Brokers & Partners

CareFirst COVID-19 Webcast, March 27, 2020  

  • CareFirst in the Community
  • Benefit Plan Design Changes
  • Interim Policy Changes
  • Impact to Service Levels
  • Legislative Support for Small Businesses

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(Full audio)

Your partnership continues to be vital as we navigate these challenging times. CareFirst is committed to keeping you up to date on the actions we are taking to meet the health needs of our members and communities.

We are working around the clock in partnership with state and local public health authorities to understand and respond to new developments, anticipate needs and institute proactive steps to help contain the spread of COVID-19.

We cannot allow financial barriers to interfere with members getting the care they need in the safest possible setting. The chart below outlines the measures we are taking to ensure our fully insured members are not subject to deductibles, copays or coinsurance.*

Cost Share Waiver Process

Deductibles, Copays and Coinsurance

ServiceCost Share Waiver must be related to COVID-19?In-NetworkOut-of-network
Diagnostic Test for COVID-19

Effective Date:
2/4/20 for the duration of the pandemic

YES Waive member liability for deductibles, copays and coinsurance CareFirst/Plan Sponsor pays 100% up to our allowed amount, but member can be balance billed
Visits (regardless of setting) associated with Diagnostic Testing

Effective Date:
2/4/20 for the duration of the pandemic

YES Waive member liability for deductibles, copays and coinsurance CareFirst/Plan Sponsor pays 100% up to our allowed amount, but member can be balance billed
Treatment of COVID-19 (regardless of setting)

Effective Date:
2/4/20 for the duration of the pandemic

YES Waive member liability for deductibles, copays and coinsurance CareFirst/Plan Sponsor pays 100% up to our allowed amount, but member can be balance billed
CareFirst Video Visits

Effective Date:
3/16/20 for the duration of the pandemic

No – member cost share waiver applies to all services Waive member liability for deductibles, copays and coinsurance N/A – as long as members receive care through the CareFirst Video Visit, they are in-network.
Provider Sponsered Telehealth Visits (includes Video)

Effective Date:
3/16/20 until June 18, 2020 (required by BCBSA)

No – member cost share waiver applies to all services Waive member liability for deductibles, copays and coinsurance Not Covered
Telephone Consultation: PCP, OB/GYN, Family Practice, Pediatrics, Nurse Practitioner, Behavioral Health *

Effective Date:
3/16/20 for the duration of the pandemic

*new benefit for fully insured and ASO accounts

No – member cost share waiver applies to all services Not subject to deductibles, copays or coinsurance Not Covered - Member responsible for 100% of the claim amount

Additionally, CareFirst worked with the Maryland Health Benefit Exchange to allow for a special enrollment period for those in Maryland communities who are uninsured for individuals to sign up for health insurance coverage. The special enrollment period starts March 16 and will run through April 15, with coverage effective April 1. Potential members can visit the Maryland Health Connection to enroll.

Update for Individual Members Who Use Our Walk-In Services

In response to the demand for social distancing and our continuing effort to provide a safe work environment for our associates, effective March 16, 2020, we will no longer provide walk-in support for customers at any of our office locations. These office locations include:

  • Union Center Plaza (UCP) Lobby Service
  • Red Run 802 Lobby Service
  • Salisbury Regional Office
  • Easton Regional Office
  • Annapolis Regional Office
  • Frederick Regional Office
  • Hagerstown Regional Office
  • Cumberland Regional Office

Staying Informed

We know there are remaining questions from employers that we are working to address as quickly and thoroughly as possible. Please continue to raise these questions to your broker representative and we will work on finding solutions.

As conditions and recommendations change rapidly, please continue to visit this site to remain up to date on the actions CareFirst is taking to support our community throughout this period.

* CareFirst will follow IRS guidance for members who are enrolled in high-deductible health plans.

** CareFirst will process and pay medically necessary and appropriate out-of-network claims at the in-network level. For care received out-of-network, as allowed, members will be responsible for the difference between the CareFirst allowed amount and the provider’s billed charge.