Important Updates About Our Discussions with Anthem in Maine
June 1, 2023
As you may know, Covenant Health, on behalf of St. Mary’s Health System in Lewiston and St. Joseph Healthcare in Bangor, and Anthem Maine are negotiating a new contract to replace our current agreements which expire on Tuesday, July 4, 2023. This impacts patients who use the services and providers affiliated with either St. Mary’s Health System or St. Joseph Healthcare. We are working diligently to successfully conclude these discussions because your healthcare is so important to us. We also know that you have questions about what this will mean for you.
What you need to know now:
- We are committed to protecting your choice and access to care. We are vigorously negotiating with Anthem in good faith for reasonable terms that will protect and preserve our ability to serve you and your ability to access the care you need and want.
- We are committed to requiring Anthem to provide fair pay for the hard work our clinicians do and the investments we make in people, technology, and facilities. We are a low-cost, high-quality provider in Maine and are asking that Anthem pay us consistent with market rates paid to other facilities and providers for the same services.
- Nothing changes today. Please keep all appointments and procedures you have scheduled. Do not delay routine health screenings, procedures, or tests important to your health.
- If you have care scheduled for after July 4th, please call Anthem to clarify the coverage provided.
What happens if Anthem does not agree to these terms?
- If an agreement is not reached, the agreements for St. Mary’s Health System and St. Joseph Healthcare will terminate as of July 4, 2023.
- This will have no impact on emergency care. Emergency care is always considered to be in-network with all insurance companies.
- Anthem members with out-of-network benefits may still choose to use the services and providers affiliated with St. Mary’s Health System and St. Joseph Healthcare. Please refer to your out-of-network benefits for information regarding your expected deductibles and co-pays.
What you can do to make your voice heard
- Contact your company’s Human Resource or Benefits Administration department and share your concern regarding a potential change in Anthem’s provider network in the State of Maine. We estimate that over 14,000 patients in the State of Maine could be impacted.
- Let Anthem hear from you to let them know that it is important that your provider and hospital remain in-network. They can be reached by calling:
Anthem of Maine
1-800-331-1476
If you have specific questions about your personal health care including coverage for elective procedures as well as continuity of care for pregnancy, oncology, and other conditions, please contact Anthem directly using the contact information on the back of your membership card. Healthcare laws and regulations do require insurance companies to cover certain kinds of continuing care regardless of network status.
We will keep you informed throughout the process. We are committed to providing you with timely and accurate information on this situation. Updates can be found by visiting our websites:
Lewiston: www.stmarysmaine.com/anthem
Bangor: www.stjosephbangor.org/anthem