Home Members Plans 2021

We can help you choose the right plan

Shopping for health insurance can be confusing. We can help. Our Maine-based team can help find the right plan for you. We'll ask you the key questions and guide you through the process to make it simple.

Breaking down the costs


The amount that must be paid for your health insurance plan. You and/or your employer usually pay it monthly, quarterly, or yearly.


The amount you owe for healthcare services your health insurance plan covers before your plan begins to pay.

Out-of-Pocket Max

The maximum amount that you have to pay each year before the plan pays for all covered services.


We offer both HMO and PPO plans. Both plans require you to select a Primary Care Provider from our network. HMO plans generally come with lower premiums but are more restrictive. PPO plans offer you greater flexibility but the premiums are higher.



  • Less coverage choice
  • Lower premium
  • PCP coordinates in-network care
  • No out-of-network coverage



  • More coverage choice
  • Higher premium
  • You coordinate care, no referrals needed
  • Out-of-network coverage at additional cost

Understanding the metal levels

All of our plans cover the same set of essential health benefits. The metal levels are based on how you and the plan will share the costs for healthcare services.

There are different metal levels

For people under 30 or with certain exemptions.
Bronze level of coverage pays 60% of health care costs.
Silver level of coverage pays 70% of health care costs.
Gold level of coverage pays 80% of health care costs.

Find out if you qualify for financial assistance

Click on the calculator button below and answer a few questions to see if you qualify for assistance.

Need help? Call our Member Services team at (855) 624-6463.


In or out-of-network?

Understanding whether your doctor is in-network is important as it will impact the cost of your visit. Our tool helps you see whether a provider is covered by your plan.

Prescription medications

Find out if your medication is covered and to what extent. We'll also show you alternatives and whether there are requirements or limits on coverage.

There are five tiers of medications going from Tier 1 (least expensive) to Tier 5 (most expensive)

Chronic Illness Support Program (CISP)

Our CISP Program reduces financial barriers (copays, deductibles, coinsurance) for select services for Members with certain chronic conditions. You will pay less for out-of-pocket medical and pharmacy services for these conditions.

Receive reduced out-of-pocket medical and pharmacy services for select chronic conditions:

  • Diabetes
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Hypertension
  • Coronary Artery Disease

Get free local help choosing a plan

We know — shopping for health insurance can be confusing. We're here to help. Call (855) 624-6463 to talk to our Maine-based team, who can answer your questions and help guide you to the right option for your needs and budget.

People and groups in the community can help you with the selection and application process, too:


  • Trained and certified individuals
  • Help you apply for and enroll in a health plan or apply for Medicaid/Children’s Health Insurance Program (CHIP)
  • Required to provide fair, impartial, and accurate information
Find an assister


  • Trained and registered by the Marketplace;
    licensed in their states
  • Provide services at no cost to you
  • Required to act in a consumer's best interest
  • Can refer customers for Medicaid/CHIP help
  • Call (207) 402-3353 to find a Broker
    near you

Get an instant healthcare quote

Our online comparison tool will help you choose health insurance coverage, determine if you are eligible for Advanced Premium Tax Credits, and find the plan that is best for you and your family. To choose and enroll, click the button below.

Need help? Call (855) 624-6463.