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Blue Shield Association. Registered trademark of CareFirst of Maryland, Inc. CUT6191-1P (12/08) 1 CUT6191-1P (12/08) V. DEPENDENT INFORMATION Name - (Last, First, MI) Social Security No. Date of Birth Spouse 1 / Name of Primary Care Physician Name - 3 (Last, First, MI) Social Security No. / Physician Code # Social Security No. Date of Birth / Child Name of Primary Care Physician (Last, First, MI) Sex Male Female Current Patient Yes No Date of Birth / N.

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A. The FCPS BlueChoice Advantage plan utilizes CareFirst's BlueChoice HMO and BluePreferred PPO provider networks, and also the national BlueCross BlueShield BlueCard PPO provider network. Members do not need referrals to see specialists. Vision benefits are provided through CareFirst's partnership with Davis Vision.

CareFirst offers a variety of plan types (HMO, POS, PPO). Plan types refer to how plans provide coverage and from which network of providers you receive care.

CareFirst BlueCross BlueShield's Preferred Provider Organization (PPO) is offered to all active State of Maryland employees as well as all retirees, with or without Medicare, regardless of their place of residence.

Employees offered this plan by their employer. Having one doctor who manages your care reduces health care costs. ... With Blue Cross Physician Choice PPO, you can choose to take advantage of these savings if you live in one of 64 Michigan counties.

In its 78th year of service, CareFirst, an independent licensee of the Blue Cross and Blue Shield Association, is a not-for-profit health care company which, through its affiliates and subsidiaries, offers a comprehensive portfolio of health insurance products and administrative services to 3.4 million individuals and ...

At CareFirst BlueCross BlueShield, we're building the future of healthcare with the widest coverage and the largest network for medical, dental and vision insurance in Maryland, Washington, D.C. and Northern Virginia.

PPO stands for preferred provider organization.

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are both independent licensees of the Blue Cross and Blue Shield Association.

Blue Options is a PPO plan that offers convenient copayments. or coinsurance for things like primary care, specialist office. visits and prescription drugs.7 Employees may receive care.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232