HMO Choice
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Your PCP will provide the preventive care you need to help keep you healthy. You’ll pay only a small copayment for most covered services. And, if you wish, you can self-refer to any doctor. Sound like a good deal?
The most recognized name in health coverage.
Anthem Blue Cross and Blue Shield is continuing the great Blue Cross and Blue Shield tradition in Maine. With HMO ChoiceSM you know your coverage will be recognized by health care providers everywhere.
The best of both worlds.
As a member of HMO ChoiceSM you select a primary care physician (PCP) who makes sure you get the care you need with the lowest possible out-of-pocket costs. Your PCP will provide basic health care services. You can also self-refer to any provider you want within the HMO ChoiceSM network, but deductibles and coinsurance amounts will apply to your benefits. If you self-refer to a provider outside the HMO ChoiceSM network, you may also be responsible for any balance that is more than our maximum allowance.
Maine’s most extensive physician network.
You’ll need to choose a PCP for each member of your family from our HMO directory. The network includes doctors and other health care providers throughout the state.
Referrals to specialists.
Your PCP refers you when necessary for other health care services to a specialist within the network. If you need care that can’t be provided within the specialist network, your PCP may refer you to someone outside the network. You’ll still be covered. You also have the option to self-refer to a specialist. However, it will cost you more. The Benefit Overview you receive with your enrollment materials explains the costs.
Away from home? You’re covered.
If you’re traveling and you need emergency care, get care immediately, just as you would at home. You should call your PCP within 48 hours for the best follow-up care. If you become ill or injured, but it’s not an emergency, you can call your PCP or 1-800-810-BLUE (1-800-810-2583) 24 hours a day. This toll-free number connects you to a nationwide network that will direct you to the care you need. These important numbers are on your ID card.
Away at school? They’re covered.
When they’re ill or injured, covered students who attend school away from home should get care from their campus clinic or from a local doctor or hospital. For maximum benefits, just send us a claim, noting that the care was for a child away at school.
Prescription drugs are hassle-free.
Your HMO ChoiceSM ID card is also your prescription drug card. Just show your ID card at almost every pharmacy in Maine, including all of the chains, and most pharmacies nationwide. Pay your copayment, and you’re on your way. No claims to file.
Healthy preventive care.
With HMO ChoiceSM your preventive care benefits may include:
 | Automatic at-home reminders for essential preventive care. |
| Regular checkups. |
| Immunizations and screenings appropriate for your age, such as mammograms, Pap tests and cholesterol checks. |
| Educational programs for people with asthma, diabetes or heart disease. |
| An effective program that will help you quit smoking. |
| Bi-annual eye exams. |
See the Benefit Overview you receive with your enrollment materials for details.
Emergency? We’re there.
If it’s an emergency, get medical care right away. Go to the nearest emergency room. You’ll be covered. You should call your PCP within 48 hours for the best follow-up care.
Enjoy healthy discounts.
As an HMO ChoiceSM member, you’ll be eligible for special deals on fitness clubs, health organizations and bike helmets.
Mental health and substance abuse services.
Mental health and substance abuse services are convenient and confidential. You’ll receive maximum benefits by calling 1-800-755-0851 before you receive any treatment. Clinical staff is available during regular business hours to help you choose the mental health or substance abuse provider that will best meet your needs. In an emergency, get care right away, and you should contact 1-800-755-0851 within 48 hours. Clinical staff is available 24 hours a day, seven days a week, to help you with urgent or emergent referrals. To receive a list of providers in your area in the Anthem Blue Cross and Blue Shield behavioral health network, just call 1-800-755-0851. We will mail the list to your home or e-mail it to you, whichever you prefer.
Answers are a phone call away.
If you’re not sure how fast you need care or where to get it, you can call our 24-hour nurse call line at 1-800-607-3262. You’ll be connected to a helpful registered nurse here in Maine, 24 hours a day, seven days a week.
Enjoy superior customer service.
Our customer service representatives are available weekdays from 8:00 a.m. - 5:00 p.m. to answer your questions. The Benefit Overview you receive with your enrollment materials has details of your HMO ChoiceSM coverage. Look it over, and give us a call. You can also visit us at our office in South Portland.
From Greater Portland (207) 822-8282
Toll-free in Maine 1-800-527-7706
Would you like to learn more about HMO Choice SM? Simply fill out our online sales information form and a member of our sales staff will contact you. | 