Important Information About the 2016 Health Insurance Marketplace
The 2016 Health Insurance Marketplace enrollment period began on November 1 and continues through January 31, 2016.
In Maine, there are three (3) healthcare companies offering a variety of plans through this marketplace system. If you live in the southern half of the state, there are some very important things you should know about these plans.
1) Community Health Options
Maine Community Health Options (MCHO) provides coverage for all Maine hospitals and healthcare providers.
MCHO is a non-profit Maine-based health insurance provider that offers a range of plans and a comprehensive statewide network of care providers – no hospitals are excluded from this plan.
Anyone who chooses the MCHO plan will be provided coverage at Central Maine Medical Center in Lewiston, Bridgton Hospital, Rumford Hospital and 400 Central Maine Medical Group care providers.
For more information, visit www.maineoptions.org or call 855.624.6463.
2) Harvard Pilgrim Health Care
Harvard Pilgrim Health Care is a non-profit health insurance provider that offers a range of plans and a comprehensive statewide network of care providers.
Anyone who chooses the Harvard Pilgrim plan will be provided coverage (with larger deductibles) at Central Maine Medical Center in Lewiston, Bridgton Hospital, Rumford Hospital and by some 400 Central Maine Medical Group care providers.
For more information, visit www.harvardpilgrim.org or call 855.354.4742.
3) Anthem Blue Cross Blue Shield
Anthem Blue Cross Blue Shield has created Health Insurance Marketplace plans for individuals and for businesses with fewer than 50 employees. These plans will not cover services at four of the state's 38 hospitals. The hospitals not included in this plan are Central Maine Medical Center in Lewiston, Bridgton Hospital, Rumford Hospital, and Mercy Hospital in Portland, as well as hundreds of care providers.
Anyone who chooses the Anthem plans will not be provided coverage at any of the four hospitals excluded from the plan, except in the event of an emergency.
What Does This All Mean For You?
If you prefer to get your healthcare at Central Maine Medical Center, Rumford Hospital, Bridgton Hospital, you will not be able to do so if you select the Anthem plans for individuals or business with fewer than 50 employees.
If fact, if you choose the Anthem plans, you may have to drive a considerable distance just to see a new primary care provider.
And what about specialty care?
The Anthem plans will not allow you to see a specialist who works for CMMC, Bridgton and Rumford hospitals. This means hundreds of speciality care providers are excluded.