Maine: Latest State Regulations and Preventive Care Benefits
Preventive Care Benefits
In accordance with new preventive care guidelines, the list of additional preventive care benefits on your plan may have changed. If applicable, these changes will be effective on 1/1/20.
Please see your Schedule of Benefits as your member cost sharing may have changed for the following preventive services, tests and devices: blood pressure monitor, retinopathy screening, and international normalized ratio (INR) testing.
If you’re enrolled in a High Deductible Health Plan (HSA) that provides the “Preventive Drug Benefit”, your plan will now cover selective serotonin reuptake inhibitors (SSRI) medications without applying your plan deductible. Your ID card will include the words “Preventive Drug Benefits” if you have this coverage.
The below coverage applies to all fully insured commercial Maine plans.
In accordance with new Maine state mandate changes, effective 1/1/20 medically necessary hearing aid coverage is now provided for members of all ages.
Voluntary Termination of Pregnancy
In accordance with new Maine state mandate changes, effective 1/1/20 voluntary termination of pregnancy is now covered for all members. Exclusions are available for religious employers.
Colorectal Cancer Screening
In accordance with new Maine state mandate changes, effective 1/1/20 there are no longer any age restrictions for members to receive a medically necessary colorectal cancer screening.
In accordance with new Maine state mandate changes, effective 1/1/20 Direct Primary Care Providers who are not in the Harvard Pilgrim network can make referrals for their patients who are Harvard Pilgrim members. Services are subject to the same member cost sharing that would apply if the referral was made by a Plan Provider. Please Note: Direct Primary Care Providers must provide additional information to the Plan.