Individual & Family
healthcare plans
Benefits you can actually use
are better for everyone.
Get comprehensive coverage with the tools and support you need to actually use it.
$5 for many common generic prescriptions
Get the medications you need at a low cost, helping you stay healthy while saving money.
Affordable care, made simple.
$25 for labs and X-rays at specified locations
Pay less for your important tests, with labs and X-rays available at a low, fixed cost.
Healthcare, without the hassle.
$0 urgent telehealth on non-HSA plans
Virtual urgent care visits anytime for free, so you can see a doctor when it matters most.
Quality care, less out of pocket.
$0 birth control on all of our plans
Birth control is fully covered on all plans, giving you one less thing to worry about.
Putting your health first.
Easy access to your prescriptions
Find your medications quickly and see what’s covered under your plan with our searchable drug formulary for the ACA.
Look up medications48,000+ providers across New England
Find the care you need with a wide network of doctors, specialists, and hospitals across New England — and beyond.
Search for providersWhat plan works best for you?
Gold Plan
If you ...
- go to the doctor a lot
- have ongoing health conditions
- want higher monthly payments and lower out-of-pocket costs
Silver Plan
If you ...
- visit your doctor regularly
- have a planned medical expense like a pregnancy or surgery
Bronze Plan
If you ...
- are in good overall health
- primarily visit your doctor for preventive checkups and screenings
Platinum Plan
If you ...
- need ongoing medical care
- have a medical condition and know you'll need care
- have an active family with children who play sports
Catastrophic Plan
If you ...
- are under 30 years old
- don't generally need care
- are comfortable with high deductibles
See how our non-HSA plans break down
For details on our Catastrophic and HSA plans, call (855) 624-6463.
| Gold | Silver | Bronze | Platinum | |
| Deductible | $1,500 - $2,500 | $3,500 - $4,200 | $7,500 - $9,000 | $500 |
| Monthly Payment | $$$ | $$ | $ | $$$$ |
| Primary Care | $25 | $25 - $40 | $25 - $50 | $20 |
| Mental Health | $25 | $25 - $40 | $25 - $50 | $20 |
| Urgent Care via Virtual Care | $0 | $0 | $0 | $0 |
| Urgent Care | $40 | $35 - $75 | $50 - $95 | $25 |
| Specialists | $50 | $60 - $80 | $80 - $80 after deductible | $40 |
| PT/OT/ST and Chiropractic Care | $30 | $40 - $45 | $45 - $60 | $30 |
| Generic Drugs | $5 - $25 | $5 - $35 | $5 - $30 | $0 |
| Brand Name Drugs | $50+ | $50+ | $50+ after deductible | $15+ |
Let's get started
I'd like to check for
financial assistance
See if you qualify for tax credits or other savings that can lower your monthly health insurance costs.
I want to talk to
an advisor
Get personalized guidance from an expert who can help you find the right health plan for your needs.
I'm ready to
shop for a plan
Start comparing health plans designed for you — view options and choose your coverage.
Health insurance is confusing.
We're here to help.
Questions? We have answers.
The ACA marketplace, sometimes called the exchange or the Health Insurance Marketplace, is where you can buy health insurance plans for yourself and/or your family. Created by the Affordable Care Act (ACA), and often called Obamacare, it is designed to allow people to more easily compare plans, find out if they qualify for subsidies or Medicaid, and enroll in coverage.
Maine’s marketplace is called CoverME.gov. Marketplace plans are grouped into “metal levels:” Bronze, Silver, Gold and Platinum, which offer different levels of coverage based on your monthly premium and out-of-pocket costs.
Are you a Small Business? You can determine your eligibility to purchase a SHOP plan at CoverME.gov- we are the only carrier in Maine that offers tax credited health insurance coverage for your employees. You can purchase SHOP plans through our store front.
CoverME.gov is Maine's Health Insurance Marketplace. It is where people and small businesses in Maine can shop and buy health plans, along with finding out whether they qualify for MaineCare or financial assistance. Individuals and families can purchase a plan during annual Open Enrollment, Nov.1 through Dec. 15, or when they qualify for a Special Enrollment Period.
About 85% of enrollees qualify for financial savings. Depending on household income, household size and other factors, you could be eligible for:
- Premium tax credits to lower monthly payments
- Other savings to reduce costs when you get care
Our Member Services team is available to answer any questions and find the right plan for your unique needs: (855) 624-6463.
Being an Individual or Group Member depends on how you get your plan:
- Individual Members buy their health insurance for themselves and/or their family on CoverME.gov, through a health insurance website or through a broker, and pay a monthly premium to Community Health Options. This is common for people who are self-employed, freelancers, contractors or who do not have health insurance offered at work.
- Group Members get their health insurance coverage at work from a plan offered by their employer. They may pay for a portion of their premium through a payroll deduction. For details about their plan, Group Members should contact their HR administrator or view their Member portal.
You can only change which health plan you have during specific times:
- Open Enrollment Period: This is the main time each year when you can sign up for or change your health plan. If you’re buying it on your own, you’ll have to sign up once a year, usually beginning in November (Nov. 15-Dec. 15 in Maine). Open Enrollment can vary from state to state.
If you get your insurance at work, your employer will generally schedule a specific open enrollment period.
- Special Enrollment Period (SEP): When your life changes—like starting a new job, having a baby, getting married or divorced, losing other health coverage or moving to a new area, that’s called a “qualifying life event.” In those cases, you can change your insurance or buy a new plan, whether you buy insurance on your own or get it at work.
If you experience a qualifying life event, like getting married/divorced, having a baby, losing other health coverage, or moving to a new area, you may be eligible to change or buy a new plan outside Open Enrollment. This is known as a Special Enrollment Period (SEP).
Individual Members can call our Member Services team at (855) 624-6463 for help with your application, call your broker, or visit CoverME.gov if that’s where you bought your plan.
Group Members should contact their employer’s HR administrator for more information on making changes to your plan.
To view our current coverage options, visit the Explore Plans page to get started. If you are looking for an Individual or Family plan and want to find out if you qualify for financial assistance, visit CoverME.gov and search for Community Health Options to see our plans. Our Member Services team is always here to answer any questions at (855) 624-6463.
For Group Members, please contact your employer’s HR administrator for details on your specific plan option.