Medicare Advantage · Local PPO
CareFirst BlueCross BlueShield Medicare Advantage
Plan year 2026

CareFirst BlueCross BlueShield Advantage Essential (PPO) H7379-001

3.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$0
+ your Part B premium
Max out-of-pocket
$8,300
in-network annual cap
Primary care
$0
per visit copay
Specialist
$45
per visit

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$0
Inpatient hospital
Days 1-5: $385/day, Days 6-90: $0/day
Inpatient mental health
Days 1-5: $250/day, Days 6-90: $0/day
Outpatient surgery
$350
Emergency room
$115
Urgent care
$25

What's included, and what it's actually worth5 benefits included. Tap any card for the detail

Hearing

$475–$1,950copay per hearing aid
Details$475–$1,950 copay per hearing aid
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$250eyewear allowance
Eyewear allowance$250 eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$50/quarter OTC allowance
Prepaid card$50/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$45 copay
In-network$45 copay per visit
Inpatient Hospital$385/day, days 1–5
In-networkDays 1-5: $385/day, Days 6-90: $0/day
Outpatient Surgery$350 copay
In-network$350 copay per procedure
Mental HealthDays 1-5: $250/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $250/day, Days 6-90: $0/day
TransportationNon-emergency transportation benefit
DetailsNon-emergency transportation benefit
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
$5
Generic
Tier 3
20%
Preferred Brand
Tier 4
40%
Non-Pref Brand
Tier 5
33%
Specialty

Our take

Where this plan shines

This plan has a $0 monthly premium.
See your primary doctor for $0.
No separate drug deductible.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO)

What does CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) cover?

CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 5 formulary tiers. Published supplemental benefits include vision ($250 eyewear allowance), hearing ($475–$1,950 copay per hearing aid), over-the-counter (OTC) ($50/quarter OTC allowance), and transportation (Non-emergency transportation benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) cost in 2026?

The published 2026 monthly plan premium for CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) is $0. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $8,300; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $45. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO)?

CMS lists CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) as a Local PPO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) cover my prescriptions?

CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) has 5 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $5, Tier 3 at 20%, Tier 4 at 40%, and Tier 5 at 33%. The listed Part D deductible is $0. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) include?

The current plan record for CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) lists vision ($250 eyewear allowance) and hearing ($475–$1,950 copay per hearing aid). It also lists over-the-counter (OTC) ($50/quarter OTC allowance). The current data does not list dental as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO)?

CareFirst BlueCross BlueShield Advantage Essential (PPO) (Local PPO) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in Maryland. Plan availability can vary by county.

Helpful next steps

CareFirst BlueCross BlueShield Advantage Essential H7379-001 (PPO) — 2026