Member Updates & Information

Member Benefit Updates

Have questions about your cost share for certain services? View this chart for details on the benefit changes we’ve made so you can get the care you need for the duration of the COVID-19 pandemic.

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CareFirst will cover, with no cost share to the member (including our members enrolled in high deductible health plans), the appropriate medically necessary diagnostic testing for COVID-19, where it is not covered as part of the Public Health Service response, and ensure patient testing and any subsequently needed care are done in close coordination with federal, state and public health authorities.
CareFirst is waiving early medication refill limits on 30-day maintenance medications (consistent with your benefit plan) and encourages you to use the 90-day mail order benefit. Your cost sharing will apply as normal.

You will not be liable for additional charges that stem from obtaining a non-preferred medication if the preferred medication is not available due to shortage or access issues.

If you don’t want to go out in public to pick-up a refill, you should call the pharmacy where you filled the prescription and ask if they deliver – many do.

You can also switch to our mail order service by:
  • Going online - Go to My Account, click on Coverage, select Drug and Pharmacy Resources and under Mail Order, click on Request a New Mail Order Prescription to set up an account.
  • Calling the toll-free number on the back of your member ID card.
Mail order processing for a new prescription can take up to 5 days plus 1 to 2 days for a refill with the mail order service. Regular delivery takes up to 5 days; 2-day and next day delivery is also available for an additional charge.
Our plans include coverage for emergency medical care anywhere in the U.S.
Anyone with symptoms should first call their PCP to discuss their symptoms and treatment options. If your doctor schedules a telemedicine visit, CareFirst will cover the charge.* CareFirst members also have two options to receive care outside a provider’s office – 24-Hour Nurse Advice Line and Video Visit.
  • Members can call our free 24-Hour Nurse Advice Line at 800-535-9700 anytime and speak with a registered nurse to discuss their symptoms and get recommendations for the most appropriate care.
  • Members can also register for CareFirst Video Visit to securely connect with a doctor, day or night, through their smartphone, tablet or computer. Members can visit CareFirst Video Visit to get started – no appointment is necessary and there is no cost* to you.
In a continuing effort to provide a safe work environment for our associates, we will no longer allow walk-in support for customers at any of our office locations. This includes our district offices. This will be effective Monday, March 16.

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
Don’t forget: Our customer service representatives are available to take calls. Please call the number on the back of your member ID card.

Yes, D.C. and Maryland residents who are uninsured can take advantage of the special enrollment periods being offered on the exchanges.

District of Columbia Residents

The DC Health Link has opened a special enrollment period so D.C. residents without insurance can get coverage during the coronavirus pandemic. Visit the DC Health Link for more information or to enroll.

Maryland Residents

For those in our Maryland communities who are uninsured, CareFirst has worked with the Maryland Health Benefit Exchange to allow a special enrollment period for individuals to sign up for health insurance coverage. The special enrollment period started March 16 and runs through April 15, with coverage effective April 1. Visit the Maryland Health Connection to enroll.

CareFirst has also opened an off-exchange special enrollment period through June 15, 2020, for Maryland and Northern Virginia residents

You can enroll today on CCI - CareFirst’s online shopping portal for individuals and families.

This enrollment period is only available to currently uninsured Maryland and Northern Virginia residents, not those who currently have other health coverage.

Medicare will cover the diagnostic testing of the coronavirus (COVID-19). Members will have no out-of-pocket costs. Additionally, Medicare covers all medically necessary hospitalizations. This includes if you are diagnosed with COVID-19 and might otherwise have been discharged from the hospital after an inpatient stay, but instead you need to stay in the hospital under quarantine. Medicare Supplement plans will pay their share of costs after Medicare pays its share of the Medicare-approved amount for covered health care costs. Medicare Supplement plans will pay Medicare Part A and Part B costs with the same cost sharing a member would normally have based on the Medicare Supplement plan they are enrolled in. For more information, visit Medicare.gov.

Members with a Medicare Supplement deductible will need to meet that deductible before their plan pays for any associated treatment.
Because Medicaid benefits vary by state, please refer to the Centers for Medicare and Medicaid Services for more information about Coronavirus testing and treatment coverage.
Centers for Disease Control and Prevention (CDC) website is the best resource for information on preventing and treating the coronavirus. We will also be updating this page as new information is made available.
According to the CDC, symptoms of the coronavirus include fever, cough and shortness of breath. Symptoms may appear 2-14 days after exposure.
Anyone who is sick with a fever and cough, or has difficulty breathing, should first call their doctor to discuss their symptoms and treatment options.
The CDC recommends everyday preventive actions to help prevent the spread of respiratory viruses:
  • Follow the CDC’s immunization guidelines, including everyone 6 months and older getting the flu shot each season
  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available
  • Avoid touching your eyes, nose and mouth with unwashed hands
  • Avoid close contact with people who are sick
  • Stay home when you are sick
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash
  • Clean and disinfect frequently touched objects and surfaces
If your plan year began between November 1, 2019 through May 2020, CareFirst is extending the time period for you to complete your Blue Rewards health screening for an additional 90 days – or through the end of your current plan year, whichever comes first. Please log in to your Sharecare account and select Achieve, then Rewards, then Blue Rewards Incentive Program to see your adjusted time period. Once the COVID-19 restrictions have been lifted, contact your PCP or visit your local CVS MinuteClinic to complete your health screening within the new time period.

The following resources are available for individuals:

Direct Payments

  • Most individuals will be eligible for a direct payment from the federal government. Adults earning up to $75,000 will receive $1,200, and joint filers earning up to $150,000 will receive $2,400. Amounts received diminish beyond these income limits, and no person earning over $99,000 (or joint filers earning over $198,000) would receive the benefit.
  • The payment will happen automatically; no further action is needed by you.
  • The distribution of the payments is expected to begin in the next three weeks.
  • See the IRS FAQs for more information.

Unemployment Insurance

  • Unemployment benefits have been extended to last an additional 13 weeks.
  • On top of your normal unemployment check, you will receive $600 weekly for the next four months.
  • You may qualify for unemployment under one of the newly eligible groups. For example, self-employed and those in COVID-19 quarantine are eligible to receive benefits.
  • The start date to receive these benefits varies by state, check with your state’s unemployment office for more information.

Yes – if you are having an urgent dental issue, you may have the option to be seen by your dentist virtually – and you’ll pay the same as you would if you were seen in the dentist’s office. Coverage for these emergency virtual encounters is limited to problem-focused evaluations and follow ups only. This dental telemedicine benefit is available for the duration of the COVID-19 public health emergency. To learn more about your dental telemedicine options, please call your dentist.

Please note – CareFirst’s Video Visit does not include access to dental providers. Please call your dentist to learn more about your dental telemedicine options.

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* Note: Some employers may offer customized health benefits. Please contact your HR department for your specific coverage.

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 charge
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
Provider Sponsored Telehealth Visits (must include video)

Effective Date:
3/16/20 until 6/18/20

No – member cost share waiver applies to all in-network and all COVID-19 services Waive member liability for deductibles, copays and coinsurance Benefits will be adjudicated in accordance with the member’s health plan. Members can be balance billed
Member-Initiated Telephone Consultation: PCP, OB/GYN, Family Practice, Pediatrics, Nurse Practitioner, Behavioral Health

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

No – member cost share waiver applies to all services Not subject to deductibles, copays or coinsurance Not Covered
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