CareFirst Medicare Advantage Plans Review in 2025

Available CareFirst Medicare Advantage Plans

With Medicare Advantage, you can expect benefits that go beyond Original Medicare. For example, most insurance carriers (including CareFirst) have plans that include Medicare Part D. Part D can greatly reduce your out-of-pocket cost for prescription drugs.

You may also find plans that offer things such as routine dental, vision and hearing coverage. Unlike Original Medicare, which provides the same general benefits to most beneficiaries, Medicare Advantage has unique features that come with each plan. That means you can theoretically tailor your Medicare coverage to fit your specific needs when you choose from the popular Medicare Advantage plans in your area.

CareFirst BlueCross BlueShield Advantage Essential (PPO)

The Essential plan offers all the benefits of Medicare at lower costs, plus additional coverage for vision, dental, fitness and prescription drugs. Members may also get other benefits — with no monthly premium — such as routine hearing exams and hearing aid coverage, as well as coverage for routine acupuncture, chiropractic, podiatry and more. Prescription drug coverage with no annual deductible is included, as is long-term care facility pharmacy drugs. You are eligible for the plan if you reside in any county in Maryland except Baltimore and Baltimore City.

The plan includes:

• $0 monthly premium
• No medical or prescription drug deductible
• Preventive dental services; $1,000 annual allowance for comprehensive dental
• Routine vision exam and $200 eyewear allowances; $250 contact lens allowance
• $50 a quarter for over-the-counter items
• Large provider network
• Exclusive member rewards for completing annual screenings
• 10 one-way rides to medical visits
• 50 percent coinsurance for most out-of-network Medicare covered services

CareFirst BlueCross BlueShield Advantage Complete (PPO)

The Complete plan features all the benefits of the Essential plan, but it has lower copays and offers additional benefits not covered by Medicare. It also offers larger allowances for dental, vision and over-the-counter (OTC) items, and it includes member rewards for completing annual screenings and transportation (10 one-way rides) for health-care-related appointments. The plan includes prescription drug coverage with no annual deductible. Coverage is also included for long-term care facility pharmacy drugs. You are eligible for the plan if you reside in Maryland or Washington, D.C.

The plan includes:

• $42 monthly premium
• No medical or prescription drug deductible
• Preventive and comprehensive dental services; $1,500 comprehensive dental allowance
• $200 eyewear allowance; $250 contact lens allowance
• Routine hearing exams
• Routine acupuncture, chiropractic and podiatry coverage
• SilverSneakers fitness program
• Large provider network
• 40 percent coinsurance for most out-of-network Medicare covered services

Salute (PPO)

The Salute plan is designed exclusively for veterans and military retirees in Maryland and Washington, D.C., who qualify for Medicare. It complements current VA and Tricare for Life coverage with a large network of providers; coverage for hearing, dental, vision and over-the-counter items; transportation; and more. The plan includes:

• $0 premium
• $100 Part B Premium Giveback
• Extras such as a prepaid card and coverage for hearing, dental, vision, fitness, transportation and OTC items
• Robust local provider network
• Access to BlueCard, in-network cost-sharing with participating BlueCross BlueShield plans
• Care management programs focused on your health-care needs and journey

DualPrime (HMO-SNP)

The DualPrime HMO-SNP plan is for seniors and other beneficiaries who have both Medicare and Medicaid status. The plan provides extra benefits such as coverage for dental, vision, hearing, transportation and more. Members receive a $130 monthly allowance, with rollover, for OTC items, rent, groceries or utilities. If you have qualified Medicare beneficiary or full benefit dual eligible status, there is no monthly premium and no cost-sharing for all Medicare-covered benefits. To be eligible for DualPrime, you must reside in Maryland and be enrolled in Medicare Parts A and B due to age or disability. The plan also includes:

• Coverage of all Original Medicare and Medicaid benefits
• Prescription drug coverage on the plans formulary with no or low cost sharing
• Access to care management and quality programs to manage your health needs
• Extra benefits, such as coverage for hearing, dental and vision, as well as bathroom safety devices, personal emergency response systems, meal benefits for chronic conditions and post-hospital discharge, and more

Extra Perks and Benefits

All CareFirst Medicare Advantage plans include:

• SilverSneakers fitness: With SilverSneakers, you can access a free gym membership, fitness classes and on-demand classes to work out from the comfort of your home.
• 24/7 nurse advice line: CareFirst Medicare Advantage plans cover calls to a designated line where you can discuss your symptoms and get recommendations for care from a registered nurse. The line is available with $0 copays and no out-of-pocket costs.
• Telehealth Visits: This feature makes it easier to connect with a doctor at any time via audio or video. Whether you have an urgent medical issue or you want to speak with a therapist for behavioral health support, you can do so from your computer or mobile device.
• In-home assessment: In addition to the annual wellness exam covered by all Medicare plans, CareFirst Medicare Advantage plans offer an annual in-home assessment. That allows eligible members to schedule a yearly physical that is conducted at home.
• Healthy Rewards: Members who complete all health screenings, such as an annual flu shot, diabetes screening or breast cancer screening, can earn $290 in Healthy Rewards.
• Preventive dental and comprehensive dental: You get oral exams, cleanings, fluoride treatment and dental X-rays three times a year. That includes comprehensive dental services, such as denture coverage, with a plan allowance and transparent copays.
• Over-the-counter items: You get a quarterly allowance toward over-the-counter items through a simple mail-order process.
• Routine eye and ear exams: Plans include routine eye exams and eyewear through Davis Vision providers and hearing exam and hearing aids through NationsHearing. They also include free routine hearing exams, fitting and evaluation for hearing aids, and low copays for hearing aids. Routine eye exam coverage includes one dilation and refraction from a Davis Vision provider per year. Plans offer allowances for frames and contact lenses. The Davis Vision network includes Visionworks, Target, Walmart, Costco, MyEyeDr., Pearle Vision and more.
• Transportation: All plans include nonemergency transportation to health-care locations such as doctors’ offices and pharmacies.

How Much Do CareFirst Medicare Advantage Plans Cost?

According to the National Council on Aging, the average Medicare Advantage plan has a monthly premium of $17.1

As of 2025, the deductibles for Original Medicare are $1,676 per benefit period (Part A) and $257 annually (Part B) for most beneficiaries.2 CareFirst Medicare Advantage plans could help you save on the cost of health-care by offering $0 deductibles. As soon as your coverage period starts, you can begin to benefit from your plan without having to meet a deductible. Rather than spending $1,676 per benefit period on medical care that falls under Part A and $257 per year on medical care that falls under Part B, you could start enjoying coverage for medical services right from the start.

Prices can vary substantially from one plan to the next, however, and premiums and deductibles are not the only factors that matter. With that in mind, let’s take a closer look at the average costs you can expect with CareFirst Medicare Advantage.

Cost of CareFirst BCBS Advantage Essential Plan (PPO)

Keep in mind that these costs do not include the Part B premium, which you may need to pay in addition to your CareFirst premium. As of 2025, the Medicare Part B premium is $185 per month for most beneficiaries.

Below are some of the most important costs you can expect with the Essential plan:

• Premium: $0 per month (varies by county)
• Out-of-pocket maximum: $8,300 in network; $13,300 combined in and out of network
• Prescription drug prices: Preferred generic medications start as low as $0 (three tier prices range from $0 to $47)
• Medical deductible: $0
• Drug deductible: $0

Some of the most common costs seniors and other Medicare beneficiaries incur are the copays required to access certain services. Here are the copays most beneficiaries can expect with the CareFirst Essential plan:

• Primary-care provider: $0
• Specialist: $45
• Urgent care: $30
• Emergency room visit: $110
• Medicare-covered preventive services: $0
• Lab services: $0
• Inpatient hospital visit (up to the first five days): $350
• Outpatient hospital services: $295

Cost of CareFirst BCBS Advantage Complete Plan (PPO)

The Complete plan comes with a higher monthly premium than the Essential plan. Just remember: You may still need to pay your Medicare Part B premium along with the costs outlined below.

• Premium: $42 (varies by county)
• Out-of-pocket maximum: $7,300 in network; $12,300 combined in and out of network
• Prescription drug prices: Preferred generic medications start as low as $0; the first three tiers range from $0 to $47. Tier 4 (nonpreferred drug) has 40 percent coinsurance and Tier 5 (specialty) has 33 percent coinsurance. Enrollees in this plan will never pay more than $35 a month for covered insulin.
• Medical deductible: $0
• Drug deductible: $0

Here are the copays you can expect with the CareFirst Complete plan:

• Primary-care provider: $0
• Specialist: $35
• Urgent care: $20
• Emergency room visit: $100
• Medicare-covered preventive services: $0
• Lab services: $0
• Inpatient hospital visit (up to the first five days): $350
• Outpatient hospital services: $275

Where Are CareFirst Medicare Advantage Plans Available?

CareFirst is the largest not-for-profit insurer in the mid-Atlantic region, serving 3.5 million members. CareFirst Medicare Advantage, however, is available only in Maryland and Washington, D.C.

Reviews and Ratings

It’s important to do ample research before choosing a Medicare Advantage plan. Fortunately, many third-party agencies review and rate Medicare Advantage companies and even individual plans. We’ve provided a few ratings of CareFirst from some of the most reputable business and insurance rating agencies:

• AM Best: B++
• BBB: B
• NCQA: 3.5 out of 5 stars
• CMS: 3.5 out of 5 stars

Customer Service

CareFirst offers various resources to help you enroll, find a plan in your area or simply learn more about your coverage. The customer-service team is available to answer calls between 8 a.m. and 8 p.m. ET, Monday through Friday.

CareFirst vs. the Competition

CareFirst offers plans in only Maryland and Washington, D.C. It’s a great option if you’re in one of those areas, but it’s never a bad idea to look at what the competition has to offer before deciding on a carrier.

CareFirst vs. Kaiser

Kaiser Medicare Advantage plans are available in only eight states, but that’s more than CareFirst offers. Unlike CareFirst, Kaiser offers mostly HMO plans, but they also offer PPO, HMO-POS and SNP. Kaiser stands out for offering emergency coverage abroad, but it doesn’t offer chiropractic, acupuncture and podiatry coverage like CareFirst does with some plans. Unlike CareFirst, many of Kaiser’s services are limited to Kaiser facilities.

CareFirst vs. Anthem

Anthem Medicare Advantage is available in 14 states and offers HMO, PPO and SNP plans, but not all plans are offered in every state. Members get 24/7 telehealth access and many other benefits, such as home health and spending allowances. Some of their plans may include dental, vision and hearing. Visit our CareFirst Medicare Advantage review for more details.

CareFirst vs. Humana

Humana Medicare Advantage offers a whopping 793 Medicare Advantage plans nationwide, and covers 89 percent of counties. It is available in 48 states, as well as Washington, D.C., and Puerto Rico. Humana offers four plan types: HMO, PPO, SNP and PFFS. The company provides a variety of perks, such as coverage for dental, vision and hearing; transportation; the SilverSneakers fitness program (in some areas); meal delivery; an OTC allowance; and an insulin savings program. Read our Humana Medicare Advantage review for more details.

Final Thoughts on CareFirst Medicare Advantage Plans

CareFirst’s geographic limitations may preclude many people from signing up, but CareFirst still offers competitive Medicare Advantage plans for seniors and other eligible beneficiaries in Maryland. The extensive benefits and $0 deductibles make CareFirst plans both affordable and comprehensive in their coverage. Plus, the inclusion of Part D, dental, vision and hearing means most policyholders will not need to purchase additional coverage. If you live in Maryland and are interested in Medicare Advantage, CareFirst is a high-quality option.