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Home > Broker > Plan Information > Maines Choice

Maine’s ChoiceSM HMO plan

Maine's Choice is a tiered plan design that can help members save 10-15% on their premiums, and gives them the power of choice when it comes to their health care. Maine’s Choice is available to small employer groups and individuals both off and on Maine’s Health Insurance Marketplace (healthcare.gov).

Enrollment area
Maine’s Choice is offered in 10 counties in Southern and Central Maine: Androscoggin, Cumberland, Franklin, Kennebec, Knox, Lincoln, Oxford, Sagadahoc, Waldo and York. To be eligible to enroll in the Maine's Choice HMO, the member must live in one of these counties for at least nine months out of the year (with the exception of out-of-area dependents).

Plan designs available
This two-tiered plan design gives members choice and flexibility through a wide range of deductible HMO plans. Plus, all plans come with our Value Tier Prescription Drug Plan option.

While members can see any provider in Harvard Pilgrim’s New England network, they’ll pay less when they receive their care from these Preferred tier hospitals and physician groups, and their affiliated providers.

Participating Preferred tier hospitals

  • Franklin Memorial Hospital
  • LincolnHealth – Miles campus
  • LincolnHealth – St. Andrew’s campus
  • Maine General Medical Center
  • MaineHealth ACO
  • The Memorial Hospital – North Conway, NH
  • Mid Coast Hospital
  • Penobscot Bay Medical Center
  • Southern Maine Health Care – Biddeford and Sanford campuses
  • St. Mary’s Regional Medical Center
  • Stephens Memorial Hospital
  • Waldo County General Hospital
  • York Hospital

Participating Preferred tier physicians
Over 700 PCPs and 3,000 specialists from these expansive physician groups are also in the Preferred tier:

  • InterMed
  • Kennebec Region Health Alliance
  • Maine Medical Center PHO
  • Martin's Point Health Care
  • Spectrum Medical Group
  • York Hospital

These are just some of the groups that participate in the Preferred tier. For a complete listing, visit the Maine’s Choice provider directory.

Extra incentives to keep members healthy
All Maine’s Choice plans come with:

  • Coverage for 20 acupuncture visits per year
  • $150 fitness reimbursement*
  • Savings on a wide range of products and services that can help you live a healthy life, including eyewear, dental services, weight and nutrition programs, complementary and alternative medicine, smoking cessation and more
  • Personalized health coaching

Questions?
Contact your account executive.


* This plan includes a tiered provider network, with two benefit levels, or tiers, known as: 1) Preferred Tier Network, which includes primary care providers (PCPs) and 2) Standard Tier Network. Members pay different levels of cost sharing depending on the affiliation of the provider delivering a covered service. If a provider changes affiliations at any time, the tier of that provider may also change. To determine a provider’s tier in the network, please use the provider search tool.

** $150 maximum reimbursement per Harvard Pilgrim policy in a calendar year. Restrictions apply. Visit our fitness reimbursement page or call Member Services for details. (For tax information, consult your employer or tax advisor.)

Maine’s Choice provider directory

Consumer brochure*

Five Facts about Maine's Choice*

How it Works*

Maine's Choice Map*