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LAST UPDATED: January 30th, 2023

CareFirst is a subsidiary of BlueCross BlueShield and has company roots that go back to 1934. In this year, Group Hospitalizations, Inc. was created.

The insurance company's name changed over the years, but in the late ’90s it became known as CareFirst.


The Good

  • Online Tools
  • Health Support
  • Small Health Insurance Provider
  • Types of Plans Offered
  • Customer Service

Online Tools

Members have access to so many tools through CareFirst. These include basic tasks like paying a medical bill, viewing plan benefits and explanations of how they work, ordering an ID card, and downloading forms. These tools also extend into helping members find a physician, check their claim or deductible status, and order prescriptions.

Through the member portal, simply called My Account, members can easily navigate through these tasks and keep up-to-date on their health plan. There are several additional resources that CareFirst has provided. Members can use a cost estimator, for example, to see how much a medical or dental care would cost before actually committing to having a procedure done.

Even before becoming a member at CareFirst, you can tour a member account to see what it looks like. Through My Account, members can also send a secure email to the company with a request or question. There's an area for members to provide CareFirst with feedback as well, showing that the insurance company is always striving to improve members' experience.

Health Support

In many ways, the company is innovative and specialized in this field. With CareFirst, customers enjoy a variety of extra features that go beyond member resources. These include a rewards program common to other BlueCros BlueShield entities. It's called Blue365® and qualifies members for discounts on things like fitness gear, therapy, alternative medicine, and hearing equipment.

With its wellness program, CareFirst members also receive motivation to set healthy goals to establish better habits for their health.

Other features offered here are online health coaching, an online section for health news, and a mobile app that allows members to view their ID cards, find a doctor or care facility, and check their claims and benefits.

With FirstHelp, members have 24/7 access to a nurse for round-the-clock health advice if needed. Providing a nurse hotline makes CareFirst competitive with other health insurers.

There's access to a pharmacist as well, which makes CareFirst stand out from other insurers.

Then there are the simple tools, like a chart for helping you decide whether to visit the ER or to wait until a doctor's visit. Though simple, member services and resources like these can make the difference for many customers.

Small Health Insurance Provider

One thing that makes CareFirst unique is that it's a relatively small health insurance provider. Rather than providing insurance across the nation, this company has a much more local feel, focusing its efforts on customers in the Maryland-Virginia area. CareFirst has been in the health insurance industry since 1934, so it has many years of experience. CareFirst boasts of having this region's largest provider network. It also created the biggest type of Patient-Centered Home Program along the way.

Types of Plans Offered

It's worth mentioning that CareFirst does a great job of describing the types of health plans it offers and the basic benefits associated with each. It offers HMO-network and PPO-network plans. It also offers catastrophic plans. In some areas, it offers plans with Health Savings Accounts (HSAs).

Like many competitors, the company offers Medicare, HSAs, PPOs, and HMOs. It also offers catastrophic plans. Common options that CareFirst doesn't offer include Medicaid and short-term health plans.

This company has a few other types of insurance plans, too. CareFirst has a Federal Employees Health Program and offers Point of Service (POS) plans. There's also something called Catastrophic Plans with CareFirst, and these involve lower premiums but higher deductibles.

Its catastrophic plans are called the BlueChoice Young Adult plan. With any of these programs come several basic benefits. These include doctor's office visits, prescriptions, X-rays, hospitalization, emergency services, and even mental health treatment. Preventive medical services are also covered with this CareFirst plan. These services include well-child care, mammograms, and cholesterol and prostate screenings. All of these benefits come without the requirement of a deductible or a copay, which is a great benefit to CareFirst plans.

As you evaluate insurance plans, be sure to consider the coverage offered, monthly premiums, and out-of-pocket costs. Understanding these three things will help you understand the value offered by your health care plan and whether or not it's a good fit for you.

Dental and vision coverage are available here as well. Dental insurance and vision benefits vary insurance plan to insurance plan, so visit CareFirst's website for more information.

Customer Service

In 2013, 2014, and 2015, the company was awarded the Most Ethical Company award. Between recognition like this and all the amount of time it has been in business, CareFirst has established a more trustworthy name for itself. Customers can contact CareFirst by phone whether they are current members or interested in purchasing insurance.

For customers who prefer to search online to find information, there is an FAQ section on the company website, great descriptions of the health plans CareFirst offers, and downloadable claims forms. There are also tools to find in-network providers, pharmacist access, and FirstHelp, a 24/7 nurse line. Through all of these resources, customers can connect with CareFirst in many ways and get their questions answered. Because the company is somewhat small and focuses on a small area of the country, this works in customers' favor because CareFirst caters all of its services to the needs of people in this region.

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The Bad

  • Insufficient Customer Insight
  • Limited Service Area
  • No Medicaid or Short-Term Health Insurance

Insufficient Customer Insight

CareFirst doesn't have many customer reviews on Best Company. With such limited information, it's difficult to guage the customer experience.

However, CareFirst is affiliated with BlueCross BlueShield. BlueCross BlueSheild has recieved high customer ratings on Best Company.

Limited Service Area

It's important to note upfront that CareFirst's health plans are available only in Maryland, the District of Columbia, and northern Virginia.

If you don't live in these areas, you'll need to find another BlueCross BlueShield subsidiary or another insurer.

No Medicaid or Short-Term Health Insurance

CareFirst doesn't mention providing Medicaid plans or short-term health insurance. If you need one of these types of insurance, then this company may not offer what you need.


The Bottom Line

So long as you live in the service area for CareFirst, it would be worth considering as your health insurance provider. Members benefit from plenty of resources to answer all their questions, assistance locating doctors, and health support. Furthermore, there are several different plans to choose from.

If you don't live in its service area or prefer a Medicaid plan or short-term insurance, then CareFirst is not a recommended company. Otherwise, it's a good insurer to explore further.

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BDaveMd Parkville, MD

Carefirst denies medication refills almost monthly. Medications that I've been using for years. Some are in genric form, one is brand name only and no alternative. It's almost like the company wants to cause patient hospitalizations with denial of these meds. Sometimes they cover a new medication for 2 or 3 refills then suddenly say they med was never covered. Yet they paid?

7 months ago

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Heidii Ash Flagstaff, AZ

They literally deny every and any test, even when a Doctor explains the necessity. They also deny every medicine and try to not cover them, even if they you have been on them for years. They have non-sensical denial letters, that have left my Doctor's scratching their heads, and the pharmacists as well. Their motto and answer is always no. It has been a nightmare - and have heard that from several other clients that got dumped onto this health care plan.

9 months ago

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Mike Warren, MI

I just began coverage with care first and am already experiencing what so many others have written about -- poor customer service. There is incompetence somewhere along the line. I don't know whether it is in their IT department or the people handling customer requests. I needed an answer to a question related to coordination of benefits. There was an easy way to ask it - click button to send email to customer service. So I submitted the question. A day later - no reply. Two days later - no reply. Three days later my submitted question disappears as if I had never written it. I think I will begin looking for an alternative insurance provider before I have to have a claim processed.

2 years ago

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Kim Roenfeldt San Diego, CA

VERY SHADY business practices. After 6 months of good coverage, CareFirst decided to change how they processed my kids' necessary specialty asthma medications, without ANY notice. We went from having a monthly $30 copay to owing around $7000 in the last 6 months. After months of calls, where I did got a different answer every time as to what was happening, I was finally informed that these prescription medicines were no longer processed under our drug benefits, but were now considered medical equipment claims. The medicine still showed up in our drug benefits as a covered prescription with a $30 copay, but only if it was filled at a regular pharmacy. It was always and continues to be a specialty medication that has to be shipped directly to our doctor. Picking it up at a pharmacy was NEVER an option. They claim that our benefits coverage didn't change, just how they define this product, which makes little difference to me. After months of appeals, they did not make any changes and we are out a ridiculous amount of money. This is exactly why people despise insurance companies!

5 years ago

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linda Tonawanda, NY

I have been trying for weeks to sign up for a video visit, I have called numerous times with no help, when I send a e-mail I get a reply with non of my questions answered and to call, so again I do, spoke to numerous people half say I am registered and the others say I am not, I feel like I am totally getting jerked around, I honestly hate this place and cannot change due to work. Do get this insurance unless you have too !

4 years ago

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Waited 10 days to receive a Notice of Cancellation because they could not email it to me a PDF document. When I received the Notice, it was a wrong notice. They sent me a proof of coverage notice instead. Not I have to wait 3 more days until Monday to call them since it is now Friday. I will then have to wait another 10 days to get the correct notice. That's a total of 23 days. With all the technology today, they don't have the capability to email a PDF file? How can they mix up the Notice like that when I repeatedly said a Notice of Cancellation. VERY INCOMPEDENT!

6 years ago

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Chantal RTW Lanham, MD

if i could give a 0 star i would they are very quick processing payments but when they charged me twice for a insurance / package i dont have it takes 20 phone calls and 3 months with still no refund and no answer from their end. not sure how an insurance company charges a member for 2 packes . worst custumor service ever.

1 year ago

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Worse company ever. it is the worse company I ever deal with trying to fix simple problems. Most like an elephant drowning in a glass of water. Took my family a year to clarify a mistake they made and still, we are on the same problem cause there is no brain inside to fix anything.

6 years ago

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Zoltar Cannon Hampstead, MD

Awful in every way. Coverage, customer service, cancelation... Next to impossible to discontinue plan at the end of the year. Buyer beware?

9 months ago