2020 ACA Consumer Health Insurance Plans - VA - CareFirst
Consumer Health InsurancePlans 2020For residents of Northern Virginia who buy their own insurance
WelcomeThank you for considering CareFirst BlueCrossBlueShield and CareFirst BlueChoice, Inc. (CareFirst)for your health care coverage. As the largest healthcare insurer in the Mid-Atlantic region, we knowhow much you and your family depend on usfor your health coverage. It’s a responsibility wetake very seriously, as we have with your parents,grandparents, friends and neighbors.We created this book to help you choose theplan that best suits your specific needs. For 2020,CareFirst offers the following plans: BlueChoice HMO Young Adult 8,150* BlueChoice HMO HSA Silver 3,000 BluePreferred PPO HSA Silver 3,000 BlueChoice HMO Gold 1,750 BluePreferred PPO Gold 1,750When you choose us as your health insurer, you are protected by the nation’s oldest and largest family ofindependent health benefits companies. For over 80 years, we have provided our community with healthcare coverage and are committed to being there when you need us for many years to come.If you have any questions as you read through this book, visit us at carefirst.com/individual or give us a callat 800-544-8703, Monday–Friday, 8 a.m. to 6 p.m. and Saturday, 8 a.m. to noon.Sincerely,Charlene Guessford-KlineDirector, New SalesCommercial Individual, Small Group & Specialty*Available to individuals under the age of 30 and those who qualify for a hardship exemption. Visit your state’s Federally-facilitated Exchangefor more details.Consumer Health Insurance Plans 2020—Northern Virginia 1
ContentsWelcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Before You Choose a Plan . . . . . . . . . . . . . . . . . . . . . 3How Health Insurance Works . . . . . . . . . . . . . . . . . . 4Included With Every CareFirst Plan . . . . . . . . . . . . . 5Dental Plans for Adults . . . . . . . . . . . . . . . . . . . . . . . 8Know Before You Go . . . . . . . . . . . . . . . . . . . . . . . . 11Choosing Your Plan . . . . . . . . . . . . . . . . . . . . . . . . . 12Four Ways to Enroll . . . . . . . . . . . . . . . . . . . . . . . . . 14Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Our Commitment to You . . . . . . . . . . . . . . . . . . . . 17Rights and Responsibilities . . . . . . . . . . . . . . . . . . . 18Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29The policies may have exclusions, limitations or terms under which the policy may be continued in force or discontinued.For costs and complete details of the coverage, call your insurance agent or CareFirst.2 Consumer Health Insurance Plans 2020—Northern Virginia
Before You Choose a PlanTo choose the best plan for your needs, you should:Understand metal levelsLook into financial assistanceUnder the Affordable Care Act (ACA) there arefour categories of health coverage—Bronze, Silver,Gold and Platinum—called metal levels. All healthplans fall into a metal level depending on the shareof health care expenses they cover. For example,bronze plans have higher deductibles than othermetal level plans.There are two types of financial assistance (alsocalled subsidies) available:In Northern Virginia, CareFirst offers plans in thefollowing metal levels: Silver GoldCareFirst also offers a Catastrophic plan(BlueChoice Young Adult) for individuals under age30 or individuals with a hardship exemption.Consider a Health Savings AccountA Health Savings Account (HSA) is a tax-exemptmedical savings account that can be used topay for your own, and your dependents’, eligiblehealth expenses. HSAs enable you to pay foreligible health expenses and save for future healthexpenses on a tax-free basis. We offer two healthinsurance plans that coordinate with an HSA. Lookfor HSA in the plan name.A tax credit to help pay your monthly premium—This subsidy helps reduce your monthly premium.Once you qualify, your tax credit will be sent toCareFirst and applied to your bill, reducing yourpremium. If you qualify for this type of assistance,you can use it toward the purchase of any plan—Silver or Gold (excludes the BlueChoice YoungAdult plan).A subsidy to lower your out-of-pocket expenses—This subsidy helps limit how much you spend onout-of-pocket expenses like copays, coinsuranceand deductibles. By lowering these out-of-pocketcosts, your health plan begins paying 100% ofyour costs sooner than it would have without thesubsidy. If you qualify, and want to take advantageof this type of financial assistance, you mustpurchase a Silver metal level plan.Note: If you are an existing member and you qualifiedfor financial assistance in 2019 and did not electautomatic reassessment, you need to contact theFederally-facilitated Exchange. You will be re-evaluatedfor financial assistance for 2020 during Open Enrollmentfrom November 1–December 15, 2019.Individuals earning up to 49,960* and a familyof four earning up to 103,000* can qualify forfinancial assistance to help pay for their healthinsurance premiums.*income based on 2019 federal poverty levelsConsumer Health Insurance Plans 2020—Northern Virginia 3
How Health Insurance WorksTo help you understand your health plan options, it’s important to understand a bit about health insurance.The graphic below explains how health insurance works and defines some key terms.Let’sgetstarted!Select a planfor 2020Begin payingyour monthlypremiumHere are some key thingsthat you get at no charge: Get yourpreventivecare Adult physicalsWell-child exams andimmunizationsOB/GYN visits and pap testsMammogramsProstate and colorectalscreeningsRoutine prenatal maternityservicesReceive yourmemberID cardMeet your deductibleYour DEDUCTIBLE is theamount of money you mustpay for health care serviceseach year before the planwill start paying for all orpart of the services.1YOU PAY 100%until you meet your deductibleNeed additional care?Many of ourplans do notrequire youto meet adeductible forprimary care andspecialist officevisits, urgent careand preventivescreenings.Pay your shareAfter you meet yourdeductible, you’ll pay aCOPAY or COINSURANCEfor covered services.Reach your annualout-of-pocket maximumYOU PAY PLAN PAYSYour premiumdoes not counttoward yourdeductible orout-of-pocketmaximum.If you reach your OUT-OF-POCKETMAXIMUM, you will pay nothing for yourcare for the remainder of the plan year.The plan will pay 100% of your coveredmedical expenses.PLAN PAYS 100%Plan yearendsCommonly used insurance terms areBOLDED throughout this book anddefined in the glossary on page 15.14Certain charges, such as charges in excess of theallowed benefit, may not be used to satisfy thedeductible. Please see your contract for moreinformation. Consumer Health Insurance Plans 2020—Northern Virginia
Included With Every CareFirst PlanCareFirst health plans are designed with your health in mind.All individual and family plans include: Prescription drug coverage Vision examination for members over age 19 Dental and vision coverage for members under age 19Prescription drug coveragePreferred Specialty Drugs (Tier 4)**—Consist of drugs used to treat chronic,complex and/or rare health conditions.These drugs may have a lower cost-sharethan non-preferred specialty drugs.As a CareFirst member, your prescriptioncoverage includes: A nationwide network of more than 69,000participating pharmacies. Access to thousands of covered prescriptiondrugs on our formulary (drug list), dividedinto tiers. The price you pay for a drug isdetermined by the tier it falls into.Generic Drugs (Tier 1)—Generic drugsare equally safe and effective as brandname drugs, but generics cost upto 85% less.* Ask your doctor if yourprescription medication can be filled with ageneric alternative.Preferred Brand-Name Drugs (Tier 2)—Brand-name drugs that may not yet beavailable in generic form, but have beenreviewed for quality, effectiveness, safetyand cost effectiveness by an independentnational committee of health careprofessionals.Non-Preferred Brand-Name Drugs(Tier 3)—These drugs often have a genericor preferred brand drug option where yourcost-share will be lower. You will pay morefor drugs in this tier. If you choose a nonpreferred drug when a generic is available,you will pay the non-preferred copay alongwith the difference in price between thegeneric and non-preferred drug.Non-Preferred Specialty Drugs(Tier 5)**—These drugs often have aspecialty drug option where your costshare will be lower. Mail Service Pharmacy, our convenient andfast mail order drug program.Save money on your maintenancemedications—those drugs taken dailyto treat a chronic condition like highcholesterol—by having them deliveredright to your home. You can get up to a90-day supply of your generic and brandmaintenance medications for the cost oftwo copays. Coordinated medical and pharmacyprograms to help improve your overall healthand reduce costs. Personalized care management noticesdetailing cost savings opportunities, safetyalerts and important drug information. We’ve included more information on prescription benefits by health plan in the fold-out chartincluded with this book. Our drug list formulary can be found at carefirst.com/acarx.* .htm** Specialty drugs must be obtained through mail order at CVS Specialty Pharmacy.Consumer Health Insurance Plans 2020—Northern Virginia 5
Health & wellnessReady to take charge of your health? CareFirsthas partnered with Sharecare1 to bring you awellness experience that puts the power of healthin your hands.You also have access to additional support tohelp you take on your wellness goals withconfidence, including:Your wellness program provides a wealth of toolsand resources, as well as easy-to-understandrecommendations and insights that reflect yourindividual interests and needs—all tailored to helpyou live your healthiest life. Access these exclusivefeatures whenever, wherever you want:Quitting smoking and other forms of tobacco canlower your risk for many serious conditions fromheart disease and stroke to lung cancer. Accessexpert guidance, support and tools to makequitting easier than you might think. RealAge : In just a few minutes, the RealAgeonline health assessment will help youdetermine the physical age of your body,compared to your calendar age. Personalized newsfeed: Receive content basedon your health and well-being goals, as well asyour motivation and interests. Trackers: Connect your wearable devices tomonitor daily habits like stress, sleep, steps,nutrition and more. Challenges: Stay motivated to achieve yourhealth goals by joining a challenge. Health profile: Access your health data,including biometric and lab results, vaccineinformation and medications, all in one place.Tobacco cessation programFinancial well-beingLearn how to take small steps toward bigimprovements in your financial situation. Whetheryou are planning for your child’s education,your own retirement, or want to improve yourcurrent situation, the financial well-being programcan help.Members can visit carefirst.com/sharecarefor a personalized experience.Vision coverageEvery CareFirst health plan includes an annual vision examination for everyone covered by your plan.In-network benefits are offered to you through Davis Vision,2 our administrator for the plans. Out-of-networkbenefits are also available.Pediatric coverage (up to age 19) includes: One no-charge in-networkroutine exam percalendar year No copay for frames and basiclenses for glasses or contact lensesin the Davis Vision collection3 No claims to file when you usea provider who contracts withDavis Vision No claims to file when you usea provider who contracts withDavis VisionAdult coverage (age 19 and over) includes: One no-charge in-networkroutine exam1 percalendar year Discounts4 of approximately30 percent on eyeglass lenses,frames and contacts, laser visioncorrection, scratch-resistant lenscoating and progressive lensesTo locate a vision provider near you, call Davis Vision at 800-783-5602 or visit carefirst.com/doctor.12346This wellness program is administered by Sharecare, Inc., an independent company that provides health improvement managementservices to CareFirst members.Davis Vision is an independent company.For BlueChoice Young Adult plans, all pediatric vision services are subject to the medical deductible, except for the vision exam.As of April 1, 2014, some providers in Maryland and Virginia may no longer provide these discounts. Provider participation varies fromyear-to-year. Make sure to call in advance to confirm discounts. Consumer Health Insurance Plans 2020—Northern Virginia
Dental coverage for children up to age 19Did you know that comprehensive dental care can help detect other health problems before they becomemore serious? The health of your child’s teeth also has a major impact on digestion, growth rate and manyother aspects of overall health. That’s why all CareFirst medical plans provide kids under age 19 with dentalbenefits at no extra charge.Pediatric Dental(under 19)Silver & Gold PlansIn-NetworkYou PayBlueChoice Young Adult PlanOut-of-NetworkYou PayCostIn-NetworkYou PayOut-of-NetworkYou PayIncluded in your medical plan premiumDeductibleOut-of-network: 50 per individualper calendar year(applies to ClassesII, III & IV)In-network: 25per individualper calendar year(applies to ClassesII, III & IV)NetworkSubject to medical deductibleIndividual: 8,150Family: 16,300(applies to Classes II, III, IV & V)Over 5,000 providers in MD, DC and Northern VA;123,000 dental providers nationallyPreventive & DiagnosticServices (Class I)—Exams(2 per year), cleanings (2 peryear), fluoride treatments(2 per year), sealants,bitewing X-rays (2 per year),full mouth X-ray (one every3 years)No charge(no deductible)20% of AllowedPediatric DentalBenefit*(no deductible)No charge(no deducible)No charge(no deductible)Basic Services (Class II)—Fillings (amalgam orcomposite), simpleextractions, non-surgicalperiodontics20% of AllowedPediatric DentalBenefit* (after dentaldeductible)40% of AllowedPediatric DentalBenefit* (after dentaldeductible)No charge (aftermedical deductible)No charge (aftermedical deductible)Major Services—Surgical(Class III)—Surgicalperiodontics, endodontics,oral surgery20% of AllowedPediatric DentalBenefit* (after dentaldeductible)40% of AllowedPediatric DentalBenefit* (after dentaldeductible)No charge (aftermedical deductible)No charge (aftermedical deductible)Major Services—Restorative(Class IV)—Crowns, dentures,inlays and onlays50% of AllowedPediatric DentalBenefit* (after dentaldeductible)65% of AllowedPediatric DentalBenefit* (after dentaldeductible)No charge (aftermedical deductible)No charge (aftermedical deductible)50% of AllowedPediatric DentalBenefit*(no deductible)65% of AllowedPediatric DentalBenefit*(no deductible)No charge (aftermedical deductible)No charge (aftermedical deductible)Orthodontic Services(Class V)—when medicallynecessaryNot all services and procedures are covered by your benefits contract. This plan summary is for comparison purposes only and does notcreate rights not given through the benefit plan.* CareFirst payments are based on the CareFirst Dental Allowed Benefit. Participating dentists accept 100% of the CareFirst Dental AllowedBenefit as payment in full for covered services. Non-participating dentists may bill the member for any amount over the Dental AllowedBenefit. Providers are not required to accept CareFirst’s Dental Allowed Benefit on non-covered services. This means you may have to payyour dentist’s entire billed amount for these non-covered services. At your dentist’s discretion, they may choose to accept the CareFirstDental Allowed Benefit, but are not required to do so. Please talk with your dentist about your cost for any dental services.On the go? Download our mobile app by searching CareFirst in your app store.Using any mobile device, you can: Search for providers and urgent care centers Download ID cards to your device Save provider information directly to yourcontacts list Receive a notification when your newExplanation of Benefits (EOB) information isready to view View claims and deductible informationConsumer Health Insurance Plans 2020—Northern Virginia 7
Dental Plans for AdultsThree optional dental plansFor adults age 19 and older, you may want to considerpurchasing one of our three dental plans: BlueDental Preferred Dental HMO Select Preferred DentalBlueDental PreferredIn-network You Pay (Out-of-network coverage available)Individual Cost Per DayDeductibleAnnual MaximumNetworkPreventive & Diagnostic Services(Class I)Approximately 1 per day*Low Option 100 Individual/ 300 Family(applies to Classes I-IV)per calendar yearHigh Option 50 Individual/ 150 Family(applies to Classes II, III, IV) percalendar yearPlan pays 1,250 maximum(for members age 19 and older)Plan pays 1,750 maximum(for members age 19 and older)Over 5,000 providers in MD, DC and Northern VA; 123,000 dentists nationallyLow OptionNo charge after deductibleHigh OptionNo chargeBasic Services (Class II)—Fillings, simple extractions, non-surgicalperiodontics20% of Allowed Benefit**after deductibleMajor Services—Surgical (Class III)Surgical periodontics,endodontics, oral surgery40% of Allowed Benefit**after deductibleMajor Services—Restorative (ClassIV) Inlays, onlays, dentures, crownsOrthodontic Services (Class V)(up to age 19)65% of Allowed Benefit** afterdeductible50% of Allowed Benefit** afterdeductible50% of Allowed Benefit** (no deductible) when medically necessaryPlease note: The benefit summary above is condensed and does not provide full benefit details.Not all services and procedures are covered by your benefits contract. This plan summary is for comparison purposes only and does notcreate rights not given through the benefit plan.* Visit carefirst.com/shopdental for a rate quote based on your age and residential location.**CareFirst payments are based on the CareFirst Allowed Benefit. Participating dentists accept 100% of the CareFirst Allowed Benefit aspayment in full for covered services. Non-participating dentists may bill the member for any amount over the Allowed Benefit. Providersare not required to accept CareFirst’s Allowed Benefit on non-covered services. This means you may have to pay your dentist’s entire billedamount for these non-covered services. At your dentist’s discretion, they may choose to accept the CareFirst Allowed Benefit, but are notrequired to do so. Please talk with your dentist about your cost for any dental services.8 Consumer Health Insurance Plans 2020—Northern Virginia
Dental HMO1Select Preferred DentalIn-network OnlyYou PayIn-network You Pay(Out-of-network coverage available)Less than .40Less than .65NoneNoneNo maximumNo maximumOver 580 providers in MD, DC andNorthern VAOver 5,000 providers in MD, DC andNorthern VA 20 copay per office visitNo charge 20- 70 copay per office visitNot coveredMajor Services—Surgical (Class III)Surgical periodontics,endodontics, oral surgeryCopays per serviceNot coveredMajor Services—Restorative (ClassIV) Inlays, onlays, dentures, crownsCopays per serviceNot coveredChild: 2,500 per memberAdult: 2,700 per memberNot coveredIndividual Cost Per DayDeductibleAnnual MaximumNetworkPreventive & Diagnostic Services(Class I)Basic Services (Class II)—Fillings, simple extractions, nonsurgical periodonticsOrthodontic Services (Class V)(up to age 19)Please note: The benefit summary above is condensed and doesnot provide full benefit details.Not all services and procedures are covered by your benefitscontract. This plan summary is for comparison purposes only anddoes not create rights not given through the benefit plan.1 T he Dental HMO plan is underwritten by CareFirst BlueChoice,Inc., which is an independent licensee of the Blue Cross and BlueShield Association.CareFirst payments are based on the CareFirst Allowed Benefit.Participating dentists accept 100% of the CareFirst AllowedBenefit as payment in full for covered services. Non-participatingdentists may bill the member for any amount over the AllowedBenefit. Providers are not required to accept CareFirst’s AllowedBenefit on non-covered services. This means you may have topay your dentist’s entire billed amount for these non-coveredservices. At your dentist’s discretion, they may choose toaccept the CareFirst Allowed Benefit, but are not required todo so. Please talk with your dentist about your cost for anydental services.Mail this card for more informationYES, please rush me more information aboutthe plan(s) that I’ve checked below. I understand thisinformation is free and I am under no obligation.Dental Plan OptionsBlueDental PreferredDental HMOSelect Preferred DentalFor more information,including an application,just mail in the postage-paidcard attached here.If you’d like to talk to adental product consultant,please call sumer Health Insurance Plans 2020—Northern Virginia 9
10 Consumer Health Insurance Plans 2020—Northern Virginia
Know Before You GoKnowing where to go when you need medical care is key to getting treatment with thelowest out-of-pocket costs.Primary care provider (PCP)Establishing a relationship with a primary careprovider is the best way to receive consistent,quality care. Except for emergencies, your PCPshould be your first call when you require medicalattention. Your PCP may be able to provide adviceover the phone or fit you in for a visit right away.Convenience care centers(retail health clinics)These are typically located inside a pharmacy orretail store and offer accessible care with extendedhours. Visit a convenience care center for helpwith minor concerns like cold symptoms andear infections.24-Hour Nurse Advice LineUrgent care centersWith our free nurse advice line, members cancall anytime to speak with a registered nurse.Nurses will discuss your symptoms with you andrecommend the most appropriate care.Urgent care centers have a doctor on staff and areanother option when you need care on weekendsor after hours.CareFirst Video VisitAn emergency room provides treatment for acuteillnesses and trauma. You should call 911 or gostraight to the ER if you have a life-threateninginjury, illness or emergency. Prior authorization isnot needed for ER services.Emergency room (ER)See a doctor 24/7/365 without an appointment!You can consult with a board-certified doctor onyour smartphone, tablet or computer. Doctors cantreat a number of common health issues, such asflu and pink eye. Visit carefirstvideovisit.com formore information.When your PCP isn’t available, being familiar with your options will help you locate the most appropriate and costeffective medical care. This chart shows how costs* (copays) vary for a sample health plan depending on whereyou choose to get care. Visit carefirst.com/needcare for more information.When your PCP isn’t availableSample costSample symptoms Video visit 20 Convenience care 20 Urgent care 60 Emergency room 200 24/7PrescriptionsCough, cold and fluPink eyeEar pain Cough, cold and fluPink eyeEar pain SprainsCut requiring stitchesMinor burns Chest painDifficulty breathingAbdominal pain * The costs in this chart are for illustrative purposes only and may not represent your specific benefits or costs.Consumer Health Insurance Plans 2020—Northern Virginia 11
Choosing Your PlanSee accompanying plan comparisonchart to help you select the coverageoption that best fits your needs.Calculating your total monthlypremiumBefore you decide on the plan that best fits yourneeds, you’ll likely want to take a look at the cost.Buying an individual planUsing the chart, find the plan(s) you are consideringand circle the dollar amount that corresponds withhow old you will be when your coverage begins(i.e., your age on January 1, 2020). That’s your rate.Buying a family planIf you are interested in a family plan, each familymember is rated individually and your rates arecombined to calculate your family premium. Tocalculate your family premium: Circle the rate for you. Circle the rate for your spouse (if applicable). Circle the rates for your oldest three childrenunder age 21.If you have more than three children under age 21,all will be covered on your plan but only the threeoldest count toward your overall premium. Circle the rate for each child age 21-25.Note: Children over age 25 must purchasetheir own health insurance. Add all individual rates together to determineyour family premium.12 Consumer Health Insurance Plans 2020—Northern Virginia
2020 Northern Virginia 596061626364 65 **Catastrophic PlanSilver Level PlansGold Level PlansBlueChoice YoungAdult* 8,150BlueChoice HMOHSA Silver 3,000BluePreferred PPOHSA Silver 3,000BlueChoice HMOGold 1,750BluePreferred PPOGold 1,750 142.26 154.90 159.74 164.57 169.78 174.99 180.38 185.96 185.96 185.96 185.96 186.70 190.42 194.89 202.14 208.09 211.06 215.53 219.99 222.78 225.76 227.24 228.73 230.22 231.71 234.68 237.66 242.12 246.40 252.35 259.79 268.53 278.94 290.66 304.04 317.25 332.12 346.82 362.99 379.36 397.02 414.69 433.84 453.18 473.83 484.05 504.70 522.55 534.26 548.95 557.88 557.88 350.52 381.68 393.59 405.51 418.34 431.17 444.45 458.20 458.20 458.20 458.20 460.03 469.20 480.19 498.06 512.73 520.06 531.05 542.05 548.92 556.25 559.92 563.59 567.25 570.92 578.25 585.58 596.58 607.12 621.78 640.11 661.64 687.30 716.17 749.16 781.69 818.35 854.54 894.41 934.73 978.26 1,021.79 1,068.98 1,116.63 1,167.49 1,192.69 1,243.55 1,287.54 1,316.41 1,352.61 1,374.60 1,374.60 735.58 800.96 825.96 850.96 877.89 904.81 932.69 961.54 961.54 961.54 961.54 965.39 984.62 1,007.69 1,045.19 1,075.96 1,091.35 1,114.42 1,137.50 1,151.92 1,167.31 1,175.00 1,182.69 1,190.39 1,198.08 1,213.46 1,228.85 1,251.93 1,274.04 1,304.81 1,343.27 1,388.46 1,442.31 1,502.89 1,572.12 1,640.39 1,717.31 1,793.27 1,876.93 1,961.54 2,052.89 2,144.23 2,243.27 2,343.27 2,450.00 2,502.89 2,609.62 2,701.93 2,762.50 2,838.47 2,884.62 2,884.62 388.16 422.66 435.86 449.05 463.26 477.46 492.18 507.40 507.40 507.40 507.40 509.43 519.58 531.76 551.54 567.78 575.90 588.08 600.25 607.87 615.98 620.04 624.10 628.16 632.22 640.34 648.46 660.63 672.31 688.54 708.84 732.69 761.10 793.07 829.60 865.62 906.22 946.30 990.44 1,035.10 1,083.30 1,131.50 1,183.76 1,236.53 1,292.86 1,320.76 1,377.08 1,425.79 1,457.76 1,497.84 1,522.20 1,522.20 768.50 836.81 862.93 889.04 917.17 945.30 974.43 1,004.57 1,004.57 1,004.57 1,004.57 1,008.59 1,028.68 1,052.79 1,091.97 1,124.11 1,140.19 1,164.30 1,188.41 1,203.47 1,219.55 1,227.58 1,235.62 1,243.66 1,251.69 1,267.77 1,283.84 1,307.95 1,331.06 1,363.20 1,403.38 1,450.60 1,506.86 1,570.14 1,642.47 1,713.80 1,794.16 1,873.52 1,960.92 2,049.32 2,144.76 2,240.19 2,343.66 2,448.14 2,559.64 2,614.90 2,726.40 2,822.84 2,886.13 2,965.49 3,013.71 3,013.71* Only available for enrollment to people under the age of 30 and those who qualify for a hardship exemption. Visit healthcare.gov for moredetails.** If you are age 65 or older, you can only apply if you are not eligible for Medicare.If you are under age 65 and disabled, you can only apply if you are not eligible for Medicare.Rates are valid January 1–December 31, 2020 only.Please note rates vary if you apply through healthcare.gov.Consumer Health Insurance Plans 2020—Northern Virginia 13
Four Ways to EnrollOnce you decide on the CareFirst plan that works best for your needs, all that’s left to do isenroll. We offer four different ways to enroll in one of our health plans below:Enroll online atcarefirst.com/individual and getinstant confirmation.If you think you qualify for financialassistance, you must purchase aplan through healthcare.gov.See page 3 for moreinformation on financial assistance.Fill out and mail the enclosedpaper application using thepre-paid envelope. We’ll mail youa confirmation and a bill.Enroll through your broker, ifyou have one. A broker is anindependent agent whorepresents you (the buyer) andworks to find you the best healthinsurance policy for your needs.When your coverage will startWhen you enroll through CareFirst, your effectivedate is the date your coverage begins. If youpurchase a new plan for 2020 during the openenrollment period, your coverage will start onJanuary 1, 2020.If you are enrolling through the Federally-facilitatedExchange, please be sure to contact them toconfirm your effective date.Paying for your planIf you buy CareFirst coverage directly from usonline, you can make an immediate payment usingyour checking account or credit/debit card.If you buy CareFirst coverage through theFederally-facilitated Exchange, or if you apply withthe paper application included in this book, you willbe mailed a bill after enrollment. Please wait foryour bill before making a payment.Learn more about payment options by visitingcarefirst.com/paymentoptions.Convenient e-billingIf you set up automated monthly premiumpayments, your first payment and each remainingpayment, will be withdrawn from your bankaccount and sent to CareFirst automatically. Asa member, you can set up recurring payments—using a smartphone, tablet or desktop computer—at carefirst.com/myaccount or with the CareFirstmobile app.14 Consumer Health Insurance Plans 2020—Northern Virginia
GlossaryHere’s a quick reference guide to many of the terms used in this book. For more glossaryterms, visit our YouTube channel videos at youtube.com/carefirst.Allowed benefit—The maximum dollar amountan insurer will pay for a covered health service,regardless of the provider’s actual charge.A provider who participates in the CareFirstBlueCross BlueShield or BlueChoice networkcannot charge members more than the allowedbenefit amount for any covered service.Coinsurance—the percentage y
Consumer Health Insurance Plans 2020—Northern Virginia 1. Welcome. Thank you for considering CareFirst BlueCross . BlueShield and CareFirst BlueChoice, Inc. (CareFirst) for your health care coverage. As the largest health care insurer in the Mid-Atlantic region, we know how much you and your family depend on us for your health coverage.
Aca - 24 Hours A Day A :06 Aca - 24 Hours A Day B :10 Aca - And The Beat Goes On And On (Repeat To Fade) :08 Aca - And The Beat Goes On :03 Aca - Doo Wah :04 Aca - Floats The Jokes Right Down The Drain :08 Aca - For The Best In Entertainment :03 Aca - Good Afternoon :03 Aca - I
Aca - Golden Mem'ries A :07 Aca - Golden Mem'ries B :06 Aca - Golden :04 Aca - Good Music :04 Aca - Good Neighbor Weather :06 . Aca - More Oldies B :08 Aca - More Solid Gold :05 Aca - More Than Music [Shout - What Radio Should Be]
Aca - More Music, Golden :04 Aca - Oldies Radio A :05 Aca - Oldies Radio B :06 Aca - Remember [With Country Steel] :05 Aca - Remember :03 Aca - Remembers :03 Aca - Solid
A: Everyone must be covered by health insurance that meets Affordable Care Act (ACA) coverage requirements. See the Affordable Care Act (ACA) section of this FAQs document to learn more about the ACA. Even if you have other coverage that meets ACA requirements, you may find that enrolling in SHIP is your best value.
The Affordable Care Act (ACA) put in place a range of nationwide protections for Americans with pre-existing health conditions. Under the ACA, insurance companies cannot deny coverage . how health insurance coverage for people with pre-existing conditions actually changed when the ACA's major insurance market reforms took effect in 2014. It .
management system must comply with the Anglo American Metallurgical Coal business ethics and values statements. These include, but are not limited to: ACA SHE Policy. Zero Harm Vision. ACA Safety & Sustainability policies. ACA Finance policies. ACA Human Resources policies. ACA Golden Rules. Grasstree Mine PHMP documents.
The Affordable Care Act The rdable Care Act (ACA) Affoof 2010 is designed to improve health insurance coverage, the quality of health care, and population health Measuresof population health and health care outcomesare essential to the success of the ACA HRQOL and WB are excellent measurement tools for these ACA efforts
The Affordable Care Act (ACA) was enacted in March 2010. A primary goal of the ACA was expanding health insurance, and the law is credited with increasing the number of Americans with health insurance by around 20 million and bringing uninsured rates to a historic low (Uberoi, Finegold, and Gee 2016; Avery, Finegold, and Whitman 2016). Recent .
