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Care, Responsibility and Recovery—Maine’s Opioid Epidemic

Sep 11, 2018
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Substance use disorders affect people of all ethnicities, ages, genders, geographic regions, and socioeconomic levels.  Like the rest of the country, Maine is experiencing a narcotic substance abuse crisis. In 2017, 418 people in Maine died of drug overdoses.

Substance use disorders affect people of all ethnicities, ages, genders, geographic regions, and socioeconomic levels.  Like the rest of the country, Maine is experiencing a narcotic substance abuse crisis. In 2017, 418 people in Maine died of drug overdoses.

As we begin to understand the societal costs of the opioid crisis, Community Health Options recognizes that we have a role in dealing with this crisis. We, like every health insurance company in the country, are challenged with the rising costs of medications, including lifesaving drug antidotes. Staying true to our core values and mission, we are working with our pharmacy providers and healthcare providers to monitor excess use of certain restricted medications and make lifesaving medications available to Members who need them.

Our intentions have been and always will be focused on the health of our Members. That’s why we partner with our Members through their healthcare journey to remove barriers, support transitions of care, and provide the tools and education for all Members to self-manage their health and wellness. Care Managers are available to answer general or complex medical questions, help Members navigate sometimes confusing processes, such as obtaining medical equipment for the home or ordering specialty medications, and can help if Members experience a critical event or diagnosis that requires extensive use of health services or resources. You can reach a Care Manager by contacting Member Services between 8 am and 5 pm, Monday through Friday, at 855-624-6463.

Prevention works; treatment is effective; people can and do recover.

SEE ALSO

What to Know About the American Rescue Plan Act

You may be eligible for financial help with health insurance costs.

There is good news about your health insurance coverage.  The American Rescue Plan Act recently increased the Marketplace tax credit dollars at every income level. With this new legislation, you could qualify for premium tax credits that you can use to lower your monthly insurance payment. This legislation, combined with the Open Enrollment extension through August 15, 2021, means more time for individuals and families to enroll and get financial help with Marketplace coverage.

How can you determine your eligibility?

We encourage you to visit healthoptions.org to obtain a summary of your Marketplace eligibility. Click on “Find a plan;” select ”Shop as an individual or family,” and answer a few basic questions to receive an estimate of your eligibility.

I am eligible for tax credits. What should I do?

If you are eligible for an additional or new tax credit, you must contact the Marketplace by calling (800) 318-2596 or visiting healthcare.gov.

Can I change my  Health Options’ plan?

Yes, now through August 15, you can switch to another Health Options’ plan based on your health insurance needs, your budget, and this additional financial help.

Will my 2021 expenditures from my current Health Options’ plan transfer to a new Health Options’ plan?

Yes, any 2021 expenditures towards your deductible or out-of-pocket maximum will carry over to any new Health Options’ plan you choose.*

When will my monthly insurance payments be updated?

Changes to your invoice will become effective the first day of the month after you contact the Marketplace. 

Although healthcare.gov determines eligibility for a Marketplace plan and premium tax credits, we are here to help answer any questions you may have about our plans. Please contact us at (855) 624-6463, Monday through Friday, 8 a.m. to 6 p.m.

*Please note: Your 2021 payments applied to deductible and out-of-pocket maximum will carry over to your new Health Options’ plan as long as there is no interruption in coverage and you are not moving from a Health Options’ group plan to an individual plan.