Health Plan Benefit Changes Effective January 1, 2024
The following changes will be effective for the Health Trust POS and PPO health plans, effective January 1, 2024.
Behavioral Health Services via Telehealth – In order to address access and other barriers to receiving behavioral health services during the pandemic, the Board of Trustees has waived the copayment for members who receive in network mental health or substance use disorder services via telehealth since 2021. The Board recognizes that the need for these services remains strong. While visits to primary care and specialty physicians have returned to more normal “in-person” utilization patterns, utilization of telehealth for behavioral health services continues to increase.
In order to facilitate continued utilization of these services, the Board of Trustees has eliminated the copayment for members who receive in-network mental health or substance use disorder services via telehealth. These services will be paid at 100% for all of the Trust health plans.
Fertility Benefits – Effective January 1, 2024, all Trust health plans will include coverage for medically necessary fertility services, as mandated by the State of Maine. Medically Necessary Covered Services will include procedures to determine an individual’s fertility and services such as artificial insemination (three lifetime cycle limit), egg retrieval and cryopreservation, and in vitro fertilization (two lifetime cycle limit). Please contact the Health Trust for additional benefit details.
Coverage for Recreational Prosthetics – Effective January 1, 2024, in accordance with state mandates, all Health Trust health plans will provide coverage for one prosthetic device that meets the medical needs of a participant under age 18 for recreational purposes.
Coverage for Certain Dental Procedures for a member who has been diagnosed with cancer – Effective January 1, 2024, in accordance with a new Maine law, certain medically necessary dental procedures for a member who has been diagnosed with cancer will be covered under all Health Trust health plans. Routine preventive dental care is not covered.