BlueChoice HMO Grandfathered/Small Group Non-ACA Benefit Summaries - Maryland

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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MSGR

Summary of MSGR Plan Options
OptionsFeaturesMedical Summary
Option 1 Copay $20/$30; $250 per admission copay CUT5566
Option 3 Copay $10/$20 CUT5568
Option 4 Copay $5/$10 CUT5569
Option 5 Copay $30/$40; $250 per admission copay CUT6534
Option 6 Core with BlueVision Copay $30/$40; $1,000 per admission copay CUT9172
Option 6 Core without BlueVision Copay $30/$40; $1,000 per admission copay CUT6940

51-199

Summary of 51-199 Plan Options
OptionsFeaturesMedical Summary
Option 1 Copay $5/10 CUT5530
Option 3 Copay $10/20 CUT5532
Option 13 Copay $30/40 CUT6195
Option 14 Copay $20/30 CUT6390
Option B Copay $20/30 $500 Ded. CUT6480
Option C Copay $30/40 $500 Ded. CUT6481
Option F Copay $30/40 $500 Ded. CUT6484

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