You have your new Community Health Options ID cards, so now what? Your health insurance does more than cover emergencies. Learn how to use your benefits to build your health and wellbeing below.
You received your welcome letter and have your ID cards and put them in your wallet. That’s a great start—it’s important to take that card with you wherever you go, whether you have an upcoming doctor’s appointment or need them for an emergency on the road. Your Health Options card is also your key to getting the care you need to take of yourself even when you’re healthy.
So, what’s next?
First, make sure you’ve set up your Member Portal, which gives you 24/7 access to your account. You can check your claim status, download documents you need and learn about your plan’s benefits. (If you’re in an Individual or Family Plan, please note your first invoice will come by mail, and we’ll send you invoices electronically after that. You can pay your premium through your portal.)
Perhaps most important, your Member Portal dashboard is your gateway to Health Options’ broad network of providers and where you can choose your primary care provider. We have a network of about 48,000 providers, including clinicians, hospitals and pharmacies, so you can manage your care no matter where you live. Our network includes all Maine hospitals*, most in New Hampshire and Centers of Excellence in Massachusetts.
If you are 18 or older you can also opt for a virtual-first primary care team through Firefly Health. Firefly provides 24/7 access to a primary care team, anytime, anywhere, making it easier to access care right from your cell phone, whether you need preventive and routine care, or help managing more complex issues. Learn more about Firefly Health and download the app here.
Also in your portal, you’ll find a Health & Wellness tab that gives you access to Amwell® telehealth services, where you can receive urgent care services or behavioral health care from the comfort of your home. Urgent care access via Amwell is provided at $0 cost-share on all non-HSA plans, and $0 after a deductible for HSA plans. So, whatever your circumstances, you can speak to a provider right away to explore recommended treatments.
Additionally, the wellness tab has a link to Healthwise®, which includes a symptom checker and access to information on more than 6,000 health and wellness topics.
And if you get sick and have to manage a serious illness, we’re here to help you get through it. Our Care Management team can help to coordinate your care so that you can focus on your needs.
Importantly, if you need help choosing a primary care provider, accessing any of your benefits, or wish to speak to someone on our Care Management Team, please contact our Maine-based Member Services team at (855) 624-6463, Monday through Friday, 8 a.m. to 6 p.m.
*Except for Togus VA
Buying health insurance probably isn’t among the more exciting purchases you’ll ever make. But like it or not, it’s one of the most important each year. So, we want to help you get it right.
When you start shopping for health insurance, likely the first thing you’ll check is the price, or monthly premium. This makes sense, but just like buying a car or a house, price doesn’t tell the whole story.
You might think of the premium—the monthly charge for coverage—as a “sticker price.” But that’s only the beginning of what you’ll pay because most plans include copays, coinsurance and deductibles, which all add up to how much you pay out-of-pocket annually. You can learn more about those costs here.
It’s important to understand the benefits you’ll use because they directly impact how much you might pay to reach an annual maximum out-of-pocket limit, when insurance takes over and pays all your costs. Generally, the less you pay for insurance, the higher your deductible—and the more you’ll pay out-of-pocket as you use more services. So, knowing what you might need will help you limit out-of-pocket costs and maximize your benefits.
You’ll also want to understand types of coverage and be sure your carrier offers a comprehensive network. For example, an “HMO,” which stands for health maintenance organization, gives you access to preferred providers; but you’ll need to stay in-network to get coverage. A second popular option, a “PPO,” or preferred provider organization, costs more but affords the freedom to use out-of-network providers at a slightly higher price.
Within each type of plan, deductible costs are designated by Bronze levels, which cost the least, and Silver, Gold and Platinum levels which cost more, but have lower deductibles. You can learn more about those levels here.
As you compare plans, you’ll get information about costs and coverages, but you’ll also see which plans offer services like wellness programs, dental or eye exams, or chronic care programs to support you along the way. Unique to Community Health Options, for example, is a care management program that partners with community services to support well-being, such as providing transportation to appointments or even meals for someone who is recovering at home.
You might consider a Silver, Gold or Platinum plan if:
You might consider a Bronze plan if:
While costs can weigh heavily when selecting a plan, it’s most important to choose coverage that fits your needs. And you might find help paying for insurance thanks to the passage of the 2022 Inflation Reduction Act, which extended Affordable Care Act premium tax credits. To find out if you’re eligible, visit CoverME.gov, Maine’s online Health Insurance Marketplace. For information or to get help choosing a plan, you can also call Member Services at (855) 624-6463. For quick tips on what to look for, how to get help with, or how to use a health plan, follow @communityhealthoptions on TikTok.
