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DirigoChoice
is the insurance product created as part of the
Dirigo Health Reform law of 2003. DirigoChoice
is administered by DHA
and 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:
Other DHA
Programs that may help:
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DirigoChoice
DirigoChoice
is health insurance provided through DHA to small businesses
with 2-50 employees, self-employed people and eligible
individuals.
Who
can enroll?
You
may be eligible if you are:
- self-employed
- unemployed
- a small business
- employed by a household
- employed by a small business where you do not have
access to health coverage
- working less than 20 hours per week for any one employer
(regardless of size)
- retired from an eligible business and that business
does not contribute to your health insurance coverage
What
does it cover?
DirigoChoice
provides comprehensive health coverage. It covers preventive
care, prescription drugs, maternity care, well-child
care, emergency care, mental health services, childhood
immunizations and more. There is no deductible for preventive
care and prescription drugs, and you don't need a referral
to see a specialist.
For more information on DirigoChoice coverage, visit
this website: http://dirigohealth.maine.gov/Pages/dirigo_choice.html
How much does it cost?
DirigoChoice
gives discounts on plan premiums, deductibles, and out
of pocket maximums based on your income level, household
size and assets. Discount levels range from 10%-80%
off the regular premium rate. Call DHA at 1-877-892-8391
to request a quote.
For
more on the cost of coverage, check out the DirigoChoice
discount estimator worksheet here: http://dirigohealth.maine.gov/Documents/DCDiscountEstimator.pdf
How do I apply?
For
more information or to request an application, call
DHA at 1-877-892-8391 or visit the website: http://dirigohealth.maine.gov/Pages/dirigo_choice.html
The
Pre-Existing Condition Insurance Plan
For
a printable version of this information, click here.
The
Pre-existing Condition Insurance Plan (PCIP) is offered
through the Dirigo Health Agency (DHA) and is made possible
by the Affordable Care Act.
Who
is eligible?
To join the plan, you must be uninsured and have at
least one of the 37 eligible conditions. Examples include
asthma, cancer, depression, diabetes, hypertension,
and many others. You must be uninsured for 6 months
before joining this plan, but if you haven't been uninsured
that long, please call anyway because there still may
be help available through other programs.
How much does it cost?
Help with premiums and other costs is available for
people with lower incomes. For example, if you are a
single person and make less than $32,490 a year, or
you are a family of four that makes less than $66,150
a year, you may be able to get help.
How do I enroll or get more information?
Contact DHA at 1-877-892-8391 to get more information
or to enroll in the plan. Or check out the DHA website
at www.dirigohealth.maine.gov
to find out more.
The
Part-Time Worker Voucher Program
This
program provides financial assistance to help uninsured
part-time and seasonal lower income workers afford
the health coverage plan offered by their employers.
Eligible workers can get assistance toward the cost
of coverage for themselves and their families.
How
does it work?
DHA
will send you an EBT card loaded with your voucher
payment on the first of each month. The EBT card works
like a debit card. The amount of your voucher will
depend on your household size, income and assets.
The health coverage will be offered through your employer,
and your employer will deduct your share of the cost
of your health insurance premium from your paycheck.
To
get an estimate of what your voucher might be, visit
the DHA voucher estimator here: http://dirigohealth.maine.gov/Documents/hrsa_voucher_estimator.pdf
How
much does it cost?
The
cost of your insurance coverage depends on many factors,
but the Part-Time and Seasonal Worker Coverage Voucher
program provides an affordable way for employers to
offer insurance coverage to their part-time and seasonal
employees, and a way to help those employees afford
that insurance coverage.
To
get an estimate of what your voucher might be, visit
the DHA voucher estimator here: http://dirigohealth.maine.gov/Documents/hrsa_voucher_estimator.pdf
Who
can enroll?
Employees
may be eligible if:
- they are a part-time employee, working an average
of 10-35 hours per week
- their employer offers health insurance
- they have had no health coverage for at least 90
days
- they live and work in Maine
To
find out more about eligibility for this program visit
the DHA website here: http://dirigohealth.maine.gov/Documents/voucher_QA_09172010.pdf
How
do I apply?
To
apply for the program or for more information, call
DHA at 1-877-892-8391 or visit the Part-Time and Seasonal
Worker Coverage website here: http://www.dirigohealth.maine.gov/Pages/hrsa_info.html
Online
Health Care Guide