For individuals and families shopping for Affordable Care Act (ACA) plans in Maine, two major names stand out: Maine Community Health Options (CHO) and Harvard Pilgrim Health Care. Both are well-established, nonprofit health insurers with a focus on affordable, high-quality care—but they differ in availability, plan design, provider networks, and digital tools.
In this comparison of Maine Community Health Options vs Harvard Pilgrim, we break down their 2025 health insurance offerings, focusing on ACA Marketplace plans, provider networks, affordability, and member experience, to help you find the best coverage for your needs.
Company Overview
Maine Community Health Options (CHO)
Maine Community Health Options is a Maine-based nonprofit health insurance provider founded in 2011. It is exclusive to Maine residents and was one of the most successful early ACA co-ops. CHO continues to be a leader in the state for individual and family plans, offering coverage on CoverME.gov, Maine’s health insurance marketplace.
Highlights:
- Serves tens of thousands of Mainers
- ACA Marketplace plans available statewide
- Focus on preventive care and community health
- Known for responsive customer support and simple plan designs
Harvard Pilgrim Health Care
Harvard Pilgrim, part of Point32Health (following its merger with Tufts Health Plan), is a nonprofit health insurer based in Massachusetts. It operates in several New England states, including Maine, offering employer plans and individual ACA coverage in select areas.
Highlights:
- Strong presence in New England (ME, NH, MA, CT)
- Offers individual, family, and employer coverage
- Emphasizes care coordination, wellness, and mental health
- Strong technology integration and regional provider relationships
Availability & Plan Types (Maine, 2025)
| Feature | Maine Community Health Options | Harvard Pilgrim Health Care |
| State Availability | Maine only | ME, MA, NH, CT |
| ACA Marketplace Plans | Yes – available statewide on CoverME.gov | Yes – available in select ME counties |
| Employer/Group Plans | Yes | Yes (strong regional network) |
| Medicare Advantage Plans | No | No (offered by Tufts Health Plan, not HPHC) |
Verdict: CHO is better for statewide ACA coverage in Maine, while Harvard Pilgrim is a great option for employer-sponsored or urban coverage.
ACA Marketplace Plan Comparison (2025)
| Category | CHO (CoverME.gov) | Harvard Pilgrim (ACA in ME) |
| Metal Tiers Offered | Bronze, Silver, Gold | Bronze, Silver, Gold |
| Monthly Premiums (after subsidy) | $0 – $450 | $0 – $475 |
| Deductibles | $1,000 – $7,500 | $1,200 – $7,000 |
| Out-of-Pocket Max | $4,800 – $9,450 | $5,000 – $9,100 |
| Virtual Care Access | Yes – 24/7 via Teladoc | Yes – via Doctor on Demand or included app |
| Dental/Vision (Adult) | Optional Add-Ons | Optional Add-Ons |
Verdict: CHO plans are slightly more affordable for many residents, while Harvard Pilgrim offers comparable digital care and slightly lower OOP max in some tiers.
Provider Networks & Access
| Category | Maine Community Health Options | Harvard Pilgrim Health Care |
| Hospital Coverage | Includes MaineHealth, Northern Light | Includes same + access to MA, NH providers |
| Specialist Access | No referral needed for most PPO plans | No referral needed |
| Out-of-Network Coverage | Available (PPO plans only) | Available in PPO plans |
| Primary Care Flexibility | Strong relationships with community doctors | Strong regional network |
Verdict: Both providers offer broad provider access, but Harvard Pilgrim may offer more flexibility if you frequently cross state lines, while CHO excels at local provider coordination.
Digital Tools & Member Services
| Feature | Maine Community Health Options | Harvard Pilgrim Health Care |
| Mobile App | Yes – account access, claims, ID card | Yes – member portal and app |
| Telehealth Options | Yes (Teladoc included) | Yes (virtual behavioral and primary care) |
| Wellness & Rewards | Preventive care incentives | Yes – fitness reimbursements, wellness tools |
| Customer Service | Highly rated, Maine-based team | Strong support via digital and phone |
Verdict: Both insurers offer strong digital tools, but CHO gets high praise for local customer service, while Harvard Pilgrim offers broader wellness integrations.
Pros and Cons
Maine Community Health Options (CHO)
Pros:
- Maine-based nonprofit with local focus
- Strong statewide ACA availability
- Affordable pricing and straightforward plans
- Excellent local customer service
Cons:
- Only available in Maine
- No Medicare Advantage or national portability
Harvard Pilgrim Health Care
Pros:
- Operates in multiple New England states
- Strong network integration for cross-border access
- High-quality digital care and wellness tools
- Good choice for employers and urban professionals
Cons:
- Limited ACA availability outside of urban ME areas
- Slightly higher premiums in some counties
Which Should You Choose?
Choose Maine Community Health Options if:
- You live anywhere in Maine
- You want local, nonprofit-focused care
- You qualify for ACA subsidies and want affordable premiums
- You prefer a Maine-based customer service team
Choose Harvard Pilgrim Health Care if:
- You live near the Maine–New Hampshire–Massachusetts border
- You want cross-state provider access
- You’re seeking robust wellness features and digital tools
- You’re covered through an employer-sponsored plan
In 2025, both Maine Community Health Options and Harvard Pilgrim offer solid health insurance options depending on your location, healthcare needs, and plan preferences. CHO is the best choice for statewide access and affordability in Maine, while Harvard Pilgrim offers competitive ACA and employer plans with regional flexibility.
Before you choose:
- Compare plans on CoverME.gov
- Use plan finders to confirm your doctors and hospitals are in-network
- Check eligibility for premium tax credits and cost-sharing reductions