Personal Comp Member Handbook - CareFirst BlueCross BlueShield

Additional CareFirst BenefitsDental and vision benefits are optional. You may havepurchased these benefits in addition to your healthinsurance policy. These benefits are not administeredthrough CareFirst. If you have questions about thesebenefits, call The Dental Network, Inc.* or Davis Visiondirectly.The Dental HMO plan offers you dental care withpredictable costs. All dental services are provided for thecost of a copay and orthodontia is covered for adults andchildren. There are no deductibles to meet and no claimforms to file.Dental HMO benefits are administered through TheDental Network, Inc. (TDN), an experienced dentalHMO plan administrator. If you added dental benefitsto your Personal Comp plan, you must select a primarydental site for your care. Each family member can selecta different dentist.To select a dentist, call TDN Customer Service Line at(410) 847-9060 or toll-free (888) 833-84648:30 am – 5:00 pm, Monday through Friday.If you do not select a dental site, TDN will select one foryou and send you information about the site. Of course,you can always change your site by calling TDN at theabove number.*The Dental Network, Inc. is an independent licensee ofthe Blue Cross and Blue Shield Association.CareFirst is pleased to offer BlueVision to meet yourvision needs. This vision plan is administered by DavisVision, Inc., a national provider of vision care services.BlueVision provides a routine vision examination(including dilation) once per benefit period for a $10copay when you visit a participating Davis Visionprovider. Through Davis Vision, you can also receivediscounts on eyeglass lenses and frames or contactlenses, as well as laser vision correction surgery. Referto your policy to find out what benefits you have underyour plan.As part of your BlueVision benefit, you areentitled to a $20 allowance if visiting anoptometrist and a $30 allowance if visiting anophthalmologist for an out-of-network exam.Discounts for lenses and frames are not availableout-of-network.If you choose an out-of-network provider, youwill be required to pay the provider directlyfor all charges and then submit a claim forreimbursement to:Vision Care Processing UnitP.O. Box 1525Latham, NY 12110Only one claim per service may be submittedfor reimbursement each benefit cycle. To requestclaim forms, visit the “Members & Visitors”Section of www.carefirst.com and click on“Forms” or call (800) 783-5602.If you don’t have dental and/or vision coverageand would like to learn more about theseprograms, call our Product Specialists at (410)356-8000 or (800) 544-8703.20