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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Video Visit

Answer: When your primary care provider (PCP) isn’t available, you can securely connect with a doctor* anytime day or night through your phone, tablet or computer for urgent care services. In addition, CareFirst Video Visit enables you to receive care for other services, such as behavioral health support from a therapist or psychiatrist, guidance from a certified nutritionist or breastfeeding support from a lactation consultant. It's convenient and easy to use.

* The doctors accessed via CareFirst Video Visit are independent providers making their own medical determinations and are not employed by CareFirst. CareFirst does not direct the action of participating providers or provide medical advice.

Answer: You can register in two ways:

When registering, use the name exactly as it appears on your CareFirst member ID card.

You may also visit www.carefirst.com/videovisit to learn more about how it works.

Answer: The urgent care service through CareFirst Video Visit is intended for the treatment of common, uncomplicated, non-emergency health concerns including, but not limited to:

  • Ear pain
  • Cough/sore throat
  • Sinus infection
  • Allergies
  • Urinary tract infection
  • Fever
  • Pinkeye
  • Cold/Flu
  • Migraine

Depending on your situation, the doctor may diagnose, prescribe medications and suggest follow-up care when appropriate.

Answer: These services provide a range of support, including, but not limited to:

  • Anxiety (therapy)
  • Stress Management (therapy)
  • Depression (therapy and psychiatry)
  • Bipolar disorder (psychiatry)
  • Latching issues (lactation support)
  • Persistently hungry baby (lactation support)
  • Weight loss (nutrition counseling)
  • High cholesterol (nutrition counseling)

Answer: The cost for Video Visit varies based on your benefits (meaning Therapy and Psychiatry align to your mental health specialist benefit, registered dietician aligns to nutritional counseling) but will never be more than the maximum cost listed below. Your Video Visit copay will be the same as what you would owe a provider had it been an office visit of the same type. The Urgent Care visit will typically be the same as your PCP office visit. You will be able to see your specific cost information before you start your Video Visit.

Note: Lactation consultations are covered as a no cost preventive service for women.

Members in a CDH HSA plan (or other products where deductible must be met first) are subject to their deductible which is the maximum cost shown below.

ProviderMaximum Cost Per Visit
Urgent Care $49
Therapist $80 (Master's level)
$95 (Doctorate level)
Psychiatrist $175 (initial visit)
$90 (follow-up visit)
Registered Dietician $60
Lactation Consultant $110 (initial visit)
$60 (follow-up visit)

Answer: Video Visit conveniently allows you to receive care from the comfort and privacy of your home. Below are examples of when you would use Video Visit.

For Urgent Care:

  • Your doctor’s office is closed
  • On business travel or vacation
  • You have children at home and can’t bring them to the doctor’s office

For Therapy/Psychiatry:

  • Finding it hard to fit a therapy appointment into your schedule
  • Experiencing anxiety, stress or other personal issues and need someone to talk to
  • Feel you are not getting better under the care of your general practitioner

For Diet and Nutrition Counseling:

  • Want to lose weight and need nutrition tips to help reach your goal
  • You’re a mom-to-be and want to learn more about eating for yourself and your baby
  • Looking for nutrition tips to help prevent chronic conditions like diabetes, high blood pressure and heart disease

For Lactation Consulting:

  • Experiencing latching issues
  • Need tips on breastfeeding when returning to work
  • Having concerns about milk supply

Answer: Yes! CareFirst Video Visit is great when you’re on the road for vacation or work. Video Visit is available in all 50 states.

Answer: All care providers have profiles so you can see their education and practice experience.

Urgent Care Providers:

  • Doctors average 15 years’ experience in primary and urgent care
  • U.S. board certified, licensed and credentialed

Therapists:

  • Network of licensed doctoral level psychologists and master’s level therapists practicing within the Online Care Group
  • Each therapist is licensed to practice in their state and trained in prevention and treatment techniques via telehealth

Psychiatrists:

  • Network of licensed physicians board-certified in psychiatry and neurology
  • Each psychiatrist is licensed to practice in their state and is trained in delivering care via telehealth

Nutritionists:

  • Nutritionists are registered dietitians (RDs); RDs receive extensive training that combines academic preparation with hands-on, practical patient experience

Lactation Consultants:

  • Lactation consultants are current IBCLCs—International Board-Certified Lactation Consultants; The IBCLC credential is the gold-standard in breastfeeding care
  • Each consultant has had thorough lactation education, completed a lactation-specific clinical internship and passed a board examination

Answer: Your spouse will need to create a separate account to register.

Answer: Parents and guardians can add their children who are under age 18 to their account and have Video Visits on their behalf. Be sure to register yourself first and then add your child to your account.

Answer: Children and adult dependents age 18 and older will need to create their own account.

Answer: Contact the service provider, American Well, directly at 877-699-4117 or CareFirstVideoVisit.Support@americanwell.com.

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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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