Integrated HealthyBlue CDH Prescription Options
Mid / Large Group Benefit Summaries - Maryland

Formulary 4 is a streamlined formulary that offers employees a choice of preferred generic and preferred brand drugs. This simplified, two-tier plan provides a lower cost drug option that includes medications from all medically necessary drug classes.

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 for HealthyBlue CDH plans only.

 

OptionsFeaturesPDF Summary
Option A-IX Int Ded., $0/$25/$45/50%/50% SUM4037
Option C-IX Int Ded., $15/$35/$60/50%/50% SUM4041


NOTE: These options have restricted generic substitution.

Options for HealthyBlue CDH plans only.

 

OptionsFeaturesPDF Summary
Option A-IX Int Ded., $10/$25 SUM5421
Option B-IX Int Ded., $15/$35 SUM5422

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These options do NOT apply to Minimum Value plans.