CareFirst BlueCross BlueShield

BluePreferred PPO Essential Platinum $0

Plan Overview

Medical Deductible
  • Individual: $0
  • Family: $0
  • Per Person: $0
Medical Out-of-Pocket Maximum
  • Individual: $2,100
  • Family: $4,200
  • Per Person: $2,100
Drug Out-of-Pocket Maximum
  • Individual: Included in Medical
  • Family: Included in Medical
  • Per Person: Included in Medical

Office Visit

Primary Doctor
  • Standard: $20 Copay
Specialist
  • Standard: $40 Copay

Prescription Drug Information

Preferred Brand Drugs
  • Standard: $15 Copay
Non Preferred Brand Drugs
  • Standard: $25 Copay
Generic Drugs
  • Standard: $5 Copay
Specialty Drugs
  • Standard: $100 Copay

Inpatient Coverage

Hospital Services
  • Standard: $250 Copay per Day
Inpatient Services
  • Standard: No Charge

Emergency and Urgent Care

Emergency Room
  • Standard: $150 Copay