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CareFirst Offers Consumers Tips for Open Enrollment Season

How consumers can determine which health plan is right for them

Baltimore, MD (October 24, 2012) - With open enrollment for 2013 health insurance coverage under way, many consumers may be confused about which plan best suits their needs. Changes in their employer-provided benefit plans or as a result of the Affordable Care Act may add to the confusion.

While insurers and their health plans vary, there are some common considerations consumers should keep in mind when choosing a health plan. Among them:

  • Don’t simply re-enroll in your current plan without considering changes that have been made. These differences could be in the plan’s design or as a result of changes in your employer’s contribution toward it, changes in your medical history or your even family—such as getting married or having a child.
  • Consider how much you want to pay out of your pocket. Consumer-directed health plans that feature a higher deductible are popular, but they may come with a higher out-of-pocket cost to you. Compare monthly premiums, copays, coinsurance, employer contributions and deductibles. The plan with the lowest premium is not necessarily the least expensive plan.
  • How much control do you want? Not all health plans allow members to choose their specialists. If doing so is important to you, look for plans that offer a choice of providers or a broad network of them in your area. You may also want to consider a plan that comes with a health savings account (HSA) through either employer or individual contributions. HSAs allow you to make tax-free contributions in a savings account and use the money toward medical expenses.
  • Review benefits. Not all health plans include coverage for prescription medications, dental or vision care. If you have a chronic illness, such as asthma or diabetes, be sure to choose a plan that provides the coverage you need.
  • Look for plans that offer financial incentives for maintaining good health or preventive care. Some plans offer monetary rewards to individuals who don’t smoke, get a flu shot and take part in other biometric and wellness screenings. CareFirst offers HealthyBlue Advantage, a plan designed to reward members for living a healthy lifestyle, while lowering out-of-pocket costs and giving them more control over the care they receive.

While health insurance can be complicated, considering these steps, along with taking time to review your health plan benefits, can save you money and most importantly, provide you and your family with the health benefits you need.

For more information please visit the Deciding on a Plan section of

Glossary of Terms:

  • Copayment: The dollar amount a member pays when services are received. Your insurance will pay the remainder of the costs. Also known as copay.
  • Deductible: The dollar amount of expenses that must be paid before an insurer will pay any expenses.
  • HMO: Health Maintenance Organization, a health plan that usually has the lowest out-of-pocket costs and members normally select a primary care physician.
  • HSA: A health savings account is available to members usually enrolled in a high-deductible health plan that allows them to make pre-taxed contributions and use the money towards medical expenses. The funds contributed roll over year to year if not spent.
  • PPO: Preferred Provider Organization, an agreement between a medical provider and a health care carrier for delivery of health care services using discounted fees for cost savings.
  • Premium: Amounts paid by or on behalf of members for ongoing health care coverage. It does not include any deductibles or copayments the plan may require.
  • Primary Care Provider (PCP): A physician selected by the member, who is part of the plan network and provides routine care and coordinates other specialized care.

About CareFirst
In its 75th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.4 million individuals and groups in Maryland, the District of Columbia and Northern Virginia. In 2011, CareFirst contributed $51 million to community programs designed to increase the accessibility, affordability, safety and quality of health care throughout its market areas. To learn more about CareFirst BlueCross BlueShield, visit our web site at or follow us on Twitter:

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