CareFirst
CareFirst BlueCross BlueShield is a not-for-profit regional health insurer serving 3.5 million+ members across Maryland, Washington D.C., and Northern Virginia with medical, dental, vision, Medicare, and Medicaid plans, supported by a vertically integrated virtual and in-person care delivery network.
- Company typePrivate
- Founded2014
- HeadquartersBaltimore, United States
- Headcount5,001–10,000
- GTM typeB2C
- OfferingServices
What CareFirst does
CareFirst BlueCross BlueShield is a not-for-profit healthcare organization and independent licensee of the Blue Cross Blue Shield Association, serving 3.5 million+ members across Maryland, Washington D.C., and Northern Virginia. Its core product portfolio spans ACA-compliant individual and family medical plans, Medicaid (CareFirst CHPMD), Medicare Advantage (CareFirst Advantage, including PPO and DSNP variants), prescription drug, dental, and vision coverage, distributed through direct consumer enrollment, the Maryland Health Benefit Exchange, employer group sales, broker partnerships, and two physical Engagement Centers in Baltimore.
CareFirst operates a vertically integrated payer-provider model through wholly owned subsidiaries including CloseKnit (virtual-first advanced primary care with 24/7 access to primary, urgent, and therapy services), Atlas Health, Comprehensive Primary Care and Associates, and CKNMG, giving members access to more than one million doctors, hospitals, and health facilities in the region. Its technology stack includes the Sapphire Digital care tools and CareFirst Mobile App, both recognized with gold medals in the 2026 Corporate Insight Health Plan Monitor Awards, plus a developer portal supporting the CARIN Implementation Guide for healthcare data interoperability.
Revenue is generated primarily through recurring health insurance premiums across individual, family, employer group, Medicaid, and Medicare Advantage segments, with additional employer-side solutions such as Max Performance Plus funding arrangements. Strategic priorities under incoming President and CEO Kurt Small (effective May 4, 2026) include strengthening affordability and access, expanding behavioral health and community health investments, adopting the CMS ACCESS model for chronic-condition care, and serving as an anchor in the Techstars AI Health Baltimore accelerator alongside the region's largest health systems and academic institutions.
CareFirst firmographics
Firmographics- Name
- CareFirst
- Legal name
- CareFirst of Maryland, Inc.
- Website
- https://individual.carefirst.com
- Company type
- Private
- Founded year
- 2014
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Short description
- CareFirst BlueCross BlueShield is a not-for-profit regional health insurer serving 3.5 million+ members across Maryland, Washington D.C., and Northern Virginia with medical, dental, vision, Medicare, and Medicaid plans, supported by a vertically integrated virtual and in-person care delivery network.
- Ownership category
- akta.pro rank
CareFirst industry classification
Industry- Product category
- Health Insurance
- NAICS
- Health and Welfare Funds (525120), Health Care and Social Assistance (62)
- SIC
- Services-Health Services (8000)
- akta.pro primary industry
- Primary Care & General Medicine Virtual Care (Employer-Sponsored) (HLALADAA)
- akta.pro secondary industries
- Virtual Specialty Care Programs (Payer-Sponsored) (HLALACAD), Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH), Primary Care & General Medicine Virtual Care (HLALAAAA)
Keywords
Where CareFirst is headquartered
LocationHeadquarters
- HQ city
- Baltimore
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
CareFirst business model
Business model- GTM type
- B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Others
Revenue model
- Health Insurance Premiums: Collection of recurring premiums from individual, family, employer group, Medicaid, and Medicare Advantage members for medical, dental, and vision coverage
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Individual & Family Plans - ACA Metal Levels |
Go-to-market motion2 records
Distribution channels6 records
Marketing channels5 records
CareFirst product offering
Product offeringCore offering
CareFirst BlueCross BlueShield sells ACA-compliant medical, dental, vision, and prescription drug health insurance plans to individuals, families, employers, Medicaid recipients, and Medicare beneficiaries across Maryland, Washington D.C., and Northern Virginia. It also operates CloseKnit, a virtual-first advanced primary care practice delivering 24/7 access to primary, urgent, and therapy services. The company generates revenue from recurring health insurance premiums and provides members access to a network of more than one million doctors, hospitals, and health facilities.
Product overview
CareFirst BlueCross BlueShield is a not-for-profit healthcare organization serving over 3.5 million members across Maryland, Washington D.C., and Northern Virginia. The company's product portfolio centers on core health insurance offerings including Individual & Family Medical Plans, Medicaid (CareFirst CHPMD), Medicare Plans, Prescription Drug Plans, Dental Insurance, and Vision Insurance. Beyond traditional insurance, CareFirst operates CloseKnit as a virtual-first advanced primary care practice providing 24/7 access to primary and urgent care plus therapy services. The company also offers employer solutions including Max Performance Plus for predictable cost management, Sapphire Digital tools for member experience, and various community health initiatives including the CareFirst Arena community space. The service area covers Maryland, the District of Columbia, and portions of Virginia, with access to over one million doctors, hospitals and health facilities.
Differentiator
Problem solved
Functional benefit
Brands
- CloseKnit: Virtual-first advanced primary care practice providing 24/7 access to primary and urgent care, therapy, and more through desktop or mobile device. A team-based approach for prevention, diagnosis, treatment, and management of various health conditions.
- Sapphire Digital
- Blue365
Products and services
- Individual & Family Medical Plans
- CareFirst CHPMD Medicaid Plan Medicaid managed care coverage for low-income families, children, pregnant women, parents, elderly, and individuals with disabilities in Maryland, providing access to over 15,000 healthcare providers plus benefits and programs.
- Medicare Advantage Plans Medicare Advantage plans covering Medicare-eligible individuals in the service area, offered through CareFirst Advantage, CareFirst Advantage PPO, and CareFirst Advantage DSNP entities, with supplemental benefits and Part D coverage.
- Prescription Drug Plans Prescription drug coverage integrated with medical plans, including drug search tools and formulary access for members across all product lines.
- Dental Insurance Plans Dental insurance plans providing coverage for preventive, basic, and major dental services through a network of participating dentists.
- Vision Insurance Plans Vision insurance plans covering eye exams, eyewear, and vision care services through a provider network.
- CloseKnit Virtual Primary Care Virtual-first advanced primary care practice offering 24/7 access to primary care, urgent care, and therapy through desktop or mobile device, with a team-based approach to prevention, diagnosis, treatment, and management of health conditions.
- Max Performance Plus (MPP) Fully insured funding arrangement for employer groups with 51+ eligible employees in D.C., Maryland, and Northern Virginia, offering stable monthly premiums with potential surplus when healthcare costs come in lower than expected; integrates with all CareFirst medical and pharmacy plans.
- CareFirst Mobile App Mobile application enabling members to manage claims, access digital ID cards, find providers, and use health trackers, recognized for mobile claims functionality by Corporate Insight's Health Plan Monitor Awards.
Quantifiable outcome
- 3.5 million+ members served
- +3 more outcomes
Companies that use CareFirst
Customer profileNamed customers14 records
Segments4 records
Ideal customer profiles4 records
CareFirst technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration2 records
Feature4 records
CareFirst partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core and minor.
- Techstars AI Health BaltimorecoreCareFirst joined as anchor collaborator alongside University of Maryland Medical System, Johns Hopkins, MedStar Health, and University of Maryland Baltimore to support early-stage startups developing AI-driven healthcare solutions. This accelerator provides access to clinical settings, operational structures, and commercialization pathways with a cohort beginning March 2026 and Demo Day at M&T Bank Stadium in June.
- CAQHminorCAQH is a healthcare data organization maintaining records on over 4.8 million providers and 75% of U.S. covered lives. CareFirst is now a co-owner alongside other leading health plans including UnitedHealth Group, Centene, CVS Health, Elevance Health, Cigna, Humana, and Blue Cross Blue Shield affiliates.
- CloseKnit HealthcoreCloseKnit provides virtual-first advanced primary care practice offering 24/7 access to primary care, urgent care, and therapy through desktop or mobile device. CloseKnit is the shared business name of Atlas Health LLC, Comprehensive Primary Care and Associates LLC, and CKNMG LLC - corporate affiliates within the CareFirst umbrella.
- Centers for Medicare and Medicaid Services (CMS)coreCareFirst signed pledge to adopt the CMS ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) model promoting technology-supported care for Medicare beneficiaries with chronic conditions including obesity, diabetes, musculoskeletal pain, and depression.
- Blue Cross Blue Shield Entities (ACCESS Model)coreMultiple Blue Cross Blue Shield entities signed pledge to adopt CMS ACCESS model for technology-supported chronic condition care with a 10-year performance period beginning July 2026.
- 19 Community-Based Behavioral Health OrganizationscoreThree-year nearly $8 million investment supporting Arlington Free Clinic, Association for Public Defender of Maryland, Centro Hispano de Frederick, Chase Brexton Health Care, Enoch Pratt Free Library, Identity Montgomery, St. Ignatius Loyola Academy, Luminis Health, Pathway Homes, Pathways to Housing DC, Pride Center of Maryland, Sasha Bruce Youthwork, SMYAL, West Cecil Health Center, Whitman-Walker Health, Worcester Youth & Family Counseling Services.
- 30 Community Organizations (Place-Based Grants)core$7.1 million investment across D.C., Maryland, and Northern Virginia targeting Healthy Food Priority Areas to combat diabetes and diet-related chronic conditions through local food systems, food-is-medicine programs, and nutrition education.
Scale indicators9 records
Recent moves6 records
Expansion highlights5 records
CareFirst competitors and assessment
Company assessmentEmerging players
- Oscar Health: Oscar Health is a technology-focused ACA marketplace insurer with strong digital member experience that competes directly with CareFirst in individual marketplace segments. While smaller, Oscar's tech-forward approach represents a competitive threat in markets where CareFirst participates.
Broad incumbents
- Cigna Group: Cigna is a global health services company with strong employer-sponsored health benefits and Evernorth care services. Competes with CareFirst on employer group business and shares CAQH co-ownership status.
- Humana: Humana is a leading Medicare Advantage-focused national payer with comparable MA product offerings to CareFirst Advantage. Competes directly in Medicare Advantage markets and shares the CAQH co-ownership relationship.
- Elevance Health: Elevance Health (formerly Anthem) is the largest BCBS affiliate and a publicly traded national health insurer with significant presence in CareFirst's mid-Atlantic footprint. It competes directly with CareFirst on employer group and Medicare Advantage, with substantially greater capital resources.
- UnitedHealth Group: UnitedHealth is the largest U.S. health insurer with vertically integrated Optum care delivery capabilities that closely parallel CareFirst's CloseKnit strategy but at vastly greater scale. Co-owner of CAQH with CareFirst and a direct competitor across all product lines.
Direct peers
- Highmark Health: Highmark is a major regional Blue Cross Blue Shield licensee serving Pennsylvania, West Virginia, Delaware, and New York with a comparable integrated payer-provider model and similar member scale (~3.5M+). Both organizations are large not-for-profit regional Blues with comparable employer, individual, and Medicare Advantage offerings.
- Independence Blue Cross: Independence Blue Cross is a Philadelphia-based BCBS licensee serving Southeastern Pennsylvania with similar individual, employer, and Medicare Advantage products. Both are mid-Atlantic/regional Blues operating in concentrated geographies with comparable regulatory environments.
- Kaiser Permanente: Kaiser Permanente is the largest integrated payer-provider in the U.S., combining insurance with owned provider networks. Its vertical integration model closely mirrors CareFirst's CloseKnit strategy of owning care delivery alongside insurance underwriting.
- Blue Cross Blue Shield of Michigan: BCBS Michigan is one of the largest not-for-profit BCBS licensees, serving ~4.5M members with a comparable diversified portfolio across individual, employer, Medicare, and Medicaid lines. The scale, not-for-profit structure, and BCBS affiliation make it a directly comparable peer.
- Horizon Blue Cross Blue Shield of New Jersey: Horizon BCBS NJ is a regional BCBS licensee serving the New Jersey market with comparable employer, individual, Medicare Advantage, and Medicaid offerings. Similar in geographic concentration, scale, and product mix to CareFirst.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks7 records
Key highlights7 records
Customer concentration
CareFirst social profiles
Digital presenceCareFirst compliance and trust
Trust signalCompliance4 records
CareFirst financial estimates
Financial estimateRevenue estimate
Valuation estimate
CareFirst leadership team
Management profileNumber of profiles
Profiles4 records
CareFirst subsidiaries and ownership
Company hierarchySubsidiaries6 records
CareFirst funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
CareFirst M&A and investment
M&A and investmentM&A1 record
Investments8 records
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about CareFirst
What does CareFirst do?
CareFirst BlueCross BlueShield sells ACA-compliant medical, dental, vision, and prescription drug health insurance plans to individuals, families, employers, Medicaid recipients, and Medicare beneficiaries across Maryland, Washington D.C., and Northern Virginia. It also operates CloseKnit, a virtual-first advanced primary care practice delivering 24/7 access to primary, urgent, and therapy services. The company generates revenue from recurring health insurance premiums and provides members access to a network of more than one million doctors, hospitals, and health facilities.
Is CareFirst a public or private company?
CareFirst is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was CareFirst founded?
CareFirst was founded in 2014. It employs 5,001 to 10,000 people.
Where is CareFirst based?
CareFirst is headquartered in Baltimore, United States, in the North America region.
How does CareFirst make money?
One revenue line is on record: health Insurance Premiums.
Who are CareFirst's main competitors?
Oscar Health is listed as an emerging player. Broad incumbents are Cigna Group, Humana, Elevance Health and UnitedHealth Group. Direct peers are Highmark Health, Independence Blue Cross, Kaiser Permanente, Blue Cross Blue Shield of Michigan and Horizon Blue Cross Blue Shield of New Jersey.
Does CareFirst have an API?
Yes. CareFirst provides a Developer Portal (developer.carefirst.com) offering interoperability resources. The company supports CARIN Implementation Guide for healthcare data exchange and provides machine-readable data files in compliance with federal transparency requirements. The interoperability page references standardized billing codes and transparency in coverage data. Developer documentation is at developer.carefirst.com.
What industry is CareFirst in?
CareFirst's product category is Health Insurance. Its primary akta.pro industry code is HLALADAA, Primary Care & General Medicine Virtual Care (Employer-Sponsored), with a secondary code of HLALACAD, Virtual Specialty Care Programs (Payer-Sponsored). Its NAICS code is 525120 and its SIC code is 8000.