Welcome MaineHealth Members

 
MaineHealth Care At Home
Franklin Community Health Network
LincolnHealth
Maine Medical Center
Maine Behavioral Healthcare
MaineHealth Corporate
Memorial Hospital (North Conway, NH)
NorDx
Pen Bay Medical Center
Southern Maine Health Care
Waldo County General Hospital
Western Maine Health
 

MaineHealth will sponsor two health plans for 2019. No matter which plan you choose, you will have high-quality, comprehensive medical coverage and access to a broad network of healthcare providers.

Your medical coverage choices are:

  • Healthy Saver Plan – Consumer-driven health plan (CDHP) design; includes a tax-advantaged Health Savings Account (HSA) with a MaineHealth contribution; must select a Primary Care Physician (PCP) during Open Enrollment, but do not need PCP referrals to see specialists or other providers.
  • Healthy HMO Plan – Co-pays for office visits and prescription drugs; lowest annual upfront deductible; must select a Primary Care Physician during Open Enrollment; PCP referral required to see specialists or other providers.

How to contact us (PDF)

 

Healthy Saver Plan

2019 Healthy Saver Plan Benefit Overview (PDF)
2019 Healthy Saver Plan SBC (PDF)
2018 Healthy Saver Summary of Material Modifications (PDF)
2017 Healthy Saver Plan Summary Plan Description/Plan Document (PDF)
2018 Healthy Saver Plan Benefit Overview (PDF)
2018 Healthy Saver Plan SBC (PDF)
Healthy Saver Preventive Rx Drug List (PDF)
 
If you are already enrolled in a medical plan, sign in to the Secure Portal on anthem.com to locate a preferred or participating provider, access your claims information, as well as access other useful tools. Click on the following link to access the Secure Portal. https://www.anthem.com/login/
 
Preferred Network
Preferred facilities and providers are built around MaineHealth and its’ collaborative partners.
 
Find a Preferred PCP or Specialist: You can search the Listings below by clicking on the link to open the Listing. Once in the Listing, you can "right click" your mouse or use the command "CTRL-F" on your keyboard to access the "find" option. Simply type the name of the provider, the specialty, the city or town of the provider, etc. that you wish to search for and click "next" in the find tool. All listings for the entity you are searching for will be located. Clicing on "next" allow syou to see each one individually on the Listing.
Please note: For Allied Specialists such as Chiropractors, Physical/Occupational/Speech Therapists, please see the participating providers.
 
COMBINED MAINE PCP NETWORK (includes PREFERRED AND PARTICIPATING) (PDF)
 
Participating Network
Comprised of providers who are part of the state wide Anthem PPO & National BlueCard Network.
 
Find a Participating Provider:
Mental Health & Substance Abuse Benefits
 
Find a Mental Health & Substance Abuse Provider:
Click on the link below to go to the Behavioral Healthcare Site, and be sure and choose Anthem BCBS as your plan when searching for a network provider.
 

Healthy HMO Plan

2019 Healthy HMO Plan Benefit Overview (PDF)
2019 Healthy HMO Plan SBC (PDF)
2018 Healthy HMO Plan Summary of Material Modifications (SMM) (PDF)
2017 Healthy HMO Plan Summary Plan Description/Plan Document (PDF)
2018 Healthy HMO Plan Benefit Overview (PDF)
2018 Healthy HMO Plan SBC (PDF)
 
If you are already enrolled in a medical plan, sign in to the Secure Portal on anthem.com to locate a preferred or participating provider, access your claims information, as well as access other useful tools. Click on the following link to access the Secure Portal. https://www.anthem.com/login/
 
Preferred Network
Preferred facilities and providers are built around MaineHealth and its’ collaborative partners.
 
Importance of Choosing a PCP (PDF)

Find a Preferred PCP or Specialist: You can search the Listings below by clicking on the link to open the Listing. Once in the Listing, you can "right click" your mouse or use the command "CTRL-F" on your keyboard to access the "find" option. Simply type the name of the provider, the specialty, the city or town of the provider, etc. that you wish to search for and click "next" in the find tool. All listings for the entity you are searching for will be located. Clicing on "next" allow syou to see each one individually on the Listing.
Please note: For Allied Specialists such as Chiropractors, Physical/Occupational/Speech Therapists, please see the participating providers.
 
COMBINED MAINE PCP NETWORK (includes PREFERRED AND PARTICIPATING) (PDF)
 
Participating Network
Comprised of providers who are part of the state wide Anthem HMO Maine Network.
 
Find a Participating Provider:
Mental Health & Substance Abuse Benefits
 
Find a Mental Health & Substance Abuse Provider:
Click on the link below to go to the Behavioral Healthcare Site, and be sure and choose Anthem BCBS as your plan when searching for a network provider.
 

Prescription Drug Benefits

The Pharmacy at Maine Medical Center is MaineHealth member's Exclusive Specialty Pharmacy. If you or a covered family member have a prescription for a specialty drug, you will need to have this prescription filled by The Pharmacy at Maine Medical Center. For information on how to transfer your existing prescription to The Pharmacy at Maine Medical Center or to have a new specialty prescription filled by the pharmacy, please call the pharmacy directly at 207-662-2626 or visit their website at www.mmc.org/pharmacy.
 
You are able to have your prescription drugs filled at one of the MaineHealth pharmacies for a reduced copayment. Please present your MaineHealth ID card at the pharmacy to ensure you receive the reduced copayment. For more information on this exciting discount program, please see your benefit overview under the prescription drug section.
 
See the Benefit Overview for your plan's details.
 
 

Additional Features

ConditionCare:
Managing an ongoing health condition isn’t easy. Having a little extra help and encouragement can make all the difference. ConditionCare is a no-cost health and wellness program that provides tools, resources and support to members and their covered dependents with Asthma, Diabetes, Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF) and Coronary Artery Disease (CAD). Signing up for ConditionCare is easy. Anthem will call you or you can call them toll free at 1-866-596-9812. When you talk to them, they will verify your identity, ask you a few questions about your health and invite you to join the program.
 
Away from Home Care
Away from Home Care (AFHC) allows members enrolled in eligible products to receive similar coverage while living out of state for at least 90 consecutive days. For MaineHealth, the eligible product is the Healthy HMO plan only. AFHC is not available to members on the Healthy Saver plan.

This courtesy coverage is available to:
  • Students living out of state for school
  • Families living apart – one or more members are living out of state temporarily
  • Long-term travelers
Members must enroll in AFHC for coverage to use while living away.
  • The AFHC member will receive an ID card upon enrollment.
  • They will have the HMO benefits of the other state (not the local MaineHealth plan).
  • The member uses the out-of-state ID while in their host state and uses their original Anthem ID at home and in other states.
To learn more or to obtain an AFHC application, please contact Anthem Customer Service team at 1-800-527-7706.
 
Anthem ConditionCare Incentive Program (ACIP) – Healthy HMO Plan Only:
If you, or a covered dependent, are dealing with Diabetes or Coronary Artery Disease, and you participate in the ConditionCare program through Anthem, your share of routine condition-related health costs may be waived. Your pharmacy copays for some medicines you take all the time to manage your condition may also be lower. To find out more about the Anthem ConditionCare Incentive Program, please contact Anthem at the member services phone number on the back of your ID card.
 
AllClear ID
Identity protection is included with many of Anthem's health plans beginning January 1, 2016, and for as long as you have active medical coverage with us. These services are provided by AllClear ID, a leading and trusted identity protection provider. For more information, please go to anthemcares.allclearid.com.
 
WOW! Works on Wellness
Your wellbeing is about more than just physical health – it’s about your emotional, financial, environmental and social wellness too. No matter where you are at on your health and wellness journey, MaineHealth has a variety of tools to help you along the way. Works on Wellness (WOW!) helps employees and their families stay active and well. Explore our programs by visiting https://mainehealth.org/employees/wellness.
 
Future Moms (PDF)
EXPECTING? Answers and support are just a phone call away. Register for the Future Moms program at no additional cost by calling our toll-free number: 866-347-8360.
 
From the First Tooth
Your medical benefits plan covers dental fluoride treatments for children up to age six at your child’s doctor’s office. Fluoride is a safe mineral that makes teeth stronger and helps prevent cavities. Ask your baby's doctor or dentist to check your baby's teeth by age one. Also, ask about safe and easy fluoride treatments. Fluoride applications should begin as soon as the first tooth appears and at routine well-child visits.
 
SpecialOffers@Anthem
Find what you need to maintain an active, healthy lifestyle & save money doing it!
 
MyAnthem Online Member Services
Haven't registered yet? Get quick, secure and easy access to personalized information and online tools.