BlueChoice HMO Open Access
Mid / Large Group Benefit Summaries - District of Columbia

Benefit summaries are now available for the health plans listed below. Please check the site frequently for summary updates.

Spanish benefit summaries are available upon request. Please contact your CareFirst sales representative for more information.

NOTE: Employers can consult with a CareFirst account executive to explore other plan options that fit their organization's benefit needs.

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Options Features Medical Summary Rx Summary
Option 3 Copay $10/20 $0 Ded. CUT8629 Non-Integrated Rx Options
Option 13 Copay $30/40 $0 Ded. CUT8639 Non-Integrated Rx Options
Option 14 Copay $20/30 $0 Ded. CUT8640 Non-Integrated Rx Options
Option 15 Copay $20/30 $0 Ded. SUM5782 Non-Integrated Rx Options
Option 16 Copay $20/30 $500 Ded. SUM5783 Non-Integrated Rx Options
Option 17 Copay $20/30 $1,000 Ded. SUM5784 Non-Integrated Rx Options
Option 18 Copay $20/30 $1,500 Ded. SUM5785 Non-Integrated Rx Options
Option 19 Copay $20/30 $2,000 Ded. SUM5786 Non-Integrated Rx Options
Option 20 Copay $20/30 $2,500 Ded. SUM5787 Non-Integrated Rx Options
Option B Copay $20/30 $500 Ded. CUT8642 Non-Integrated Rx Options
Option C Copay $30/40 $500 Ded. CUT8643 Non-Integrated Rx Options
Option I Copay $30/40 $500 Ded. CUT8494 Non-Integrated Rx Options
Option J Copay $30/40 $0 Ded. CUT8495 Non-Integrated Rx Options
Option K Copay $20/30 $1,000 Ded. SUM2680 Non-Integrated Rx Options
Option L 10% $1,000 Ded. SUM4634 Non-Integrated Rx Options
Option M $20/20% $1,000 Ded. SUM4635 Non-Integrated Rx Options
Option N Copay $20/40 $1,500 Ded. SUM4636 Non-Integrated Rx Options
Option O Copay $20/40 $2,000 Ded. SUM4637 Non-Integrated Rx Options
Option P Copay $10/20 $500 Ded. SUM4638 Non-Integrated Rx Options

All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.


OptionsFeaturesMedical SummaryRx Summary
Option 1-S $0 Deductible SUM3296 Non-Integrated Rx Options
Option 2-S $500 Deductible SUM3297 Non-Integrated Rx Options
Option 3-S $1,000 Deductible SUM3298 Non-Integrated Rx Options
Option 4-S $2,000 Deductible SUM3299 Non-Integrated Rx Options
Option 5-S $1,500 Deductible SUM4097 Non-Integrated Rx Options
Option 6-S $3,000 Deductible SUM4098 Non-Integrated Rx Options

All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.

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