Health Insurance Plan Information

The State Employee Health Plan recently updated the preferred hospital list based upon the Maine Health Management Coalition hospital ratings. Hospitals that are awarded blue ribbons for Patient Safety and the four Select Clinical quality categories (heart attack, heart failure, pneumonia and surgical infections) are considered preferred hospitals for the State employee health plan. A new measurement has been introduced to the Maine Health Management Coalition ratings. Mortality and readmissions information is now available. Several Maine hospitals scored better than the national benchmarks in either mortality or readmissions. It is a significant achievement to perform better than the national benchmark. In an effort to recognize those Maine hospitals the State Employee Health Commission is awarding extra credit as a preferred hospital.

The e-mail serves to announce the preferred hospital list effective August 1, 2009:

The Aroostook Medical Center (Presque Isle)
Blue Hill Memorial Hospital
Cary Medical Center (Caribou)
Central Maine Medical Center (Lewiston)
Down East Medical Center (Machias)
Eastern Maine Medical Center (Bangor)
Franklin Memorial Hospital (Farmington)
H.D. Goodall Hospital (Sanford)
Houlton Regional Hospital
Inland Hospital (Waterville)
Maine Coast Memorial Hospital (Ellsworth)
Maine Medical Center (Portland)
MaineGeneral Medical Center (Augusta/Waterville)
Mayo Regional Hospital (Dover-Foxcroft)
Mercy Hospital (Portland)
Mid Coast Hospital (Brunswick)
Miles Memorial Hospital (Damariscotta)
Millinocket Regional Hospital
Mount Desert Island Hospital (Bar Harbor)
Northern Maine Medical Center (Fort Kent)
Parkview Adventist Medical Center (Brunswick)
Penobscot Bay Medical Center (Rockport)
Redington-Fairview General Hospital (Skowhegan)
Sebasticook Valley Hospital (Pittsfield)
Southern Maine Medical Center (Biddeford)
St. Joseph Hospital (Bangor)
St. Mary's Regional Medical Center (Lewiston)
Stephens Memorial Hospital (Norway)
Waldo County General Hospital ( Belfast)

Note: The most recent hospital performance results may not be posted on the Maine Health Management Coalition website ( http://www.mhmc.info ) until the week of August 10th .

Members will continue to be able to receive care from all Maine hospitals. Under the State employee health plan, inpatient admissions require $100 per day co-pay ($300 calendar year maximum) and outpatient surgery requires a $50 co-pay. Both the inpatient co-pay and outpatient co-pay are waived if the services are provided at a preferred hospital.

The preferred hospital list will be updated again effective February 1, 2010.

Reminder: Colonoscopies and mammograms are fully covered regardless of which hospital you may go to. There is no deductible or copayment for these screening services. These are valuable tests that can detect potential problems early when treatment is more effective. We urge you to follow your doctor's recommendations and have these routine tests when scheduled.