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August 20, 2019

Anthem, MaineHealth team to offer Medicare plans

Courtesy / Maine Medical Center Anthem Blue Cross and Blue Shield is forming a joint venture with MaineHealth, whose flagship hospital, Maine Medical Center in Portland, is shown here.

Maine’s largest health insurer and largest health care system are forming a joint venture to provide health coverage for seniors in 2020.

Anthem Inc. (NYSE: ANTM), a national insurer that does business as Anthem Blue Cross and Blue Shield in Maine, and MaineHealth, which operates eight hospitals in the state, plan to offer Medicare Advantage health plans during an enrollment period this fall, according to a news release Monday.

The plans will be marketed under the Anthem | MaineHealth brand and managed by the joint venture, AMH Health LLC.

Medicare is the federal health benefit program for people over age 65 or who are disabled, and Medicare Advantage is a spin-off in which private health plans contract to provide the benefits and often additional services with reduced out-of-pocket costs.

Since being introduced in 2005, Medicare Advantage plans nationwide have quadrupled in enrollment, covering 22 million beneficiaries in 2019, or 34% of Medicare members, according to the federal Centers for Medicare & Medicaid Services.

Anthem is one of the country’s largest Medicare Advantage insurers, and has long written the plans in Maine. But the company has never teamed with a Maine health care provider to do that.

The only other provider-sponsored Medicare Advantage plans in Maine are the Generations Advantage plans written by Portland-based Martin’s Point Health Care, which also operates a half dozen primary care centers in the state. Those plans have an enrollment of 45,000, and Martin's Point claims they are the state’s most popular Medicare Advantage offerings.

Mainebiz reached out repeatedly to Martin’s Point for comment on the potential new competition, but calls and emails were not returned.

In the release, Tomas Orozco, president of Anthem’s Medicare East Region, said, “This joint venture aims to make it easier for Maine seniors to receive high-quality, affordable health care in their communities through a broad network of care providers offering a wide range of services.”

MaineHealth CEO Bill Caron added: “This venture creates a provider-sponsored health plan focused on quality care, patient experience, and access to care that will drive unprecedented value for Maine beneficiaries. It will be structured to promote longer-term, more beneficial patient/provider relationships. The potential for healthier patients, and thus healthier communities, is great.”

The annual enrollment period for Medicare runs from Oct. 15 to Dec. 7.

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