The POS plan provides in-network access to local providers in Northern Virginia, Maryland, and the District of Columbia. The plan also provides access to out of network providers both locally and nationwide.
- You must choose a PCP who coordinates your care.
- You may receive treatment from in-network providers without referral, or from out-of-network providers, but you will pay more for such care.
- Routine obstetrical/gynecological care does not require referrals.
- $20 copayment* applies for most office visits.
- Other in-network services are covered at 90% of the plan allowance. The remaining 10% is the coinsurance amount for which you are responsible.
- Your maximum out-of-pocket expense for in-network services is $250 for an individual, or $500 for a family. After you reach the out-of-pocket maximum, the plan pays 100 percent of eligible expenses, excluding copayments, for the rest of the year.
- Inpatient and outpatient behavioral health care services are coordinated through Magellan.
- Lower premiums than the CareFirst BluePreferred PPO plan.
- Vision benefits are provided through United Healthcare Vision.
- Prescription drug benefits are provided through Express Scripts, Inc.
*As of January 1, 2013