When You Need Care Frequently Asked Questions


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General Information

Answer: Your out-of-pocket costs, which may include copays, coinsurance and deductible, are directly related to the cost of the service itself, as well as where (office location or type of facility) the service is being provided.

Generally speaking, emergency rooms and hospitals are the most expensive places to receive care, so your out-of-pocket costs will be the highest in these locations.

Remember, you have many choices when you need care and the more you know before you go, the better chance you have to get the best care at the best price.

Answer: PCPs play a huge role in keeping you healthy for the long run. If you don’t already have a PCP, you can begin researching one today. Get started by asking your family and friends about their doctors.

You can also search for providers who participate in your health plan by using our Find a Doctor tool. You can choose from family practice, internal medicine, or general practice doctors as your PCP.

Things to consider:

  • Would you like your PCP to be close to your home? Close to your office?
  • What time of day would you like to make appointments?
  • Once you have narrowed down your options, visit the doctor’s office. Is the staff friendly? Do you like the facility?
  • Review your decision to make sure you’re happy.

Answer: It’s easy to find the most up-to-date information on health care providers and facilities who participate with the CareFirst provider networks.

Answer: Where you receive that care is a personal decision, and you always have choices. However, establishing a relationship with one doctor is the best way for you to receive consistent, quality care. Your PCP is most familiar with your medical history and may be able to see you right away, or direct you to further medical care should it be necessary.

Additionally, your out-of-pocket costs will be less when visiting a PCP office versus an urgent care center. Don’t forget convenience care centers are also an option for immediate care and they are often a lower cost option than urgent care centers.

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Patient-Centered Medical Home

Answer: Patient-Centered Medical Home (PCMH) PCPs can help you take an active role in improving or maintaining your health through coordinated care and access to tools and resources. They may design custom treatment plans, direct you to the proper care centers and closely monitor your health conditions with the help of a large network of CareFirst nurses.

Additionally, selecting a PCMH PCP is one of the steps required to earn your Blue Reward, if applicable. Blue Rewards is an incentive program available to most members that encourages you to get healthy and rewards you for doing so.

Answer: To locate a PCMH PCP, use our Find a Doctor search tool. When you search for a PCMH PCP, you can filter to show only those providers who participate in the PCMH program. These providers will have the PCMH logo in their listings.

PCMH logo

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