Cost Sharing Clarity/Plan Design:
In accordance with new Maine state mandate changes, effective January 1, 2021, members in our small group and individual market segment plans who are not enrolled in HSA plan designs will receive, at a minimum, their first nonroutine primary care visit and first mental health and substance use disorder treatment visit at no cost. Additionally, these members will not be required to pay toward any deductible for their second and third nonroutine visits with the same providers. This mandate does not apply to Medicare Enhance plans. Please see your Schedule of Benefits for member cost sharing details.
Insulin Cost Sharing
In accordance with new Maine state mandate changes, effective January 1, 2021, there is a cap on the total amount that a covered person is required to pay for each covered insulin drug prescription. The maximum a person will be required to pay for up to a 30-day supply of insulin will be $35.