Maine - Community Safe Harbor

Maine, 2017

  • Plan Type

    PPO

  • Metal Tier

    Catastrophic

  • Out of Pocket Maximum

    $7,150

  • Deductible

    $7,150

Enroll Now
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Call (855) 866-5590 to speak with a licensed agent about a new health plan.

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Cost Sharing Benefits (In Network)

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $7,150
Deductible (Family) $14,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit No charge after deductible
Specialist Visit No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible
Emergency Room Services No charge after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge after deductible

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx No charge after deductible
Preferred Brand Rx No charge after deductible
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge after deductible

Other Plans in Maine

Plan Communty Focus Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Reliant HSA Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,550
Plan Community Align Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Value Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Choice Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Community Edge Deductible $1,200 Coinsurance Not applicable Out of Pocket $4,300
Plan Community Complete Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Advance Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,500
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Cost Sharing Benefits (In Network)

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $7,150
Deductible (Family) $14,300
Coinsurance Not applicable
Out of Pocket Maximum (Individual) $7,150
Out of Pocket Maximum (Family) $14,300

Doctor Visits

Primary Care Visit No charge after deductible
Specialist Visit No charge after deductible
Inpatient Facility No charge after deductible
Inpatient Physician No charge after deductible
Emergency Room Services No charge after deductible

Tests and Imaging

Imaging (CT/PET Scans, MRIs) No charge after deductible
Laboratory Outpatient and Professional Services No charge after deductible
X-Ray and Diagnostic Imaging No charge after deductible

Health Management Programs

Asthma Not available
Depression Not available
Diabetes Available
Heart Disease Not available
High Blood Pressure / High Cholesterol Available
Lower Back Pain Not available
Pain Management Not available
Pregnancy Not available
Weight Loss Not available

Other

Mental / Behavioral Health Inpatient No charge after deductible
Mental / Behavioral Health Outpatient No charge after deductible
Rehabilitative Speech Therapy No charge after deductible
Rehabilitative Occupational & Physical Therapy No charge after deductible
Outpatient Facility No charge after deductible
Outpatient Surgery No charge after deductible

Prescription Drugs

Generic Rx No charge after deductible
Preferred Brand Rx No charge after deductible
Non Preferred Brand Rx No charge after deductible
Specialty Drugs No charge after deductible

Other Plans in Maine

Plan Communty Focus Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Reliant HSA Deductible $5,500 Coinsurance Not applicable Out of Pocket $6,550
Plan Community Align Deductible $5,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Value Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Choice Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,500
Plan Community Edge Deductible $1,200 Coinsurance Not applicable Out of Pocket $4,300
Plan Community Complete Deductible $2,500 Coinsurance Not applicable Out of Pocket $7,150
Plan Community Advance Deductible $2,000 Coinsurance Not applicable Out of Pocket $6,500