Bowdoin College PPO Health Plan Preferred In-Network Providers
Why does the College offer a “Preferred In-Network” benefit for the Bowdoin College PPO Health Plan?
The Preferred In-Network benefit helps both you and the College get the best value out of the money spent on health care. Rising healthcare costs are a challenge for everyone, and this is one way to receive high quality care at a lower cost.
What does it mean to use a “Preferred In-Network” provider?
If you choose to receive covered services from a Preferred In-Network provider, you will have:
- Lower deductible
- Lower out-of-pocket costs
Who are the Preferred In-Network providers (effective 1/1/2017)?
- Lincoln County Healthcare (Damariscotta)
- Maine Coast Memorial Hospital (Ellsworth)
- Maine Heart Center (Portland)
- Maine Medical Center (Portland)
- MaineGeneral Health (Augusta/Waterville)
- Memorial Hospital (North Conway, NH)
- Mid Coast Hospital (Brunswick)
- New England Rehabilitation Hospital (Portland)
- OA Centers for Orthopaedics (Brunswick/Portland/Windham/Saco)
- Pen Bay Medical Center (Rockport)
- Southern Maine Health Care (Biddeford)
- Spring Harbor Hospital (Westbrook)
- St. Mary's Regional Hospital (Lewiston)
- Stephens Memorial Hospital (Norway)
- Waldo County General Hospital (Belfast)
- York Hospital (York)
What are the savings and how are the savings applied to the plan?
For services billed directly by one of the preferred in-network facilities listed above that are normally subject to the deductible and the coinsurance, the deductible is reduced to $500 per individual/$1,000 per family (regular in-network deductible is $750/$1,500). Services are then covered at 90% and the out-of-pocket calendar year maximum is reduced to $3,000 per individual/$6,000 per family (regular in-network $4,000/$8,000). For OA Centers for Orthopaedics, in addition to savings on charges subject to the deductible and coinsurance, the copayment for office visits and physical therapy visits is reduced to $20 versus the regular in-network copayment of $50 per visit for a specialist office visit. The negotiated savings to the plan by using one of these providers is applied to lower your deductible and reduce your out-of pocket maximum that would otherwise be charged for services at these providers.