CareFirst Rebates – Do you know what to do with it?

CareFirst has started sending out the rebate checks that are required under the provisions of the Affordable Care Act.  If they don’t spend a certain amount of every claims dollar (either  $0.80 or $0.85) on actual claims, they must rebate premiums.  The rebates are calculated by jurisdiction, group size and product.    If you receive a rebate, do you know the rules surrounding distribution?  Here is some guidance:

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Posted on by Melanie Epstein in CareFirst, Health Care Reform Leave a comment

New CareFirst Benefit – Introducing Video Visits!

New Benefit – CareFirst Video Visits!

CareFirst has just introduced Video Visits, a new benefit immediately available to all of their group and individual(except those enrolled in a Medicare plan**) members.    CareFirst has partnered with American Well to offer this new telemedicine service that provides 24 hour access to a board certified doctor when your primary care provider is not available.

If you are traveling or you wake up sick in the middle of the night, Video Visits can be an alternative to the Emergency Room as you can consult with a doctor day or night from your smartphone, tablet or computer.

Video Visit allows you to connect with a doctor whenever or wherever you want without an appointment!   The service is great for Bronchitis, Fever, Vomiting, Cough/Sore throat, Pinkeye, Diarrhea, Sinus infection, Cold/Flu or Headaches.

The cost for the visit is the same as your Primary Care Physician copay for a sick visit.    If your plan has a deductible, the visit will cost no more than $60 and will apply to your deductible.

Video Visit can be accessed from the CareFirst member website at  You can also download the CareFirst Video Visit app (iTunes and Android) to see a doctor on your smartphone or tablet.

Before the first visit, you will need to register for an account. Upon successful registration, you will receive a welcome email with instructions on how to schedule a visit.

Let us know what your experience is like when you use Video Visits.

*American Well is an independent company that provides Video Visit services.  The doctors accessed via Video Visit are independent providers making their own medical determinations and are not employed by CareFirst.  CareFirst does not direct the action of participating providers or provide medical advice.

**Video Visit is not a covered benefit for consumer direct members enrolled in over 65 products.  However they can access the service and pay the full $60 copay.

Posted on by Melanie Epstein in CareFirst Leave a comment

Rite Aid Joins the CareFirst medical network for vaccines

Yes, sadly summer is almost over and before we know it winter along with the flu season will be upon us.    CareFirst has announced that it’s members can receive the flu, shingles(for members ages 50+) and pneumonia vaccines covered under your in-network preventive benefit from Rite Aid Pharmacies which has now joined their medical network.  This means for most of us, we can get these important vaccines covered in full at Rite Aid with no claims to file.    

Many primary care physicians also administer these shots and if they are in your plan’s network, will file the  claim for you.   You can also go to a non-participating pharmacy and in this case, you will pay for the cost of the vaccines when you receive them and submit a claim to Carefirst for reimbursement.

Start thinking about these vaccines now before the lines get too long and the shortages start  – yes, I must admit I wasted a Saturday last winter in search of  a flu shot for my daughter!  Of course, if you have any questions about whether to get these shots, please discuss with your primary care physician.

Let us know if you have any questions!

Posted on by Melanie Epstein in CareFirst Leave a comment