Member Updates & Information

CareFirst covers, 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. Tests must be FDA authorized or approved and ordered by an authorized healthcare professional. 

CareFirst does not provide benefits for COVID-19 testing for surveillance, work or social purposes, which includes but is not limited to testing conducted:

• at the direction of a member’s employer to obtain or maintain employment;
• for the return to school or to participate in school activities (e.g., sports); or
• to participate in recreational activities (e.g., concerts, public events, cruises).

This policy will apply to all CareFirst members except where testing for surveillance, work or social purposes is required by law.

Some large employers may have elected different benefits. To be sure you understand your benefits, and coverage for COVID-19 testing where you live and work, please call member services at the number on the back of your member ID card.

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.

CareFirst will fully cover the cost of emergency use authorized home COVID-19 testing when ordered by a doctor, nurse practitioner or other authorized provider. 

CareFirst does not provide benefits for COVID-19 testing for surveillance, work or social purposes, which includes but is not limited to testing conducted:

• at the direction of a member’s employer to obtain or maintain employment;
• for the return to school or to participate in school activities (e.g., sports); or
• to participate in recreational activities (e.g., concerts, public events, cruises).

This policy will apply to all CareFirst members except where testing for surveillance, work or social purposes is required by law.

Some large employers may have elected different benefits. To be sure you understand your benefits, and coverage for COVID-19 testing where you live and work, please call member services at the number on the back of your member ID card.

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.

During the COVID-19 pandemic, most people have not been able to see their orthodontist except for emergency or urgent care. But some people may receive a bill even though their appointment was cancelled.

Treatments like braces require multiple visits over many months, even years. At the start of your treatment, many orthodontists work with you to create a payment plan, which may be automated. As a result, you may still be receiving a monthly bill, even though you have not been seen by your orthodontist due to the COVID-19 public health crisis. 

If you are experiencing difficulties making these payment plan payments or are concerned about owing a large payment once you can begin office visits again, CareFirst encourages you to contact your orthodontist and ask about payment options. The total amount you owe should not change, despite delays in check-in visits during the COVID-19 public health crisis.

CareFirst’s participating providers should not bill you for any costs associated with PPE. If your in-network doctor or dentist has added an additional charge, or sent you a separate bill, for PPE or other “enhanced infection control” measures,  please contact our customer service department by secure email through My Account, or call the number on the back of your member ID card. 

• 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 for urgent care services.

District of Columbia Residents

D.C. residents without insurance can get coverage during the coronavirus pandemic through January 31, 2022 during their special enrollment period.