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MAIN
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A Joint Project of the Maine
Association of Interdependent Neighborhoods |
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Volume 8 No. 3 |
September 2004 |
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MAIN
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A Joint Project of the Maine
Association of Interdependent Neighborhoods |
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Volume 8 No. 3 |
September 2004 |
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Health Care News
DirigoChoice to start in January
MaineCare expansions to followDirigoChoice. The Dirigo Health Agency (DHA) and the Maine Department of Health and Human services (DHHS) have reached an agreement with Anthem Blue Cross Blue Shield for Anthem to deliver DirigoChoice – the health plan arising from the Dirigo Health reform law. DirigoChoice will look like other Anthem plans with some very important additions:
Sliding Scale. First, the DirigoChoice member’s costs will slide according to ability to pay. A person on MaineCare will have free coverage (not even the co-payments required in regular MaineCare). A person just over the MaineCare income guidelines will pay less and have a smaller deductible than a person with higher income.
100% Coverage for Preventative Care. Second, DirigoChoice will give better preventative health coverage and will not exclude people because of preexisting conditions.
In October, Anthem and DHA will begin marketing the plan for enrollment to begin in January 2005.
MaineCare Expansions. Three months after enrollment begins in DirigoChoice (about April 1st) MaineCare expansions are scheduled to take effect. Eligibility for parents with minor children at home will expand to 200% of the poverty level ($24,980 for a family of two; $31,340 for three). Whenever a child is eligible, chances are, the parent will be too! In addition, income limits will expand for adults from 100% to 125% of the poverty level ($11,638 for one; $12,490 for two). Everyone who meets the new income guidelines will be eligible, whether or not they enroll in DirigoChoice. With state budget deficits looming for next year, MAIN will have to be vigilant at the legislature to be sure that the state follows through with these expansions.
MaineCare members who work for an employer who buys DirigoChoice for their employees can choose to stay in regular MaineCare, or to enroll, at no cost, in DirigoChoice. Any services not covered by DirigoChoice (such as transportation to medical appointments) will continue to be covered by regular MaineCare.
For those on MaineCare who are lucky enough to work for an employer who buys DirigoChoice, you’ll have some better benefits, including:
no co-pay
better payment for your healthcare providers
financial incentives for preventative care
better access to some mental health services
