Covenant Health, which operates St. Joseph’s hospital in Bangor and St. Mary’s hospital in Lewiston, has been negotiating a new contact with Anthem. Covenant has recently stated that unless an agreement can be reached, they will remove their physicians, providers, and other facilities in Maine from the Anthem provider network, effective July 5, 2023.
The Health Trust is concerned about the potential lack of access to these established providers and hospitals, and we understand that members may be anxious about disruption with their current providers. However, we also recognize that there is a balance to be maintained in order to control the costs of healthcare. Covenant has asked for very large increases in the amounts they are paid for services provided.
Anthem has created a website to share information about this matter at https://www.anthem.com/covenantmaine/.
We are hopeful that an agreement will be reached prior to July, and that all Covenant providers will remain in the Anthem network. However, state law requires that 60 days notice be provided to members if their doctor leaves the network. Anthem has sent out letters to all members who utilized a Covenant Health provider within the past 12 months.
Under the Continuity of Care provisions, you may also be able to continue treatment with your current doctor(s) for a limited time past July 4th, if you are receiving certain types of care.
Under federal law, this includes care if you are:
- In treatment for a serious and complex condition. This can be a sudden (acute) illness that requires specialized treatment in order to avoid death or permanent harm. It can also be an ongoing (chronic) illness that is life threatening or potentially disabling and requires specialized care over a long period of time.
- In a hospital or other inpatient facility.
- Scheduled for nonelective surgery by your current doctor, including your post-operative care for the surgery.
- Terminally ill.
Please contact MMEHT Member Services so that we can assist you with the Continuity of Care process, or with finding a new in-network provider if you so choose. Member Service Representatives are available Monday through Friday from 8:00 a.m. – 4:30 p.m. at 1-800-852-8300.