FOR MEMBERS

Responsive, caring service with the benefits you expect
and deserve.

PioneerASO… it feels different, because it is.

With PioneerASO powered by Community Health Options, we take wellness and Member service very seriously. It’s an innovative approach that prioritizes people over profits and helps you and your employer take control of rising healthcare costs. You’ll feel the difference right away. The local Member Services and Care Management teams redefine the meaning of responsive and caring service. When you need us most, you’ll find a team that bends over backwards to help navigate complex situations and get the answers you need.

For members!
For Members

You can count on us.

Easy-to-use Member portal

  • Get 24/7 account access. Check your claim status, download forms and documents, learn more about your health plan’s benefits and services—at your convenience. Check it out.

Claims processing: Fast. Accurate. Fair.

  • You’ll find PioneerASO claims administration to be fast, accurate, and fair. Most claims are processed in a week.

Extensive provider network within Maine and beyond

  • PioneerASO Members enjoy access to a robust provider network of 48,000 providers—which includes:
    • 100% of hospitals in Maine and most in New Hampshire
    • Many premier institutions in New England
    • First Health® network outside of New England
  • Use the provider look-up tool in your Member portal. It’s easy.

Help managing your medications

  • Our in-house pharmacists work closely with our pharmacy benefits management team on prescription formulary design.
  • We offer our Members an easy-to-use prescription drug portal through Express Scripts that includes:
    • look-up tool to find covered medications;
    • suggestions for lower cost alternatives;
    • option to set up mail order

Responsive caring service — promises delivered

  • Maybe it’s our Maine roots. But when we make a promise to you, we deliver. Simple. We measure this constantly. In follow-up call surveys, our Member score us: 
    • 99% for courtesy and respect
    • 98% for getting the information needed
    • 98% for speed of answer

We don't issue homework

  • If a matter requires follow up or more information is needed from a provider, pharmacy, or Community Health Options department, we will help. Our team will advocate for you to get the information needed and to ensure you are connected to the right people.

Integrated physical and emotional health services

  • We believe that good health encompasses both physical and emotional health, and for some, the management of substance use disorders as well. In addition to in-person visits, PioneerASO Members have access to behavioral health telemedicine which provides online access to specialized behavioral health providers and services anywhere, anytime.

Protecting and promoting your health

  • Many healthcare preventive services cost you nothing. These may include screenings, checkups, counseling, flu shots, mammograms and more. For more information, check out the details for preventive care in your Member portal.

Get the most from your benefits.

Log in to the Member portal to learn more about your benefits, preventive care and wellness programs. Our knowledgeable Member Services team is available Monday through Friday, 8 a.m. to 6 p.m., if you have questions.

Log in now

or call Member Services at (855) 624-6463