HealthyBlue Advantage HSA
Note: The information below briefly describes important features about this health care program. It is not a contract. A detailed description of your benefits is included in the Evidence of Coverage. Please refer to the Evidence of Coverage for specific terms, conditions, limitations and exclusions.
HealthyBlue Advantage rewards you for knowing your health status and gives you choices each time you need care.
HealthyBlue Advantage allows members the flexibility to choose a health care provider when and where treatment is needed. When care is received inside the CareFirst service area members will experience the lowest out-of-pocket costs when they visit a BlueChoice provider. Members still have the option to access a BlueCard PPO doctor, but will be subject to higher out-of-pocket expenses.
Members receiving care outside the CareFirst Service area will experience the lowest out-of-pocket costs by accessing a national BlueCard PPO provider. Members will still have the option to opt-out of this network at a higher out-of-pocket expense.
With HealthyBlue Advantage, you can earn a financial reward by completing three simple steps. Children under the age of 2 are not eligible for the Healthy Reward.
- Freedom to choose any doctor, specialist or hospital
- 365 days of hospital coverage
- No referrals* required
- No claims to file when visiting an in-network provider
Preventive Care at no cost when using a CareFirst BlueChoice provider when in the service area or a BlueCard PPO provider when outside of Maryland, D.C. or Northern Virginia:
- Annual routine examinations and office visits
- Well-child care and immunizations
- Women's health coverage, such as routine mammograms and Pap tests
- Men's health coverage, including routine prostate cancer screenings
Plans typically have some member out-of-pocket costs in the form of copayments, deductibles or annual maximums. Please refer to your Evidence of Coverage for more information.
HealthyBlue Advantage HSA also includes the tax savings of a Health Savings Account (HSA).
Health Savings Account (HSA): A health savings account is like a personal savings account, but the money in it can only be used for health care expenses. Only those individuals enrolled in a special type of health insurance called a high-deductible health plan are eligible to open a health savings account and contribute money into the account. The money in an HSA is always member owned, even though both the employer and member may deposit money into the account.
- Financial control over how you spend your health care dollars.
- The money deposited remains in your account from year to year.
- HSA funds can be used to offset your out-of-pocket costs (copayment, coinsurance and deductibles) that are associated with qualified health care expenses, including medical, pharmacy, dental and vision services.
- An HSA is the only account that provides you with three types of tax savings:
- Contributions to your HSA made by your employer (including contributions made through a cafeteria plan) may be excluded from your gross income.
- All interest accrued in the account is not subject to federal income tax.
- Withdrawals made to pay for qualified expenses are tax free.
- Select Preventive Generics available at no cost - used to treat asthma, blood pressure, cholesterol, depression and diabetes
- Tier 1 - Generic copays offer the lowest cost to the member
- Tier 2 - Copays for formulary/preferred brand name drugs are higher than for generic drugs
- Tier 3 - Copays for non-formulary/non-preferred brand name drugs have the highest level of copay
- HSA products require combined medical and prescription deductible
- No-cost preventive services for children and adults
- Wellness Discount Program - Learn about Blue365, an exciting program that offers great discounts from top retailers on fitness gear, gym memberships, family activities, healthy eating options and much more.
- Find a Provider - This provider directory is updated every two weeks.
- Prescription Drug Information - Look up your prescription drug coverage levels and learn how to save money on prescription drugs.
- Vitality member magazine
- Health education programs
- 24/7 Advice: FirstHelp gives you health care advice 24-hours a day, 7-days a week from registered nurses who can answer your health care questions and help guide you to the most appropriate care.
- My Care First - Provides health and wellness information along with health risk assessment and health goal-setting tools.
The discount dental program offers CareFirst BlueChoice members savings of 20% to 40% on dental services.
BlueVision coverage includes an annual eye exam and discounts on lenses, frames and materials.
- DHMO Dental
- Preferred (PPO) Dental
- Traditional Dental
- BlueVision Plus is an enhanced vision plan that may be purchased separately by employer groups. BlueVision Plus provides a routine eye examination and the opportunity to receive one pair of eyeglasses or a supply of contact lenses for a single copayment during each benefit period.
*While a referral is not needed to visit plan specialists when receiving services rendered in an office setting, pre-authorization may be needed for certain services such as mental health and substance abuse treatments and non-emergency hospitalizations, among others. Please refer to the benefits booklet (also called Evidence of Coverage) for the specific services that require pre-authorization.
For more information about this plan, contact our Member Services Department at the phone number on your member ID card.