Is Carefirst Community Health Plan Medicaid: What You Need to Know
CareFirst Community Health Plan (CareFirst) is a Medicaid Managed Care Plan headquartered in Arlington, Virginia. It offers health coverage to Medicaid-eligible individuals in Maryland and the District of Columbia. Members of CareFirst have access to a wide variety of benefits, including comprehensive medical coverage, prescription drug coverage, mental health and substance abuse treatment, and vision and dental care, among others. CareFirst also provides members with access to a network of providers and facilities, as well as care management services to help them manage their health. Additionally, CareFirst offers a variety of programs and services to help members stay healthy, such as health education, disease management, and wellness programs.
Carefirst Community Health Plan
Carefirst Community Health Plan is a Medicaid health insurance plan that provides comprehensive coverage to low-income individuals and families in Maryland. The plan is offered through Carefirst BlueCross BlueShield, a leading health insurer in the state. Carefirst Community Health Plan offers a wide range of benefits, including:
- Medical care
- Dental care
- Vision care
- Mental health care
- Substance abuse treatment
- Prescription drug coverage
Carefirst Community Health Plan is available to Maryland residents who meet certain income and eligibility requirements. To be eligible for Carefirst Community Health Plan, you must:
- Be a Maryland resident
- Be a U.S. citizen or legal resident
- Have a household income at or below 138% of the federal poverty level
If you meet these requirements, you can apply for Carefirst Community Health Plan online or through a paper application. You can also find more information about the plan by calling Carefirst BlueCross BlueShield’s customer service line.
| Benefit | Covered Services |
|---|---|
| Medical care | Doctor’s visits, hospital stays, surgery, prescription drugs, and other medical services |
| Dental care | Routine cleanings, fillings, X-rays, and other dental services |
| Vision care | Eye exams, glasses, and contact lenses |
| Mental health care | Counseling, therapy, and medication management |
| Substance abuse treatment | Detoxification, counseling, and therapy |
| Prescription drug coverage | A wide range of prescription drugs, including brand-name and generic medications |
Eligibility
To be eligible for Carefirst Community Health Plan Medicaid, you must meet certain requirements. These include:
- Being a resident of the District of Columbia
- Being a U.S. citizen or legal resident
- Meeting income and asset limits
- Being pregnant or having a child under 19
- Being disabled or elderly
- Meeting other specific criteria
Coverage Details
Carefirst Community Health Plan Medicaid provides a wide range of benefits and services, including:
- Medical, dental, and vision care
- Hospitalization
- Prescription drugs
- Mental health and substance abuse treatment
- Long-term care
- Rehabilitation services
- Home health care
- Transportation to medical appointments
The specific benefits and services covered by Carefirst Community Health Plan Medicaid may vary depending on your individual needs and circumstances.
| Family Size | Income Limit | Asset Limit |
|---|---|---|
| 1 | $25,760 | $2,000 |
| 2 | $34,840 | $3,000 |
| 3 | $43,920 | $4,000 |
| 4 | $53,000 | $5,000 |
| 5 | $62,080 | $6,000 |
| 6 | $71,160 | $7,000 |
| 7 | $80,240 | $8,000 |
| 8 | $89,320 | $9,000 |
Note: Income and asset limits are subject to change. Please visit the Carefirst Community Health Plan website for the most up-to-date information.
Benefits and Services Offered:
Carefirst Community Health Plan Medicaid provides a comprehensive range of healthcare benefits and services to eligible individuals.
Medical Benefits:
- Preventive care, including well-child visits, annual checkups, and screenings.
- Doctor visits and specialist consultations.
- Hospitalization and emergency services.
- Laboratory and radiology tests.
- Prescription drugs.
- Durable medical equipment and supplies.
- Nursing home care.
- Physical, occupational, and speech therapy.
- Home health services.
- Hospice care.
Mental Health and Substance Abuse Services:
- Individual and group therapy.
- Medication management.
- Crisis intervention.
- Substance abuse treatment.
- Residential and outpatient programs.
Dental and Vision Services:
- Regular dental checkups and cleanings.
- Fillings, extractions, and root canals.
- Dentures and other prosthetic devices.
- Comprehensive vision exams.
- Eyeglasses or contact lenses.
Carefirst Community Health Plan Medicaid also offers a variety of additional services and programs to support the health and well-being of its members, including:
- Transportation assistance.
- Interpretation services.
- Health education and wellness programs.
- Case management.
- Coordination of care with other providers.
- Family planning services.
- Tobacco cessation programs.
| Age | Income | Other Requirements |
|---|---|---|
| Under 19 | Up to 138% of the federal poverty level (FPL) | U.S. citizen or legal resident |
| 19 to 64 | Up to 138% of the FPL | U.S. citizen or legal resident |
| Pregnant women | Up to 200% of the FPL | U.S. citizen or legal resident |
| Disabled adults | Up to 100% of the FPL | U.S. citizen or legal resident |
| Children with disabilities | Up to 100% of the FPL | U.S. citizen or legal resident |
Provider Network
Carefirst Community Health Plan Medicaid offers an extensive provider network, ensuring access to a wide range of healthcare professionals and facilities. With Carefirst Medicaid, you can choose from:
- Primary care physicians
- Specialists
- Hospitals
- Behavioral health providers
- Dentistry
- Vision care
- Pharmacy services
To find a provider in your area, you can use the Carefirst Medicaid provider directory or call the customer service number on your member ID card.
Access to Care
Carefirst Community Health Plan Medicaid offers a variety of programs and services to help members access the care they need. These include:
- Transportation assistance
- Language interpretation services
- Help finding a doctor or specialist
- Assistance with medication costs
- Coverage for preventive care
- Chronic disease management programs
- Mental health and substance use disorder treatment
These programs and services are designed to make it easier for members to get the care they need, when they need it.
| Provider Type | In-Network Providers |
|---|---|
| Primary Care Physicians | 5,000+ |
| Specialists | 3,000+ |
| Hospitals | 100+ |
| Behavioral Health Providers | 2,000+ |
| Dentistry | 1,000+ |
| Vision Care | 500+ |
| Pharmacy Services | 3,000+ |
,>=