Frederick County Medicaid MCO Comparison Chart Name of MCO Aetna Better Health Amerigroup CareFirst Community Care BlueCross Blue Shield Community Health Plan of MD

Customer (866) 827-2710 (800) 600-4441 (800) 730-8530

Services www.aetnabetterhealth.com/maryland www.myamerigroup.com/MD www.umhealthpartners.com Numbers 24 hours a day/7 days a week Monday-Friday, 8am-6pm Monday-Friday, 8am-5pm

Pharmacies CVS, Epic, Giant, K-Mart, Safeway, CVS, Epic, Giant, Safeway, Target, CVS, Epic, Giant, K-Mart, Target, Walgreens, Walmart, Weis, Walmart, Weis, Costco, Food Lion, Giant Safeway, Target, Walgreens, ***For a full list of Costco, Rite Aid, ShopRite, The Eagle, K-Mart, Martins, Sam’s Club, Walmart, Weis, Costco, Food pharmacies, contact Medicine Shoppe, Wegmans ShopRite, The Medicine Shoppe, Lion, Martin’s, Rite Aid,Sam’s your MCO*** Wegmans Club, Shoppers, ShopRite, SuperFresh, Wegmans, The Medicine Shoppe

Pharmacy No Copays Brand name $3 Brand name $3 Co-pays for Generic drugs $0 Generic drugs $0 Adults

Adult Dental • Oral exam, fluoride treatment, and • Oral exam and cleaning twice a year • Oral exam and cleaning twice Services cleaning twice a • X-rays a year year • Fillings • X-rays • X-rays • Extractions • Fillings • Fillings • Maximum benefit $750 per calendar • Extractions • Extractions year • Maximum benefit $500 per • Emergency treatment (limit 4 per calendar year year) • Maximum benefit $750 per calendar year (not including basic care like exams and cleanings)

(866) 827-2710 (800) 720-5949 (800) 341-8478 Dental Healthy Smiles Dental Program (855) 934-9812 Services for Children, Children under the age of 21 ➢Pregnant women (coverage ends on day of delivery) ➢Former foster care adults Pregnant up to the age of 26 ➢Adults in the Rare and Expensive Case Management (REM) Program ➢Adults ages 21 Women & through 64 who are dually eligible for Medicare/Medicaid Care Specific CareFirst BlueCross Populations

Adult Vision • 1 eye exam per year • 1 eye exam per year • 1 eye exam per year Services • 1 pair of glasses OR contact lenses • 1 pair of glasses OR contact lenses • 1 pair of glasses OR contact a year every 2 years lenses every 2 years • Maximum benefit for frames: $25 • Maximum benefit for frames: $50 • Maximum benefit for frames: • Maximum benefit for contact lenses: • Maximum benefit for contact $150 $25 lenses: $100 • Maximum benefit for contact lenses: $150 Behavioral Health Services through Optum MD: (800) 888-1965 ✓ Specialty mental health services (like counselors, psychologists, psychiatrists) ✓ Substance use disorder treatment and recovery services

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Name of MCO Maryland Priority Partners United HealthCare Physicians Care Community Plan

Customer (800) 953-8854 (800) 654-9728 (800) 318-8821

Services www.marylandphysicianscare.com www.ppmco.org www.uhccommunityplan.com Numbers Monday-Friday, 8am.-5pm Monday-Friday, 8am-5pm Monday-Friday, 8am-7pm

Pharmacies CVS, Epic, Giant, K-Mart, Safeway, CVS, Epic, Giant, K-Mart, CVS, Epic, Giant, K-Mart, Safeway, Target, Walgreens, Walmart, Weis, Safeway, Target, Walgreens, Target, Walmart, Martin’s, Rite Aid, ***For a full list of Costco, Food Lion, Martin’s, Rite Aid, Walmart, Weis, Food Lion, Rite Sam’s Club, ShopRite, The Medicine pharmacies, contact your Sam’s Club, Shoppers, ShopRite, Aid, Sam’s Club, Shoppers, Shoppe, Wegmans MCO*** The Medicine Shoppe, Wegmans SuperFresh, The Medicine Shoppe Pharmacy No Copays Brand name $3 Brand name $3 Co-pays for Generic drugs $1 Generic drugs $1 Adults Adult Dental • Oral exam and cleaning twice a • Oral exam and cleaning twice a • Oral exam and cleaning twice a year Services year year • X-rays • X-rays • X-rays • Fillings • Fillings • Extractions • Extractions • Extractions • Maximum benefit $750 per calendar • Maximum benefit $750 per calendar year year • 20% off non-covered dental services

(800) 685-1150 (800) 698-9611 (800) 318-8821 Dental Services Healthy Smiles Dental Program (855) 934-9812 for Children, Pregnant Children under the age of 21 ➢Pregnant women (coverage ends on day of delivery) ➢Former foster care Women & adults up to the age of 26 ➢Adults in the Rare and Expensive Case Management (REM) Program ➢Adults Specific ages 21 through 64 who are dually eligible for Medicare/Medicaid Care Populations CareFirst BlueCross

Adult Vision • 1 eye exam per year • 1 eye exam per year • 1 eye exam per year Services • 1 pair of glasses OR contact lenses • 1 pair of glasses OR contact • 1 pair of glasses OR contact lenses every 2 years lenses every 2 years every 2 years • 1 pair of lenses every year if needed• Maximum benefit for frames: $19 • Maximum benefit for frames: $50 • Maximum benefit for frames: $50 • Maximum benefit for contact • Maximum benefit for contact • Maximum benefit for lenses: $100 lenses: $150 contact lenses: $100

Behavioral Health Services through Optum MD: (800) 888-1965 ✓ Specialty mental health services (like counselors, psychologists, psychiatrists) ✓ Substance use disorder treatment and recovery services

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