ABEL BUSINESS SERVICES, INC.
Health Plan: Rates and Services Chart
FOR MARYLAND
(Employee's primary doctor is in Maryland)CareFirst BlueChoice HMO
| Coverage Details | BlueChoice HMO Plan | ||||||||
|
Plan Year:
April 1, 2008- March 31, 2009 |
|
||||||||
| Primary Doctor Office Visit | $30 | ||||||||
| Specialist Office Visit | $40 | ||||||||
| Hospitilization (per admission) | $0 | ||||||||
| Emergency Room | $50 | ||||||||
| Prescription: generic/formulary*/
non-formulary* Non-Maintenance |
$10 / $25 / $45
$100 deductible per person (each family member) $4,000 maximum |
||||||||
| Prescription: generic/formulary*/
non-formulary* Maintenance |
90 day supply
$20 / $50 / $90 |
||||||||
| Vision:
Davis Vision
Plan
Click on the website and then on "Member Login", use your Carefirst ID number as your login name. |
$10 Copay download plan details (PDF) |
* formulary = list of prescription drugs approved for preferred rates.
See the website:
http://www.carefirst.com
Check for a list of Doctors at http://www.carefirst.com
(Click on the "Members & Visitors" tab. Then go to "Find a Doctor". Check the box for Carefirst BlueChoice HMO)
<< >>
The Dental Network Enrollment Form (PDF) Plan Details (PDF)
| Provider Choice II Plan - PC-5 | |
| Plan Prices | Individual
$22.00
Parent/Child $36.00 Husband/Wife $41.00 Family $55.00 |
| Dental Visit Copay | $5 |
| Specialist Visit copay | $5 |
| No deductibles
No Benefit Maximums No Pre-existing condition limitations No Waiting periods No claim forms |
View Acrobat Reader File
of plan details: (click here) |
| Website: www.thedentalnet.org | Search for a dentist: Provider Choice |