Insurance & coverage
The family health plan and what it means for lining up Dad's Phase 3 specialists. Plan-level details are family-wide — and so is the member ID: Angela's (primary) and Joe's cards both show the same ID with no suffix, so Dad's is almost certainly the same. The family is told apart by name + DOB at the eligibility check, not by a number on the card.
What this means for booking
No referral needed — book specialists directly
BC ADV Open Access · PPO · "PCP Not Required"
Because this is an Open Access PPO, Dad can self-refer straight to a cardiologist and a Tourette's neurologist — no PCP gatekeeping. In-network specialist copay is $40. (Urgent care $60 · ER $200.)
Out-of-area: confirm BlueCard before you call FL/CA offices
CareFirst BlueChoice is a DC / Maryland / N. Virginia Blue plan
Dad is in Apollo Beach, FL (and may move to CA), which is outside CareFirst's home region. Confirmed: the card back lists the BlueCard out-of-area provider locator — 800-810-2583 (1-800-810-BLUE), plus the PPO "suitcase" logo on the front — so he has national Blue-network access to see in-network Blue providers in FL/CA. Most FL/CA cardiologists and neurologists take BlueCard, but still say "I have a CareFirst BlueChoice BlueCard PPO" and confirm in-network when you call each office.
The plan — family-wide
Shared across the family contract (confirmed from Joe's card). Everyone on the plan shares these; only the per-member ID/suffix changes.
- Insurer: CareFirst BlueChoice (Blue Cross Blue Shield)
- Plan: BC ADV Open Access · PPO · BC/BS Plan 080/580
- Group #: 2KBN
- Rx: RxBIN 004336 · RxPCN ADV · RxGrp RX7546 · Rx out-of-pocket integrated with medical
- Copays: Specialist $40 · PCP $20 · Convenience/urgent care $60 · ER $200
- Family deductible: $4,000 in-network / $8,000 out-of-network
- Family out-of-pocket max: $13,700 in-network / $15,700 out-of-network
Members
Paul Mederos Sr. (Dad) — book with this ⭐
High-confidence inferred from the two family cards
- Member ID: XIR916575152 (shared family ID — same on Angela's & Joe's cards)
- Member name: Paul Mederos Sr.
- DOB: 2/14/1963
- Group: 2KBN
Give the office member ID + Dad's name + DOB; their eligibility check resolves him to the right dependent record (the internal dependent code isn't printed on the card and you don't need it). One thing to verify first: that Dad is still an active dependent on the plan — Angela is the primary subscriber and controls enrollment, and given the situation it's worth a 2-minute eligibility check (member services, or let the first provider's office verify) before you rely on it.
Angela G Mederos — primary subscriber, confirmed
Card photo (front + back), 2026-06-16
- Member ID: XIR916575152
- Group: 2KBN
Believed to be the primary subscriber. EOBs/claims for Dad's visits route to her — loop her in before booking.
Joseph V Mederos (Joe) — confirmed
Card photo, 2026-06-16
- Member ID: XIR916575152
- Group: 2KBN
Identical ID to Angela's — this is what confirms the family shares one member ID with no per-person suffix.
Member services & key numbers
From the card back. Read the exact digits off the physical card before dialing — the photo is small/rotated, so treat these as starting points (the BlueCard line and CVS Caremark are the verified-standard ones).
- Website: carefirst.com
- BlueCard out-of-area provider locator: 800-810-2583 (1-800-810-BLUE) — use this to find in-network providers in FL / CA
- Pharmacy: benefits via CVS Caremark
- Mental health / substance abuse line: ~800-245-7013 (verify off card) — relevant for the recovery side
- Provider claims & benefits / member services: ~800-642-0975 · 443-738-2920 (verify off card)
Open items
- ✅ Dad's member ID — XIR916575152 (shared family ID). No longer a blocker.
- Verify Dad's active enrollment — quick eligibility check; Angela controls the plan as primary.
- ✅ BlueCard out-of-area confirmed (locator on card back) — still confirm in-network per office.
- Find in-network cardiologist — urgent given BP 180+.
- Find in-network Tourette's / motor-conditions neurologist — his standing ask.
- No referral needed (Open Access) — book directly once enrollment + network are confirmed.
- See the Phase 3 prep checklist for the full provider list + what to bring.
Source: Angela's (front + back) and Joe's CareFirst BlueChoice cards, photographed 2026-06-16. Dad's member ID inferred from the shared family ID (verify active enrollment). PHI kept in this private repo per family decision.