Maine plan offerings

Individual and family plans offered directly through Harvard Pilgrim or on CoverME.gov. Get details on benefits, cost sharing and more in our product guide.

HMO and HMO HSA – 2025

Choose a primary care provider (PCP) from Harvard Pilgrim’s HMO network. They’ll coordinate your care with participating specialists and hospitals.

Plan details:

  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

Maine’s Choice Plus HMO and Maine’s Choice Plus HMO HSA – 2025

Flexible plans that can help you save money with two networks of providers and hospitals.

Plan details:

  • Two networks: Preferred Network (lower cost sharing) and Standard Network (higher cost sharing)
  • PCP required
  • Referrals to most kinds of specialists required
  • Must receive care for covered services from providers in the Maine’s Choice Plus HMO directory (exceptions include medical emergencies)
  • Includes Core ME 5-Tier prescription drug coverage

POS – 2025

Choose to get care with or without referrals and outside of Harvard Pilgrim’s network.

Plan details:

  • PCP required
  • In-network coverage and lower cost sharing when you receive care for covered services from participating providers with your PCP’s referral*
  • Out-of-network coverage and higher cost sharing when you receive care for covered services from:
    • Participating providers without your PCP’s referral
    • Non-participating providers
  • Find participating doctors and hospitals in the POS provider directory
  • Includes Core ME 5-Tier prescription drug coverage

PPO – 2025

Choose to get care from providers inside or outside of our extensive network.

Plan details:

  • PCP encouraged but not required
  • Referrals not required
  • In-network coverage and lower cost sharing when you receive care for covered services from participating providers
  • Out-of-network coverage and higher cost sharing when you receive care for covered services from non-participating providers
  • Find participating doctors and hospitals in the PPO provider directory
  • Includes Core ME 5-Tier prescription drug coverage

Disclosures

*Certain in-network services do not require referrals.