Working With Your Health Insurance
Private Insurance Carriers
Acadia Hospital bills all health insurance plans for inpatient and outpatient services if we are provided with proof of insurance (i.e. your insurance card) at the time of service.
Many insurance plans require prior approval, or pre-authorization, for services by patients and/or their Primary Care Providers (PCPs) before services can be covered.
While our staff is not able to answer questions regarding specific plan details, we encourage you to contact your insurance company before your visit to Acadia Hospital. It is also helpful to review your health-plan booklet to clarify your specific policy benefits and requirements. You may also find this information listed on your insurance company’s website. To find out if your insurance carrier participates with Acadia Hospital, please contact them through the number listed on your insurance card.
MaineCare may require prior approval, or pre-authorization, for services by patients and/or their Primary Care Providers (PCP's) before services can be covered. If you have MaineCare Managed Care, you need to contact your PCP for pre-authorization.
Your MaineCare benefit may have a "spend down," or "co-pay".
A spend down is a semi-annual expense that you must pay before your MaineCare benefits can begin. This amount can vary depending on income, assets, or where the service is delivered (i.e. your doctor’s office vs. a large hospital).
A co-pay is a set amount paid each visit based on the service or a dollar amount
There are two parts to Medicare coverage: the Facility portion (Part A) and the Physician portion (Part B). Each account may contain several claims, which the government requires us to bill separately to different claims processing centers of Medicare. As a result, you may receive statements where the balance due changes as different parts of the account are paid. In addition to statements from Acadia Hospital, you may receive two Medicare Summary Notices (MSNs), which will show total charges—what Medicare covered and what is still owed by you. The MSNs are not bills and you do not need to pay anything when you receive them.
If you have additional insurance coverage that pays after Medicare, we will bill each deductible and co-insurance amount to your insurance as Medicare pays us. If your supplemental insurance pays all deductibles and co-insurance amounts in full, you may not receive a statement from us at all.
If you do not have additional insurance coverage beyond Medicare, you will receive statements for deductibles, co-insurance and non-covered charges. You may also receive statements from other providers or specialists, who don't bill through Acadia Hospital.
If you have questions or need to make special payment arrangements please contact one of Acadia Hospital’s customer service representatives at (207) 973-5000 or toll-free at (877) 366-3662 ext. 5000.