DirigoChoice

DirigoChoice is the insurance product created as part of the Dirigo Health Reform law of 2003. DirigoChoice is designed to provide health coverage to small businesses, self-employed, and certain groups of people buying coverage outside of a workplace. What you'll find on this page: Who can get DirigoChoice? What does it cover? What does it cost? How do I apply? What are the Dirigo Health reforms?	...	Online Health Care Guide Helpful programs for the following groups of people: Kids and Parents Pregnant Women Young Adults Disabled or Elderly Adults Other Adults Other helpful programs for many groups of people: COBRA Dental DirigoChoice Hospital Programs Mental Health Prescription Drug Programs Private Insurance Substance Abuse Other Resources Getting Quality Health Care

Who can get DirigoChoice?
There are three groups of people who can get DirigoChoice.

1. Small businesses with 2 to 50 full-time employees can enroll,
2. Self-employed people with no other employees, and,
3. Some people looking for health insurance outside of a workplace.

For more information about these groups, call the HelpLine at 1-800-965-7476.

Waiting list: The DirigoChoice rules limit the number of people they can enroll outside of a workplace. Right now, they are only enrolling new members in the self-employed and small business groups. People looking for coverage outside of a workplace are currently being placed on a waiting list unless they are laid off workers eligible for the Health Coverage Tax Credit (HCTC).

Laid off Workers Eligible for HCTC: People in this group can get discounts off the cost of their DirigoChoice coverage. First, they get a discount off their monthly premium through the HCTC program, and then they could also get a discount off their deductible and maximum out of pocket limit through the DirigoChoice program, based on their household income. For more information, call the HelpLine at 1-800-965-7476.

What does it cover?
DirigoChoice includes coverage for 100% of preventative services with no co-pays or deductibles, and prescription drug coverage with no deductible. In addition, there are no preexisting condition exclusions for enrollees, and it provides mental health coverage in the same way it provides coverage for physical ailments. For more detailed information, call the Dirigo Health Agency at 1-877-892-8391.

What does it cost?
Cost is based on household income with discounts available on the premium, deductibles, and CO-pays For more about the discount you may qualify for, call the HelpLine at 1-800-965-7476.

Waiting list for NEW discounts: DirigoChoice is a public/private partnership. There are a limited amount of funds available for discounts. In order to balance the DirigoChoice budget, right now there is a waiting list for NEW discounts.

• People and small businesses who are currently enrolled will not be
  affected by this waiting list and will keep their income-based discounts.
• New employees and eligible dependents of currently enrolled members
  will still be eligible for discounts.
• Laid off workers who are eligible for the HCTC tax credit will still be eligible for discounts off the premium through the HCTC program, and possible discounts off the deductible and out of pocket limits through DirigoChoice, based on household income.
• Self-employed and small businesses who wish to enroll without any discount may do so.
  

How do I apply?
To apply or to get on the waiting list for discounts, you should call the Dirigo Health Agency at 1-877-892-8391.

What are the Dirigo Health reforms?
DirigoChoice is just one part of the Dirigo Health reforms, which are a three pronged approach to addressing access to quality, affordable health care in Maine. For more detailed information, feel free to contact us at 1-800-838-0388, or you can look through our Research and Policy pages. In general, Dirigo Health:

• Expands access to affordable comprehensive coverage
  
  
• Controls health care costs
  
  
• Improves the quality of care