DirigoChoice

DirigoChoice is a comprehensive program of services offered through a public/private collaboration between the Agency and Harvard Pilgrim Health Care (HPHC), with a focus on extending wellness and preventive services. The Agency partnered with HPHC to administer DirigoChoice effective January 1, 2008.

DirigoChoice offers:

• No pre-existing condition restrictions
• Discounts from 20% to 80% off the monthly cost depending on income and family size
• Reductions in deductibles and annual out of pocket expenses depending on discount level
• Routine preventive care
• Inpatient/outpatient services
• Prescription drug coverage
• Maternity care
• Well-child care
• Childhood immunizations
• Emergency care
• Mental health services
• No deductible for preventive care or prescription drugs
• Smoking cessation education programs
• Domestic partner coverage
• Extensive provider network
• Out of network coverage (at greater out of pocket cost)
• No referral required to see a specialist

Eligible enrollees receive discounts on the monthly cost and reductions in deductibles and annual out-of-pocket expenses based on income and family size. This sliding scale of monthly payments, deductibles, and out of pocket maximums helps make DirigoChoice more affordable to enrollees.

To view available discounts on monthly costs, deductibles, and out-of-pocket expenses, go to the DirigoChoice Discount Estimator.

DirigoChoice is availble to residents of the State of Maine in the following categories:

• Small Employers (2-50 employees)
• Sole Proprietors (Self-employed of 1)
• Individuals

DirigoChoice is currently open!

Individuals and Sole Proprietors must complete a Certification Statement.

Small Employers must contribute 60% of the cost of their employees' coverage. Employers are not required to make any contribution toward the cost of their employees' dependents.

Sole proprietors must contribute 60% of the cost for single coverage prior to the discount being applied.

Individuals have no minimum contribution requirements.

There are three plan options. The benefits are the same for all options but the deductible levels and out-of-pocket maximums are different.

• Plan 1 - $1,250 deductible
• Plan 2 - $1,750 deductible
• Plan 3 - $2,500 deductible

These deductible levels may be reduced based on the discount level.