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Benefits

Ensuring the highest level of benefits at competitive prices is the key goal of the MEA Benefits Trust. The Standard, Choice Plus, Standard 500 and Standard 1000 Plans all include coverage for: Routine Preventive Care, Screenings and Immunizations, Well-Child Care, Inpatient and Outpatient Care, and Emergency Care.

Your deductible and out-of-pocket limits both are based on a calendar year (Jan.-Dec.).

 

 

Starting July 1, 2016

4-Tier Prescription Drug Benefit; 

Tier I includes all generic drugs (except in rare situations) and some preferred medications. The copay when you fill one of these prescriptions is $10 for a 30-day supply.

Tier II includes preferred medications with a $35 copay when you fill one of theses prescriptions for a 30-day supply.

Tier III includes nonpreferred medications which have a $60 copay for a 30-day supply. 

Tier IV(Specialty Medications) $85 copay. These drugs have the highest cost share. They may cost more than others used to treat the same condition. Tier IV may also include drugs that were recently approved by the FDA. Specialty drugs are used to treat complex, chronic conditions and may need special handling.

Your doctor will always determine the best drug for you. Most doctors will also work with you to find a drug that will treat your condition at the lowest cost. PLEASE NOTE: Only  "90-day supply for a 60-day copay" benefit does not apply to Tier IV. Almost all of the pharmacies in Maine are now participating in the "mail match" program, meaning that you can get a 90-day prescription for a 60-day copay, at your local pharmacy in addition to ordering through the mail. To find out which tier your prescription falls under, visit Anthem's Drug Formulary.

 

To download or view benefit documents, click here Resources.