Resources for Individuals

Community Health Options® takes pride in being a resource to our Members and communities. This page provides you with up-to-date information about the health insurance marketplace, assistance available, consumer protections, and other health insurance topics. Some of these links will take you to other web sites you can explore and others are PDFs regarding key topics that you can download.

If you have questions about other topics not listed on this page, please visit our Frequently Asked Questions.


Resource Links:

Our Commitment to Quality

  • Quality Improvement Program - Community Health Options commitment to improvement is ingrained throughout the organization. Health Options has actualized this commitment and focus through a Quality Improvement Program (QIP), which is based on its mission to partner with people, businesses, and health care professionals to provide high-quality healthcare benefits that promote health and wellbeing. 


Enrolling & Choosing Plans

 

Getting the Most Out of Your Membership

  • Rx Savings Solutions - Community Health Options has partnered with Rx Savings Solutions to provide you with a no-cost benefit that helps you and your family save money on prescription medications. Learn more about Rx Savings Solutions and start saving money today.
  • Specialty Pharmacy Benefit - Understanding your specialty pharmacy benefit, including information on tiers, designated specialty pharmacies and manufacturers coupons.
  • Our Behavioral Health Approach - Health Options firmly believes in treating the whole person- that includes physical health, mental health, and substance use disorder services.  Find out more here. 
  • Our Prior Approval Process - People often misunderstand the need for doing Prior Approvals and what is called Utilization Management. At Community Health Options our goal is to encourage the highest quality of care, in the most appropriate setting, from the most appropriate provider, for the appropriate length of time. 

  • Preventive Services – We want to support and encourage your efforts to protect and promote you and your family’s greatest asset, your health. Many preventive health care services including screenings, checkups and counseling cost you nothing.

  • Annual Meetings  As a member, you will have the opportunity to attend our annual meeting in person at our office in Lewiston or via webinar. An audio recording of the November 17, 2016 annual meeting is available for audio streaming now.

  • Safe Use of Prescription MedicationsStudies show that more than half of the adults in the U.S. take at least one prescription and that 20% are taking at least five. Here are some simple ideas you can use to stay organized and track your medicines.

  • Setting up and Managing the Online Payment System - We've put together a quick guide, and video to show you how to set up, edit, or delete your auto pay plan. 


Understanding Health Insurance, the Marketplace and Advanced Premium Tax Credits (APTC)

Check out our new video series to help you prepare for the next time you need to use your insurance!

More Resources:

  • Explanation of Household Size and Income – How to determine who to include in the household and what should be included in income in the Marketplace Application.

  • Advanced Premium Tax Credits - A simple guideline to see if someone is eligible to receive assistance in paying for your monthly premiums. 

  • The Health Insurance Marketplace - A link to the Federal Health Insurance Marketplace website. 

  • The Maine Bureau of Insurance - State-specific information about the Health Insurance Marketplace, FAQs, consumer tips and how to file a complaint. 

  • Enroll 207.com - A Maine Connection to the Health Insurance Marketplace.
  • http://www.comparemaine.org - Know what to expect before you receive care.  CompareMaine shows the average cost of common healthcare procedures at different facilities in Maine. You can also see patient experience ratings and how Maine hospitals compare on patient safety.  Please note that the cost estimates on CompareMaine are median payments. They are meant to serve as a reference point for comparison. In order to find out your actual payment, please contact the facility that you are interested in.   

  • Choosing Wisely - Choosing Wisely aims to promote conversations between providers and patients by helping patients choose care that is (1) Supported by evidence, (2) Not duplicative of other tests or procedures already received, (3) Free from harm, and (4) Truly necessary.

  • Member Orientation Webinar recording with slides - Are you interested in learning more about your health insurance coverage and how to use it effectively?  This presentation is an opportunity for you to learn more about plan benefits and getting the most out of your coverage. It covers a wide variety of topics including insurance concepts and terms, forms and processes, accessing free services, and features of the Member Portal.