‘Historic’ Rate Cuts for Maryland Individual Health Insurance Plans Detailed by CareFirst
The Affordable Care Act (ACA) individual health insurance rates approved today by the
CareFirst offers both Preferred Provider Option (PPO) plans and
"This development is historic,'' said CareFirst President & CEO
When 2019 Maryland rates were first filed in
"There is no doubt that this is - after years of increases - positive news for those seeking individual coverage in
The benefits available through CareFirst PPO and HMO plans are comparable at the respective "metal levels" offered through CareFirst and the MHBE. In addition, the medical provider network is broad in both the PPO and HMO - with the HMO provider network representing 93 percent of all PPO providers. So, for many PPO members, it may be possible to switch to a substantially lower-priced HMO plan without losing access to their preferred medical providers.
Key benefits including deductibles, out-of-pocket payment maximums and copays for medical provider visits are the same in the HMO and PPO. There are some differences between the plan types, including requirements related to prior authorization and use of laboratory services. When open enrollment begins, CareFirst customer service teams, MHBE's statewide network of health insurance "navigators," and insurance brokers will be able to aid consumers in selecting the path that best meets their needs at the lowest cost.
"We recognize that many PPO members will opt to continue their coverage, especially since they'll be able to do so at a lower cost than last year," said Pieninck. "But we have an obligation to make sure our members understand their options, the benefits, and the associated cost."
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