HealthyBlue Advantage FAQs

Frequently Asked Questions – HealthyBlue Advantage

 

HealthyBlue General FAQs

Q: How does the HealthyBlue Advantage plan work?

A: HealthyBlue Advantage offers you the flexibility to see any in-network and out-of-network providers.

In-Network Providers:

  • Access to more than 33,000 CareFirst BlueChoice providers (PCPs, nurse practitioners and specialists) and 60 hospitals in-network, in our service area.
  • Access to more than 600,000 BlueCard® PPO providers, in-network but outside of our service area (MD, DC and Northern Virginia).

Out-of-Network Providers:

Access to any out-of-network provider. Out-of-network providers may increases the cost, but afford you greater flexibility to choose any physician or medical facility to provide the care you are seeking.

Q: How is HealthyBlue Advantage different from other plans?

A: HealthyBlue Advantage takes a different approach to health insurance. Instead of focusing on covering you when you get sick, it provides coverage to keep you well and informed about your health by:

  • Removing obstacles to preventive screenings and primary care services by offering those services for little to no cost.
  • Encouraging you to use our health assessment to help you understand and improve your health status.
  • Providing incentives when you to take control of your health by completing three simple steps.

Health Assessment

Q: How do I take the Health Assessment?

A: You can access the online Health Assessment through My Account, CareFirst’s secure member site. If you do not have computer access, you also may get a paper copy by calling 866-454-5375.

Q: Who can see my Health Assessment?

A: You are the only person who can access your Health Assessment online. If you elect to share your Health Assessment results with your PCP (a required step to earn your Healthy Reward), we may share the data with your selected PCP.

We also recommend that you take a copy with you to your Health and Wellness Evaluation so you can discuss the results with your doctor.

HealthyBlue Rewards

Q: How much of a reward can I get?

A: If you purchase your health insurance directly through CareFirst:
Healthy Reward cost savings are given to our members as a reward card that they can use for a variety of health and wellness services. Each member can:

  • Earn $125-$225 for adults (age 18+)
  • Earn up to $325-$525 for your entire family


If you get your CareFirst health insurance through your employer:
Once your Health and Wellness Evaluation Form and the Health Assessment are completed (with the consent portion checked) and received by CareFirst, you qualify for a Healthy Reward. Your Healthy Reward will be a reduction in your annual deductible. Each member can:

  • Earn $250-$300 for adults (age 18+)
  • Earn $25 per child (age 2-17)
  • Earn $500-$700 for family (maximum reward per 2 person family)

If you have already met your deductible, you will be reimbursed with a check. It’s that simple.

Q: How do I know my effective date?

A: You can find out your effective date by logging into My Account, CareFirst’s secure member site, or by calling member services at the number listed on your member ID card.

You have 180 days from your effective date to complete the steps required to earn your Healthy Reward.

Q: I recently joined my company, and our benefit year ends soon. Can I qualify for a Healthy Reward this year?

A: Yes, you are eligible to qualify for the Healthy Reward.

Q: What information will my employer get?

A: Your personal health information is only available to you and will not be shared with anyone without your written consent. Federal and/or state privacy rules prohibit anyone at your company from receiving any of your personal health information without your written consent.

Q: Can my children get a Healthy Reward?

A: Children are eligible to receive a Healthy Reward, if they are age 2 or above on your effective date. They must also have a Health and Wellness Evaluation visit and you must submit a Health and Wellness Evaluation Form to CareFirst. Children (up to age 18) are not required to complete an online Health assessment to qualify to a Healthy Reward. Your dependent child who is age 18 or over on their effective date, will be required to complete the online Health Assessment to qualify for a Healthy Reward.

Q: How long does it take to receive your reward after you have met with your PCP?

A: Members with coverage directly through CareFirst:
You must be enrolled in HealthyBlue for at least 90 days to be eligible for your Healthy Reward. Once you have completed all 3 steps and qualified for the reward, you will receive your Healthy Reward as a gift card or HSA deposit.

You should expect to receive the reward about two weeks after the 90 days are up, and you have completed the 3 steps. For example, if you have an effective date of April 1 (and you have completed your 3 steps), you should expect to receive the reward in mid-July. Keep in mind the 3 steps must be completed within 180 days of your enrollment into HealthyBlue.

You may check your eligibility status by logging into My Account. If you have not already registered for My Account, registration only takes a few moments.


Members with CareFirst coverage through their employer:
 
Look for your Healthy Reward, as a reduction in deductible, within 10 business days after completing the 3 steps. Keep in mind, the 3 steps must be completed within 180 days of your enrollment into HealthyBlue.

If you have already met your deductible by the time you complete your 3 steps, you will receive a check from CareFirst for your reward.

You may check your eligibility status by logging into My Account. If you have not already registered for My Account, registration only takes a few moments.

Q: What can I buy with my reward card?

A: Members who have purchased their coverage directly through CareFirst, can receive their reward as a gift card.

You may use your gift card for the services noted below. However, if you have a HSA plan, you cannot use your gift card for medical expenses until after your deductible is met. With the HSA plan you can use your Reward for medical expenses if it has been deposited directly into your HSA account.

Members can use their gift cards to:

  • Pay their premiums
  • Pay out of pocket medical expenses (copays and deductibles)
  • Pay for the following types of medical and wellness services:
    • Medical Professionals: Doctors, Chiropractors, Podiatrists, Dentists, Optometrists
    • Medical Facilities: Hospitals, Labs, Pharmacies, Urgent Care Facilities, Ambulance Services, Home Health Agencies*,
      Opticians, Eyeglasses and Hearing Aid Providers
    • Complementary and Alternative Medicine and Wellness: Yoga, Pilates, Meditation
    • Recreational Activities: Sporting Goods Stores, Bicycle Shops, Camps, Gyms and more
  • See the full list.

Q: Who do I call with issues with my gift card or if I lost my card?

A: The gift card program is managed by our partner, PayFlex. You can contact them with any questions related to the gift card at 1-866-208-8587.

Q: Does my reward card expire?

A: Reward cards will have an expiration date on the card, but a new card will be reissued to members who still have a remaining balance. However, beginning 12 months after the last deposit to the card, a $1 monthly administrative fee will be applied to any remaining balance.

Please note: Gift cards are issued to members who purchase their health care insurance directly through CareFirst.

Health and Wellness Evaluation Form

Q: Where can I get a copy of the Health and Wellness Evaluation Form to give to my doctor?

A: The Health and Wellness Evaluation Form is available on the Forms page of CareFirst.com.

Please be sure to take a copy of this form to your Primary Care Physician (PCP) when you go for your Health and Wellness Evaluation.

Q: Do I have to send in the Health and Wellness Evaluation Form or is that my doctor's responsibility?

A: For the quickest processing, you can submit the form through My Account. Other ways to submit the form to CareFirst are listed on the back of the Health and Wellness Evaluation Form.

Q: How did CareFirst determine the standards on the Health and Wellness Evaluation Form?

A: The health factors measured on the form are consistent with the guidelines provided by The American Journal of Preventive Medicine. These factors are believed to be the most reliable in predicting future health outcomes.

Q: How will I know when the Health and Wellness Evaluation Form is received and when my Healthy Reward is available?

A: You can check the status of the form by logging in to My Account or calling the member service number on your ID card.
 
If your Healthy Reward is a gift card or HSA deposit, you should expect to receive the reward about two weeks after you’ve been enrolled in the plan for 90 days, and have completed your 3 steps. For example, if you have an effective date of April 1, you should expect to receive the reward in mid-July (if you completed the 3 steps).

If your Healthy Reward is a deductible reduction, look for your reward within 10 business days after completing the 3 steps.