Page 6 - The Legacy School Benefit Booklet 2021-2022

Medical Benefits

The Legacy School provides medical benefits through CareFirst and offers the following three plan
options:
BlueChoice HMO HSA Silver $1500

» Limited to in-network benefits only.
» Must seek care from a Blue Choice HMO participating provider (Maryland/DC/Northern Virginia)
» Open Access- No referrals required to see a Specialist

» Must choose a primary care doctor at the time of enrollment

BlueChoice HMO HSA Silver $3000

» Limited to in-network benefits only.
» Must seek care from a Blue Choice HMO participating provider (Maryland/DC/Northern Virginia)

» Open Access- No referrals required to see a Specialist
» Must choose a primary care doctor at the time of enrollment

BlueChoice Plus Gold $1000

» Benefits are covered In-Network and Out-of-Network
» Refer to the summary of benefits brochure for more details

» Not HSA eligible