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Integrated 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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Minimum Value and HealthyBlue CDH plans have other options.

 

Summary of Integrated Rx Options
OptionsFeaturesPDF Summary
Option A-I Int Ded., $0/$25/$45/50%/50% SUM4036
Option B-I Int Ded., $10/$25/$45/50%/50% SUM4038
Option C-I Int Ded., $15/$35/$60/50%/50% SUM4039
Option D-I Int Ded., $15/$50/$100/50%/50% SUM4042


NOTE: These options have restricted generic substitution.

Minimum Value and HealthyBlue CDH plans have other options.

 

Summary of Integrated Rx Options
OptionsFeaturesPDF Summary
Option A-I Int Ded., $10/$25 SUM5392
Option B-I Int Ded., $15/$35 SUM5393
Option C-I Int Ded., $20/$60 SUM5394

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These options do NOT apply to Minimum Value plans or HealthyBlue CDH plans.