Affordable Health Insurance in Maine

Hassle Free Health Plan Shopping For Maine Citizens

Best Maine Health Insurance Plans

If you’re a resident of Maine state in the US and looking to buy an affordable health insurance plan, this brief reckoner is for you. Though, the state uses federally run exchange HealthCare.gov for offering health care services, authorities are mulling to switch to its own exchange very soon.

The state starts open enrollment for 2020 coverage from November 1 to December 15, 2019. If you fail to enroll during the period, there is no other way out for the enrollment. However, enrollments outside the window are considered for the people who are going through the qualifying events.

In the state, Short-term health plans are available with initial plan terms up to 12 months. Mine joined Medicaid expansion program in 2019 and since them a considerable drop has been witnessed in uninsured rates. The rate was dropped from 11.2 percent in 2013 to 8 percent in 2018.

Top Health Insurance plan in Maine

  • Anthem Blue Cross and Blue Shield

    Anthem Catastrophic X HMO 8150

    premium $189.83/mo

    Deductible $8150/yr

    Coinsurance3%
    Insurance Type HMO
    HSA Eligible No
  • Harvard Pilgrim Health Care

    HMO Catastrophic

    premium $192.81/mo

    Deductible $8150/yr

    Coinsurance3%
    Insurance Type HMO
    HSA Eligible No
  • Community Health Options

    Community Safe Harbor PPO

    premium $195.68/mo

    Deductible $8150/yr

    Coinsurance0%
    Insurance Type PPO
    HSA Eligible No
  • Anthem Blue Cross and Blue Shield

    Anthem Bronze X HMO 6350

    premium $280.8/mo

    Deductible $6350/yr

    Coinsurance5.5%
    Insurance Type HMO
    HSA Eligible No
  • Anthem Blue Cross and Blue Shield

    Anthem Bronze X HMO 6250 for HSA

    premium $285.92/mo

    Deductible $6250/yr

    Coinsurance6%
    Insurance Type HMO
    HSA Eligible Yes

Maine’s health insurance marketplace:

In Maine, health insurance plans are available via federally run health insurance exchange. This is why residents in Maine have to enroll via HealthCare.gov. However, Maine is now exploring opportunity to become a state-run exchange very soon.

The state opens the enrollment for health plans from November 1 to December 15, 2019 via HealthCare.gov and the state’s insurance companies. People missed the enrollment window may still have the chance if they present a qualifying event to validate their eligibility for the enrollment. As of now, three insurers are offerings health insurance plans in the state:

  • Community Health Options
  • Harvard Pilgrim HMOs
  • Anthem

Medicaid expansion in Maine:

Maine rejected the federal funding for Medicaid expansion in very beginning. But later on authorities changed the stance. In 2018, Maine’s Attorney General had promised resume Medicaid expansion and signed an executive order to expand coverage on her first day in office. By September 2019, 38000 Maine citizens had participated in Maine’s Medicaid program.

Status of Medicare in Maine:

In Maine, the number of people opted for Medicare reached 338,387 by July 2019. The amount is more than 25 percent of the total population of the state. Number wise, Maine enjoys the highest average age in the country for Medicare enrollment. Therefore, it’s evident that a larger percentage of the state’s population is Medicare covered.

Medicare users in Maine can buy a Medicare Advantage plan instead of Original Medicare for some additional benefits beyond traditional healthcare advantages.

Maine Individual and Family Insurance Plans

In Maine, several health insurance carriers are providing their plans for individuals and families. Here you can compare Maine individual and family health plans from several health insurance carriers ay one place and buy the best suited for your health care needs.

You can buy these individual and family plans if you are self-employed or not availing a group plan from your current employer. In case you’re enrolled for a plan but plan does not offer coverage to spouses or dependents, you may go for the plan.

Short term Health Insurance Plans

In Maine, short-term health insurance plans are underwritten by Golden Rule Insurance Company. These plans are designed to offer insurance seekers flexible health insurance coverage when you need it the most.

Short term health insurance plans are ideal for a health care coverage for a limited period of time. If you’re dwindling between jobs or waiting for group coverage to begin, you can check these affordable healthcare solutions.

Short term health insurance is a great choice if you missed the Affordable Care Act enrollment and don’t qualify for Special Enrollment. You may also apply for the plans if you’re waiting for ACA coverage to start or waiting your group benefits to start.

Dental Insurance Plans:

Mine Dental insurance plans are designed to offer insurance seekers coverage against common dental care issues and help them with budget for dental services at all levels. The coverage allows monetary support for preventive, basic and major dental care services. In Maine, dental insurance plans are offered by Golden Rule Insurance Company. These plans are best suited for all your dental insurance needs.

The coverage is available for preventive care like routine cleanings and fluoride treatments. Plans are available with NO deductible or waiting period at all. Other coverage that dental plans Maine offer includes basic services like fillings or emergency treatment for dental pain. Major services like retainers and root canals are also covered but subject to the plan’s deductible and waiting periods

Insurance careers in the state take care of the claims and pay in-network dentists directly. This reduces chances of manual claim submission of any kind.

Vision Insurance Plans:

Like dental insurance in Maine, vision insurance brings coverage and budget for ongoing vision care expense. This includes routine eye exams, prescription glasses and contact lenses. In the state, vision insurance plans are underwritten by Golden Rule Insurance Company. These plans offer coverage for people without any age limitation or waiting periods. Carriers offer coverage benefits through a national network of vision service and eyewear providers.

Hospital and doctor indemnity insurance:

Hospital and doctor fixed indemnity insurance is designed to offer a fixed amount of money for specific services covered by the plan. The plan provides payments toward other health plan’s deductible. In some cases, the plan also offers cash benefits to patients meet prescription drug copays. The plan is underwritten by Golden Rule Insurance Company and is a fixed-benefit insurance plan with a preset benefit amount.

FAQ on Maine Health Insurance

The Affordable Care Act requires residents of Maine to have minimum essential coverage so that they are financially protected in case of a sudden medical emergency. However, the federal tax penalty for not having health insurance has been zeroed out. This means that residents of the state won’t have to pay a penalty if they are not covered, but they will still have to report their coverage status on their federal tax return. Maine is not of the few states that have passed their own health insurance requirements where residents are required to have minimum essential coverage or face a federal tax penalty.

The Open enrollment period for 2021 medical coverage in Maine will run from the period November 1, 2020, to December 15, 2020, and the plan will become effective from January 1, 2021. Residents are required to enroll in the plan of their choice during this open enrollment period, as they will not be allowed to enroll in any plan outside this open enrollment period. Outside the open enrollment period, only residents with qualifying events are allowed to enroll in a health plan or make changes in their health plans.

Yes, short-term health plans are available in Maine, but the state has tightened its short-term health plan regulations in January 2020, as per the new law that was enacted in 2019. Due to the state’s strict regulations, there were no insurers selling short-term health plans in Maine. Short-term health plans in the state are no longer allowed to extend beyond December 31 of the year in which the plan is issued, so the maximum duration, which was earlier of 12 months, will now vary depending on the date on which a plan is purchased. The new law has also imposed additional restrictions like banning the sale of short-term health plans during the open enrollment period for ACA-compliant plans if they are scheduled to become effective in the new year.   

Maine residents can find the best and cheap health insurance option either on the state exchange or through Medicaid if they qualify for it based on their income. After researching all health insurance plans available on the state marketplace, it was discovered that either Anthem Silver X HMO 5800, or Anthem Silver X POS 5800, or Maine Choice HMO Silver 6200 was the cheapest health plan available in the state. Though, the cheapest health plan for an individual may depend on their age and choice of plan’s metal tier.

Though the cost of the health insurance plan for every individual is significantly driven by their age, locations, and the metal tier of coverage they choose. After comparing all health insurance plans available in Maine, the cheapest health plan in each metal tier is as follows:

  • The cheapest Catastrophic health plan in Maine for a 40-year old is Anthem Catastrophic X HMO 8150 having a monthly premium of $232.
  • The cheapest Bronze health plan in Maine for a 40-year old is Community Secure HMO having a monthly premium of $378.
  • The cheapest Expanded Bronze health plan in Maine for a 40-year old is Anthem Bronze X HMO 6350 having a monthly premium of $342.
  • The cheapest Silver health plan in Maine for a 40-year old is Maines Choice HMO Silver 6200 has a monthly premium of $450.
  • The cheapest Gold health plan in Maine for a 40-year old is Anthem Gold X HMO 1600 having a monthly premium of $500.
  • Currently, Maine is having three health insurance carriers offering health plans in the marketplace:

  • Community Health Options
  • Harvard Pilgrim HMOs
  • Anthem
  • Find a Right Affordable Plan For You

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