CareFirst BlueCross BlueShield Advantage Signature (PPO)

CAREFIRST ADVANTAGE PPO, INC. · 2027 plan year

Plan ID H7379-004-001

Local PPO★ 2.5 CMS StarsNew for 2027
MOOP (in-network)
$7,151
MOOP (combined)
$12,000
Monthly premium
$47/mo
Part C $9.60 + Part D $37.40, before Extra Help
Prescription drugs
Included

Plan information

Contract / Plan / Segment
H7379-004-001
Medical deductible
$320
Part D premium
$37.40/mo (part of the monthly premium above)Before Extra Help, which can lower or remove it for people with limited income.
Part D deductible
$600/yr
Also owed
Your Medicare Part B premium, paid separately

Other segments for this plan:

More CAREFIRST ADVANTAGE PPO, INC. plans in MD

Benefits & cost sharing

Hospital

BenefitIn-network
Inpatient Hospital — Acute$325/day for days 1–5, $0 after
Inpatient Hospital — Psychiatric$300/day for days 1–5, $0 after
Worldwide Urgent Care CoverageNo charge

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$40
Mental Health — Group Sessions$40
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $218/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$20
Intensive Cardiac Rehabilitation — Additional Sessions$20
Pulmonary Rehabilitation — Additional Sessions$20
Supervised Exercise Therapy (SET)$20
Emergency Services$115
Urgently Needed Services$40
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Partial Hospitalization Program$60
Intensive Outpatient Program (IOP)$50
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$5
Occupational Therapy Services$25
Physician Specialist Services$45
Podiatry Services$40
Laboratory ServicesNo charge
Radiological ServicesSee plan details
Podiatry Services$40
Other Health Care Professional Services$0-$45
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$35
Psychiatric Services — Group Sessions$35
Physical Therapy & Speech-Language Pathology$15-$25
Additional Telehealth Services (Part B)$0-$45
Opioid Treatment Program Services$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$50
Diagnostic Radiology$0-$800
Therapeutic Radiology20% coinsurance
X-Ray Services$100
Outpatient Hospital Services$0-$800
Hospital Observation Services$340/day
Ambulatory Surgical Center (ASC)$600
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$35
Substance Abuse — Group Sessions$35
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$350
Air Ambulance$400
Durable Medical Equipment (DME)20% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic Supplies20% coinsurance
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic Monitors10% coinsurance
Dialysis Services20% coinsurance
Acupuncture$40
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Kidney Disease Education ServicesNo charge
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)0%-20% coinsurance (max $35)
Dental — Medicare-Covered Services$40
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative Services$15-$400
Dental — Endodontics (Root Canal)$100-$200
Dental — Periodontics (Gum Care)$50-$300
Dental — Removable Prosthodontics (Dentures)$30-$700
Dental — Implant Services$70-$500
Dental — Fixed Prosthodontics (Bridges)$40-$400
Dental — Oral & Maxillofacial Surgery$40-$100
Dental — Adjunctive General Services$15-$30
Vision — Eye Exams$40
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — Other Eye Services$0-$60
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$500-$1,975
Prosthetics & OrthoticsSee plan details
Vision — Eyeglasses (Lenses & Frames)$0-$10
Hearing — Exams$40

Service area

  • MD: 18 counties

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