Maine Medical Center to drop Anthem customers from in-network coverage in 2023 – Bangor Daily News
Mainers with health insurance through Anthem Blue Cross and Blue Shield will no longer be able to receive in-network coverage at Maine Medical Center in Portland beginning in 2023, MaineHealth announced Wednesday.
The change will take effect on Jan. 1, 2023. MaineHealth’s other facilities will continue to accept Anthem.
MaineHealth officials said providing coverage through Anthem had become untenable, especially because the health insurance company owes MaineHealth more than $70 million.
“We need partners who will help us get there and achieve the vision. We are not sure we will be able to get there and achieve that vision with what Anthem has done,” Andrew Mueller, CEO of MaineHealth, said Wednesday.
Anthem is among the most widely used health insurance companies in Maine. The lifting of in-network coverage by Maine’s largest hospital will affect the coverage of many Mainers including state employees, who are insured through Anthem.
As of 2019, Anthem was listed as the largest insurer in Maine with 131,237 insured — a 69 percent market share, according to data from the Kaiser Family Foundation.
Mainers with Anthem can continue to receive treatment at Maine Medical Center. However, that care will be considered out-of-network and thus may be more costly.
Emergency care at Maine Medical will still be considered in-network for Anthem customers.
Out-of-network care generally requires higher out-of-pocket costs than in-network coverage. Many Americans avoid receiving health coverage out of their network to avoid unnecessary expenses.
Nurse Cassandra Pateneaude treats a patient in the hallway of the Maine Medical Center emergency department on Dec. 8, 2021.
This is not the first time Anthem has faced backlash from hospitals due to its practices. Last week, the state of Georgia fined the company $5 million after officials said Anthem misled patients about what hospitals and providers were available through its network. Georgia’s insurance commissioner said he had been inundated by complaints from hospitals and doctors about Anthem since his “first day in office” in 2019.
The company owes hospitals and doctors across the U.S. billions of dollars, according to officials in several states.
