From the community

Cioppa: Check insurance plan to see if your doctor participates

Posted Feb. 25, 2014, at 2:14 p.m.

GARDINER, Maine — Maine Insurance Superintendent Eric Cioppa is encouraging Mainers enrolling in a new health insurance plan to clarify whether or not their providers of choice are part of the plan’s network, before finalizing their purchase.

“I urge people to call both the insurance company and their health care provider to verify that the provider will be covered under the specific plan being considered,” Superintendent Cioppa said in a press release.  “Mainers should understand that a provider may be contracted by an insurance company under one plan, but not under another.”

Cioppa noted that charges for medical services from a provider that is not in the plan network do not apply to the annual out of pocket maximum of $6,350 under the federal health law.  He emphasized that this may add expenses for enrollees who use out of network providers.

Individuals in Maine may call the Bureau of Insurance at 800-300-5000 with questions or concerns about their insurance options and the networks offered under the various plans sold in Maine.

The current open-enrollment period to purchase an individual or small group plan ends March 31, 2014.  The next open enrollment is scheduled to begin Nov. 15.

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