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.