Community Health Options has filed 2024 Individual and Small Group plan rates with Maine's Bureau of Insurance and over the next two weeks, Individual subscribers will receive a letter detailing upcoming premium rate changes.
Health plans for 2024 will be available for purchase beginning November 1, 2023, the first day of open enrollment. As the only Maine-based nonprofit healthcare insurer, we strive to provide Members with access to the services they need and to reduce out-of-pocket costs. For more than a decade, we’ve worked closely with our network of 48,000 providers including clinicians, hospitals, and pharmacies in New England, as well as 100% of hospitals in Maine, and most in New Hampshire, to offer the people of Maine affordable, accessible healthcare, while we continuously evolve to meet Member needs.
For 2024 we will provide more HMO tiered plan options that offer savings in premiums and cost sharing with preferred providers—and we’re the only carrier that includes 100% of hospitals in Maine in its preferred network. We continue to offer our recently added Healthy Maine plan, which includes a wellness program and unlimited personal health coaching at $0 cost, and no deductible and copays for acupuncture.
For 2024, all non-HSA plans will include:
The Bureau of Insurance will hold a public forum regarding 2024 Individual health plan rates at 1:30 p.m., Thursday, August 3, 2023. Read more and register for the hearing at the State of Maine website. For more information about proposed rates, you may also contact our Maine-based Member Services team from 8 a.m. to 6 p.m., Monday through Friday, at (855) 624-6463.
Sample Health Plan Rates as of January 1, 2024, can be viewed here.
Beyond routine care and wellness, one of the major reasons for having health insurance is to protect yourself and your family in case of serious illness or injury. At Health Options, our medical management approach ensures that you also have a team of healthcare experts at your side in times of a serious medical crisis. In addition, our Care Managers are here for everyday wellness questions and at every step of recovery after a major medical incident.
Our Care Management Team partners with local agencies to find the help our Members need, from financial assistance to transportation, housing, and other issues affecting wellness and recovery. On-staff medical, pharmacy and healthcare experts help Members access medication and durable medical equipment, receive authorization support and assistance with provider outreach, and drug formulary education. The team also makes outbound calls to our Members to assist with chronic illness support or to provide post-discharge coordination from hospital stays. This collaborative approach to medical management focuses on improving care, creating positive health outcomes, and reducing the total cost of care.
What does a medical management approach look like to our Members? On a day-to-day basis, our in-house pharmacy team keeps Members updated about drug recall changes in medication availability and ways to access prescription medications at lower costs. Our team will also reach out to encourage immunizations, wellness visits, and other low-cost, or $0 cost-share benefits that can help our Members live their healthiest lives. In cases of hospitalizations and transitions to home, our medical management’s Site of Care Program offers Members the option to transition certain medications and infusions to a preferred site of care, including in-home care.
If a Member needs extra care for a particular condition, our team is instrumental in securing assistance. For example, one Member of our asthma outreach program had concerns about her condition combined with possible COVID-19 symptoms when the virus first emerged. Her COVID-19 symptoms kept her from seeing her primary care provider. After using a walk-in clinic for testing to determine she was COVID-19 negative, she continued to have a cough, low-grade fever, and fatigue. Our Care Management team was able to quickly find her an in-network pulmonologist who treated her with antibiotics for suspected pneumonia. She also had her asthma medications adjusted, and her condition improved.
Our hands-on strategies have resulted in more than $12.1+ million saved through Care Management programs since 2017, a 48 percent total reduction in our hospital readmission rate from 2018 to 2020. Our Script Saver program, led by in-house pharmacists, provided personal outreach to Members that led to out-of-pocket savings of $98,000 on medications in 2020. All of these efforts combined help improve health and reduce costs for our Members.
Call us if you have a question about prescription drug costs, need support for an upcoming medical procedure, or have a serious medical crisis. Our medical management team is in your corner, and they can be reached through Member Services at (855)624-6463, or use our secure email messaging.