
If you live in the right area, and especially if you qualify for ACA tax credits, CareFirst BCBS Maryland may have the right plan at the right price. No matter which company you choose, make sure you do your research so you know you’re getting the plan you want.
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.