Waterville, Maine (207) 859-3165
Health

Aurora Healthcare, a Healthcare Facility that Cares

Our team at Aurora Healthcare treat each patient as if they are our only patient, giving them options for their upcoming health appointment; in-office visits, telehealth calls, virtual visits, or home visits for homebound patients. Never rushed, always caring and professional. We are currently accepting new patients and look forward to serving your healthcare needs.

Services Offered at Aurora Healthcare

In-House Lab

In-House Lab


  • Blood Draws
  • Urine Tests
  • Rapid Strep Testing
  • Hemoglobin A1C
Pediatrics

Pediatrics


  • Sports Physicals
  • Well Child Visits
  • Acute Visits
  • Immunizations
  • Lactation Consultation
  • Breast Feeding Support
Wellness Visits

Wellness Visits


  • Medicare Wellness
  • Adult Male Exams
  • Female Gynecological Exams
  • Breast Exams
Chronic Disease Management

Chronic Disease Management


  • Hypertension
  • Diabetes
  • COPD
  • Asthma
  • And So Much More
Injections

Injections


  • Vaccinations
  • Trigger Points
  • Knee Joints
  • Shoulder Joints
  • Hip Joints
  • Elbow Joints
Acute Care

Acute Care


  • Splinting
  • Suturing
  • Acute Illness
Other Services

Other Services


  • Allergy Shots
  • Botox for Migraines
  • IV Hydration Therapy
  • Holistic Options

Payments Accepted at Aurora Healthcare

We accept various payment options including cash, check, credit card and care credit, as well as the in-network and out-of-network insurances listed below.

In-Network Insurances

In-Network
Insurances


  • AARP
  • Aetna
  • Anthem
  • Blue Cross Blue Shield
  • Cigna
  • Community Health Options
  • Harvard Pilgrim
  • Health Plan Inc.
  • Humana
  • Medicare
  • MaineCare
  • Multi-Plan
  • Patient Advocates
  • Railroad Medicare
  • United Healthcare
  • WellCare
  • Worker's Comp
Out-Of-Network Insurances

Out-Of-Network
Insurances


  • Martin's Point
  • Tricare East

Understanding Your Health Insurance and Cost Sharing

Your health insurance company will not pay all your covered healthcare expenses. You’re responsible for paying part of your healthcare bills even when you have health insurance. This is known as cost sharing because you share the cost of your health care with your health insurance company.

To clarify one point of potential confusion, “covered” does not necessarily mean that the health plan will pay for the service in its entirety. It means that the service is considered medically necessary and is something that your health plan will pay for if you have met your cost sharing obligations, which include deductibles, copayments, and coinsurance.

The three basic types of cost-sharing are deductibles, copayments, and coinsurance. Some health plans use all three techniques, while others may only use one or two. If you don’t understand your health plan’s cost sharing requirements, you can’t know how much you’ll have to pay for any provided healthcare services.

Deductible is what you are required to pay each year before your health insurance coverage begins to fully pay its share. For example, if you have a $1,000 deductible, you must pay the first $1,000 of your healthcare bills (for services that count toward the deductible, as opposed to being covered by a copay) before your health insurance starts paying. Once you’ve paid $1,000 toward your healthcare expenses, you’ve “met the deductible” that year and you won’t have to pay any more deductible until next year (note that if you have Original Medicare, your Part A deductible is per benefit period rather than per year).

Copayments are a fixed amount—usually much smaller than your deductible—that you pay each time you get a particular type of healthcare service. For example, you might have a $40 copayment to see a healthcare provider. This means each time you see the healthcare provider, you pay $40 whether the healthcare provider’s bill is $60 or $600. Your insurance company pays the rest.

Coinsurance is a percentage of the bill you pay each time you get a particular type of healthcare service (it's not the same thing as a copayment; a copayment is a fixed amount, coinsurance is a percentage of the cost). Coinsurance applies after you've met your deductible but before you've met your out-of-pocket maximum.

Out-Of-Pocket Maximum is the point at which you can stop taking money out of your own pocket to pay for deductibles, copayments, and coinsurance. Once you’ve paid enough toward deductibles, copays, and coinsurance to equal your health plan’s out-of-pocket maximum, your health insurer will begin to pay 100% of your covered healthcare expenses for the rest of the year. Like the deductible, the money you have paid toward the out-of-pocket maximum resets at the beginning of each year or when you switch to a new health plan.

No Surprises Act

What is the No Surprises Act?

The No Surprises Act is a federal law that took effect January 1, 2022 to protect people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities

Surprise balance billing happens when an out-of-network medical provider sends a patient a bill for their services, beyond whatever amount (if any) the patient’s health insurance paid. Surprise balance billing refers to two types of situations in which the patient has little to no control over whether they’re treated by an out-of-network provider:

Emergencies. The general rule is to go to the closest emergency room. This may or may not be in-network, and it may or may not have out-of-network providers caring for patients. But the patient is not in a position to determine whether the care they’re receiving is in-network. Under the No Surprises Act, the consumer protections also extend to hospitalization immediately following emergency room care, until the patient can safely be transferred to an in-network facility.

Non-emergency situations in which the patient goes to an in-network hospital but is unknowingly treated by an out-of-network provider. For example, you might choose an in-network hospital for your planned surgery, but not realize that the radiologist or anesthesiologist or assistant surgeon isn’t in your insurance network. In some cases, you might never interact with this provider at all.

In those scenarios, it was quite common for patients to receive an unexpected (surprise) balance bill for the care that they unknowingly received from a medical provider who wasn’t in their insurance plan’s network.

Can patients still receive balance bills under the No Surprises Act?

Yes, depending on the circumstances. The No Surprises Act doesn’t apply to situations in which a patient chooses to use an out-of-network provider (as opposed to situations in which the patient had no choice or was unknowingly treated by an out-of-network provider at an in-network facility). So, if a person goes to an out-of-network facility or doctor in a non-emergency situation, balance billing can still be expected, and a health plan’s normal rules for out-of-network coverage would be used.

And in limited non-emergency situations, out-of-network medical providers can ask patients to waive their rights under the No Surprises Act. In that case, if the patient signs a form indicating that they agree to the out-of-network charges, they can still receive a balance bill. And the out-of-network medical provider can refuse to provide treatment if patients don’t waive their balance billing protections.

For more information about your rights under federal law, visit the Maine Bureau of Insurance website at https://legislature.maine.gov/statutes/22/title22ch401sec0.html.