Maine plan offerings

Individual and family plans offered directly through Harvard Pilgrim or on CoverME.gov

2026 plan offerings

Get details on benefits, cost sharing and more in our product guide.

HMO and HMO HSA

Choose a primary care provider (PCP) from Harvard Pilgrim’s HMO network. They’ll coordinate your care with participating specialists and hospitals.

Plan details:

  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

Maine’s Choice Plus HMO and Maine’s Choice Plus HMO HSA

Flexible plans that can help you save money with two networks of providers and hospitals.

NEW Expanded Network:

Harvard Pilgrim Health Care is expanding its Maine Choice network in 2026, bringing coverage across the state. As part of this expansion, Northern Light Health hospitals will be designated as Preferred providers in the Maine Choice Plus HMO network. This enhancement improves statewide access to high-quality care and strengthens our commitment to providing choice and affordability.

Plan details:

  • Two networks: Preferred Network (lower cost sharing) and Standard Network (higher cost sharing)
  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the Maine’s Choice Plus HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

PPO Access

The PPO Access network offers comprehensive care and coverage from our extensive network of doctors, specialists and hospitals, ensuring members receive access to top-quality care. Visit harvardpilgrim.org/providerdirectory to select a provider.

Plan details:

  • The same robust regional network of 152 hospitals and 74,000+ doctors and specialists throughout Maine, Massachusetts, New Hampshire, Vermont and Rhode Island.
  • A nationwide network with more than 950,000 doctors and specialists and 4,300 hospitals
  • And the great benefits, programs, and services offered by Harvard Pilgrim. For details on plan options, please contact the Individual Sales team at 855-354-4742.
  • Includes Core ME 5-Tier prescription drug coverage.

It’s easy to confirm if your current providers are part of the PPO Access plan network.

  1. Visit harvardpilgrim.org/providerdirectory
  2. Select “PPO ACCESS”
  3. Search according to your preferences.

2025 plan offerings

Get details on benefits, cost sharing and more in our product guide.

HMO and HMO HSA

Choose a primary care provider (PCP) from Harvard Pilgrim’s HMO network. They’ll coordinate your care with participating specialists and hospitals.

Plan details:

  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

Maine’s Choice Plus HMO and Maine’s Choice Plus HMO HSA

Flexible plans that can help you save money with two networks of providers and hospitals.

Plan details:

  • Two networks: Preferred Network (lower cost sharing) and Standard Network (higher cost sharing)
  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the Maine’s Choice Plus HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

POS

Choose to get care with or without referrals and outside of Harvard Pilgrim’s network.

Plan details:

  • PCP required
  • In-network coverage and lower cost sharing when you receive care for covered services from participating providers with your PCP’s referral1
  • Out-of-network coverage and higher cost sharing when you receive care for covered services from:
    • Participating providers without your PCP’s referral
    • Non-participating providers
  • Find participating doctors and hospitals in the POS provider directory
  • Includes Core ME 5-Tier prescription drug coverage

PPO

Choose to get care from providers inside or outside of our extensive network.

Plan details:

  • PCP encouraged but not required
  • Referrals not required
  • In-network coverage and lower cost sharing when you receive care for covered services from participating providers
  • Out-of-network coverage and higher cost sharing when you receive care for covered services from non-participating providers
  • Find participating doctors and hospitals in the PPO provider directory
  • Includes Core ME 5-Tier prescription drug coverage
Footnote(s)
1

Certain in-network services do not require referrals.