CareFirst BlueCross BlueShield Advantage Essential (PPO)

CAREFIRST ADVANTAGE PPO, INC. · 2027 plan year

Plan ID H7379-001-000

Local PPO★ 2.5 CMS Stars
MOOP (in-network)
$7,151
MOOP (combined)
$13,300
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H7379-001-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More CAREFIRST ADVANTAGE PPO, INC. plans in MD

Benefits & cost sharing

Hospital

BenefitIn-network
Worldwide Urgent Care CoverageNo charge
Inpatient Hospital — Acute$385/day for days 1–5, $0 after
Inpatient Hospital — Psychiatric$300/day for days 1–5, $0 after

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$10
Mental Health — Group Sessions$10
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Skilled Nursing Facility (SNF)$0/day for days 1–20, $150/day for days 21–100
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$10
Intensive Cardiac Rehabilitation — Additional Sessions$10
Pulmonary Rehabilitation — Additional Sessions$10
Supervised Exercise Therapy (SET)$10
Emergency Services$115
Urgently Needed Services$25
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency CoverageNo charge
Partial Hospitalization Program$40
Intensive Outpatient Program (IOP)$40
Home Health ServicesNo charge
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$20
Physician Specialist Services$30
Podiatry Services$10
Other Health Care Professional Services$0-$45
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$10
Psychiatric Services — Group Sessions$10
Physical Therapy & Speech-Language Pathology$15
Additional Telehealth Services (Part B)$0-$30
Opioid Treatment Program Services$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$15
Radiological ServicesSee plan details
Diagnostic Radiology$0-$350
Therapeutic Radiology$80
X-Ray Services$25
Outpatient Hospital Services$0-$500
Hospital Observation Services$250/day
Ambulatory Surgical Center (ASC)$275
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$10
Substance Abuse — Group Sessions$10
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Ground Ambulance$300
Air Ambulance$300
Durable Medical Equipment (DME)20% coinsurance
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Diabetic MonitorsNo charge
Dialysis Services20% coinsurance
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 — PreventiveNo charge per office visit (combined preventive services)
Dental — Oral ExamsSee plan details
Dental — X-RaysSee plan details
Dental — Prophylaxis (Cleaning)See plan details
Dental — Fluoride TreatmentSee plan details
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$20
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
Vision — Eyeglasses (Lenses & Frames)$10
Hearing — Exams$20
Hearing — ExamsSee plan details
Laboratory ServicesNo charge
Prosthetics & OrthoticsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)$475-$1,950

Service area

  • MD: 16 counties

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