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A Joint Project of the Maine
Association of Interdependent Neighborhoods |
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Volume 9 No. 1 |
February 2005 |
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MAIN
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A Joint Project of the Maine
Association of Interdependent Neighborhoods |
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Volume 9 No. 1 |
February 2005 |
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DirigoChoice -- Enroll Now!
DirigoChoice coverage for small businesses and self-employed people began on January 1, 2005. Now, enrollment for individuals has opened, with coverage starting on April 1. You are eligible as an individual if you:
Are unemployed; or
Work fewer than 20 hours per week for any one employer; or
Work for a small business (fewer than 50 employees) that has not offered health insurance for at least the last year.
DirigoChoice coverage is more affordable for most individuals than other insurance plans. You will be able to purchase coverage at a group rate; and sliding scale discounts of up to 80% reduce the cost of premiums, deductibles and the annual out-of-pocket maximum, if your income is at or below 300% of the federal poverty level. In addition, there are some expenses, such as childcare, that can be deducted from your household income. This chart shows how much income a family can have and be eligible for the discounts:
Family Size
300% of the Federal Poverty Level (FPL)
1 $28,710 2 $38,490 3 $48,270 4 $58,050 5 $67,830 FPL will increase slightly in February or March 2006
DirigoChoice is offered by Anthem BlueCross BlueShield. If you fill out an application for DirigoChoice as an individual and you are eligible for full benefit MaineCare, you will be enrolled in MaineCare instead of DirigoChoice. If an employer chooses to enroll in DirigoChoice, employees who are eligible for MaineCare will be able to enroll in DirigoChoice.
Here are some of the highlights of DirigoChoice:
100% coverage for preventive health. Preventive services, including annual physicals, mammograms, well-baby care and flu shots will be 100% covered, without co-pays or deductibles.
Prescription drug coverage will not have a deductible (co-pays of $10/$25/$40).
Mental health parity (mental health and substance abuse services will be covered at the same level as physical conditions).
Cash incentives for selecting a Primary Care Physician and completing a health risk assessment.
Pre-existing conditions are covered with no waiting period.
Coverage for domestic partners.
This year, only a limited number of participants will be enrolled in DirigoChoice as individuals or self-employed, so be sure to apply soon! Here's who to contact:
If you are a… Who Do You Call? Things to remember SMALL BUSINESS
(2-50 employees)
Get a Rate Quote & ApplicationYour insurance agent or Anthem
1-800-541-4251You can request a rate quote and apply right now. Your application must be received by the first day of the month before coverage is to begin. (For example: If you enroll before March 1st, your coverage will begin April 1st.)
If you have questions about
the Discount Application or MaineCare Assistance, call: 1-888-243-8731SELF-EMPLOYED *
(Sole Proprietor)
Get a Rate Quote & ApplicationINDIVIDUAL *
Get a Rate Quote & Application
* The total number of self-employed and individual members who will be enrolled in 2005 is limited to 4,500 people.MaineCare coverage for parents to expand on April 1, 2005
Dirigo Health Reform calls for the expansion of MaineCare eligibility for parents with minor children from 150% of the poverty level to 200% on April 1, 2005. Other adults age 21 through 64 without minor children at home (both “non-categoricals” and adults with disabilities) were also scheduled to have an eligibility increase from 100% to 125%. Unfortunately, the non-categoricals and adults with disabilities expansion is unlikely to happen at this time (See related article) With the current budget challenges, we still need to work together to make sure the parent expansion takes place in April.
DirigoChoice is part of Dirigo Health Reform, which calls for increasing health care access, controlling costs and improving health care quality. For more information about Dirigo Health Reform, DirigoChoice or to find a list of Anthem appointed insurance producers/agents, go to:
