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Health Benefits

Details about the following can be found at the Office of Employee Health website.

The State of Maine health plan for active employees and non-Medicare retirees will have a premium increase of approximately 4% for both the employer and the employee/retiree. The coverage changes are as follows. You can see a comparison by going to: These two links explain the changes for the new health insurance plan.

Find a Provider

You do not need to find a new doctor; the State of Maine Health Plan will continue to provide coverage for both in and out-of-network services. To find out if your doctor is in the Anthem network, call Anthem Member Services at 1-844-273-4614 visit theAnthem Health Insurance website to find a provider.

Preventive Care Coverage: For Active Employees and Non-Medicare Retirees

For active employees and non-Medicare retirees

Many of the recommended preventive services provided are covered by the State of Maine Health Plan and are at no cost to you when the services are performed by an in-network provider unless stated otherwise. Although it is important to coordinate your care with your primary care doctor, referrals are not required for these services. For more information regarding the coverage effective July 1, 2020, see the Anthem Preventive Care flier (PDF)

Routine Physical Exams: Routine physicals for adults and children are covered at 100% with no copay with an in-network provider.

Routine Eye Exams: These exams are covered at 100% with no copay once per calendar year when provided by an in-network doctor.

Routine Gynecological Care Exams: These exams are covered at 100% with no copay when provided by an in-network doctor or specialist.

Immunizations: Immunizations recommended by the American Medical Association are covered at 100% with no copay when given by an in-network provider. For more information, the Centers for Disease Control and Prevention (CDC) recommended schedules for the current year can be found here: from birth through age 6, from age 7 through 18 and for adults.

Mammograms: Screening and diagnostic mammograms are covered at 100% with no deductible at both the in-network and out-of-network benefit level.

Colorectal Cancer Screenings: The coverage for routine and medically necessary screenings is 100% no deductible.

Routine Digital Rectal Exam/Prostate-Specific Antigen Test: One exam per calendar year is covered at 100% no deductible. There is no coverage for these exams if you go outside of the Anthem network.

Lung Cancer Screening: Lung cancer screenings are provided for eligible members at no cost. To learn more about the eligibility requirements, visit the U.S. Preventive Services Task Force website.

Wellness Resources

WellStarMe

Online wellness program available to employees, retirees and spouses/domestic partners enrolled in the State of Maine Point of Service health insurance plan.

  • Webite: www.WellStarME.org
  • WellStarME can help you:
    • Keep track of your health numbers (e.g. blood pressure, cholesterol).
    • Connect you with local, no-cost resources for help with pre-diabetes and tobacco cessation.
    • Maintain an activity log.

Gym Membership Reimbursement Program

  • e-mail: Info.Wellness@maine.gov
  • Employees are eligible for reimbursement of up to $40 per month at any qualifying gym. *Members must be eligible for State of Maine paid benefits.
  • Visit the Office of Employee Health and Wellness page for additional program information including attendance requirements, sample list of qualifying gyms and tax information.