Personal Comp

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 your Evidence of Coverage. Please refer to your Evidence of Coverage for specific terms, conditions, limitations and exclusions.

Personal Comp is a cost sharing plan where members pay a percentage of the cost of the services they receive. The amount that a member is responsible for is based on the provider they choose and whether the service is covered. Personal Comp lets you decide how much you will pay for deductibles and coinsurance amounts. The higher the deductible, the lower your monthly premium.

A Comparison of Providers

If members use participating providers:

  • Claims are submitted directly to CareFirst BlueCross BlueShield (CareFirst) by the provider.
  • CareFirst will pay benefits directly to the provider.
  • The member is responsible for only the deductible and coinsurance.

If members use non-participating providers:

  • Members may have to file the claim.
  • Payment will be made to the member. The member is responsible for the difference between the CareFirst BlueCross BlueShield payment and the non-participating provider's billed charges.
  • The member is responsible for having the provider contact CareFirst BlueCross BlueShield to receive any necessary approval for care.

Preventive Care:

  • Adult wellness
  • Child wellness, including immunizations
  • Cancer screenings (mammograms, Pap tests)
  • OB/GYN exams

Medical Benefits:

  • Surgery
  • Hospitalization/inpatient services
  • Outpatient hospital services
  • Emergency care for injury and illness
  • Office visits for illness
  • Maternity care and infertility services
  • Diagnostic tests and X-rays

Additional Features:

  • No-cost preventive services for children and adults
  • BlueCard coverage. Members receive benefits while they live or travel outside our service area
  • Disease management programs
  • Vitality member magazine
  • Discounts on drugs available at more than 50,000 pharmacies nationwide
  • Health and wellness information through My Care First
  • Discounts on alternative therapies: Options provides discounts on alternative therapies including acupuncture, massage therapy and chiropractic care. It also provides discounts for fitness center memberships
  • 24/7 Advice: FirstHelp gives you 24-hours a day, 7-days a week health care advice from registered nurses who can answer your health care questions and help guide you to the most appropriate care.

A Dental Plan May Be Purchased Separately:

  • Personal Comp members may purchase separate dental coverage through CareFirst. The plan, administered by The Dental Network, Inc. (TDN), offers dental benefits for the price of a copay through a network of primary care dentists. Orthodontia coverage for adults and children is included.

A Vision Plan May Be Purchased Separately:

  • Personal Comp members may purchase separate vision coverage through CareFirst. The plan, BlueVision, is administered by Davis Vision, Inc., a national provider of vision care services. For a $10 copayment, members receive an annual routine examination and discounts on frames and lenses or contact lenses.

Frequently Asked Questions:

  • Get answers to Frequently Asked Questions regarding this plan.

Member Handbook:

For more information about this plan, contact our Member Services Department at the phone number on your member ID card.

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