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Dirigo Health

The US is facing a health care crisis, but Maine is doing something about it!

Health care is a matter of fairness. Dirigo Health helps all Maine people. It helps the uninsured and those of us who feel stuck in the middle, struggling to maintain the coverage they have. Expanding access to coverage reduces the "hidden tax" we all pay with our premiums in bad debt and charity care.

Because of Dirigo Health, Maine saved $78 million in the health care system over the last two years, and this helps all hard working Maine families. As of June, Dirigo is providing health care to over 15,400 Maine people, including 2,300 small businesses, with more joining each month.

Maine is one of 7 states nationally, and the only state in New England, to reduce its uninsured population between 2000 and 2004.

Governor Baldacci established a Blue Ribbon Commission to make Dirigo Health work for more Maine people. The commission will propose options for additional sources of funding for the DirigoChoice program.

What is Dirigo Health?

Dirigo Health addresses the entire health care system to bring down the growth of health care costs, to improve quality of care and to ensure access to coverage. Dirigo Health Reform includes:

  • DirigoChoice insurance - coverage for small businesses, sole proprietors and individuals based on ability to pay
  • Maine Quality Forum - working with providers and others to improve quality of care
  • State Health Plan - a roadmap to improve Mainers' health

Dirigo Health Reform is recognized as one of the top government innovations by the Council for Excellence in Government and Harvard University.

Information on DirigoChoice

DirigoChoice is an insurance plan for small businesses, sole proprietors and individuals. It is offered through a public/partnership between Anthem Blue Cross and Blue Shield and the Dirigo Health Agency.

How DirigoChoice works

DirigoChoice is like private insurance. It covers hospital, doctor and specialist care, and prescription drugs.

But DirigoChoice does more than traditional insurance. There is no waiting period for pre-existing conditions and it covers preventive care at 100% and mental health parity. Its Healthy ME Rewards Program gives individuals and families $100 to $200 for completing a health risk assessment with their physician.

Subsidies

Your income will determine how much you pay for DirigoChoice coverage. DirigoChoice has a subsidy program that reduces monthly payments AND deductibles. Members with household incomes below 300% of federal income levels receive subsidies up to 100% of costs. For instance, incomes below $58,000 for a family of four or $28,700 for a single adult will get subsidies.

For small businesses, DirigoChoice seeks a balance between what the employer pays and what the employee pays. Employers pay at least 60% of the employee premium. Employees and their dependents receive the subsidies.

Steps to enroll in DirigoChoice

  1. Get a quote from Anthem. NOTE: the quote will not include subsidies you may be eligible for.
  2. Complete enrollment packet provided by Anthem, including the subsidy application, and mail it to the Dirigo Health Agency.
  3. The Dirigo Health Agency will notify you of your eligibility for subsidies and how much you will pay for DirigoChoice when including your subsidy.
  4. Decide if you want to enroll or not.

Estimate your subsidies

Go to dirigohealth.maine.gov and go to the DirigoChoice section to try the "Discount Estimator" to estimate your level of subsidy.

Contact information

Dirigo Health Agency, for questions about subsidies:
1-888-243-8731 toll-free in Maine (TTY: 207-287-4344)

Anthem BCBS, to get a quote:
* Small businesses and employers: 1-800-541-4251
* Sole proprietors and individuals: 1-800-934-3233

Adam Thompson
Legislative and Constituent Liaison
Governor's Office of Health Policy and Finance
15 State House Station
Augusta, ME 04333-0015
(207) 624-7445
(207) 624-7608
Adam.Thompson@maine.gov

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Authorized by the Candidate and paid for by Beavers for Maine House
Floyd Beavers, Treasurer, 72 Woodland Hills, South Berwick, ME 03908