CareFirst BlueChoice Advantage CDHP with HSA
The CareFirst BlueChoice Advantage CDHP (Consumer Directed Health Plan) with HSA (Heath Savings Account) offers a different means of accessing health care services for Georgetown employees and their covered dependents. For a better understanding of the different cost structure of the CDHP with HSA and how your out of pocket expenses may be impacted, look through this Georgetown-specific guide.
- Summary of Benefits and Coverage (SBC, 2019)
- Summary of Benefits and Coverage (SBC, 2018)
- Plan Benefits Summary (2018)
- BlueVision and the Davis Vision Network (2018)
- Pharmacy Benefits Summary (2018)
- Pharmacy Benefits Summary – CVS Caremark (2019)
- Participating Pharmacy Locator Tool (2019)
Some restrictions do apply. You cannot enroll or contribute to a Health Savings Account if…
- You, or another member of your household, are participating in a Health Care Flexible Spending Account for 2019
- As of December 31, 2018, you have an unused balance in your 2018 Health Care Flexible Speding Account
- You are enrolled, or plan to enroll, in Medicare Part A or B in 2019
What’s the same between the CareFirst POS and CDHP?
- The same flexible network access provided in the CareFirst BlueChoice Advantage POS plan
- Zero copay for in-network preventive care services
- Freedom to select any doctor- in or out of network, no referrals required by the plan
What’s different from the CareFirst POS plan?
- Lower monthly premium
- Higher deductible that must be met before plan benefits will begin
- Access to a tax-advantaged Health Savings Account (HSA)* that can be used for qualified health care expenses
*An HSA is different from the Health Care Reimbursement Account (Flexible Spending Account) you may have participated in previously through Georgetown University
What is an HSA?
An HSA allows you to save dollars to pay health care expenses, now or in the future. You can set aside, tax-free, up to $3,500 for self-only coverage or $7,000 for family coverage in 2019. Your HSA is 100% vested immediately, and the account balance rolls over from one year to the next. Once your HSA balance reaches $1000, you are able to invest the money in your HSA. Review the HSA Enrollment Guide for more information.
Provider Network Access
The CareFirst BlueChoice Advantage plan provides you with different ways to access care:
- BlueChoice Network: Use this network when seeking in-network benefits in the DC/MD/Northern Virginia area. A more strictly defined network of local providers. Deductible and coinsurance apply.
- BlueCard PPO Network: Use this network when seeking in-network benefits outside of the DC/MD/Northern Viriginia area. Deductible and coinsurance apply.
- BCBS Participating Network (BCBS provider): Members also have freedom of choice and out-of-pocket savings received through tradional medical coverage by using BCBS-participating providers. Deductible and coinsurance apply. Over 80% of all providers nationwide participate in the BlueCross BlueShield (BCBS) network. You’ll pay more, but generally less than going completely non-network.
- Non-Network (non-BCBS provider): Providers who do not participate in either the BlueChoice network or “par” network. Members may see a provider who is not a member of the BlueCross BlueShield network but may pay a higher out-of-pocket cost due to balance billing. Members typically must file their own claims.
Finding a Doctor
The BlueChoice network is a local network of providers. To locate a medical provider, go to CareFirst’s online directory and look for providers in the “BlueChoice Advantage” network. You may also use this online directory to search for BlueCard PPO providers outside of the local area. Follow the instructions above, then click on the link for providers outside the Metro area.
Vision: If you are interested in receiving a routine eye exam you must access care within the Davis Vision Network. When looking for participating doctors from www.carefirst.com, be sure to select “Vision” when conducting your search.
Mental Health: Mental health service through CareFirst are administered by Magellan. To find a provider, visit CareFirst’s Provider Directory page and click the link at the bottom for Magellan.
Prescription Drug Plan
Prescription drugs are subject to the same combined deductible as other medical services. After participants have met the deductible, copays apply.
Effective January 1, 2019, CareFirst BlueChoice plan participants will receive their pharmacy benefits directly through CVS Caremark. members will receive two ID cards: one for medical visits and one for pharmacy. Please be sure to discard any old cards and replace them with the newest versions!
Find a participating network pharmacy using the CVS Caremark Pharmacy Locator. Participating pharmacies include CVS, Rite Aid, Walgreens, Safeway, Giant, Harris Teeter and many more.