Maine Health Insurance

Health Insurance Overview

Maine residents have many options for health care coverage. There are numerous Maine insurance providers to choose from, along with a variety of Maine medical insurance plans designed to meet the specific needs of individuals, families and groups.

Whether you need independent self-employed health coverage, or your employer simply doesn’t offer group Maine health insurance benefits. Whether you are looking to cover your spouse and children under the same low rate, or you are a small business that wants to provide your employees with affordable coverage. Whatever your situation, we are your one stop resource for all your health care needs – including reliable Maine medical insurance from the best Maine insurance providers around.

Each state is unique in its laws and regulations, as well as the types of coverage it offers. Here you will find an array of resources and useful information to help you better understand Maine health insurance and the range of options available to you. This includes current facts and statistics about residents, important state legislation, financial assistance and public Maine health insurance programs, and even details on some of the top Maine insurance providers.

To compare specific Maine medical insurance plans offered by the various Maine insurance providers, and get a personalized quote for the options that are right for you, contact us now for free. We’ll connect you with a highly qualified insurance agent near you who will be happy to help you with all of your Maine health insurance needs.

At Healthcare Solutions Team, we’re committed to making affordable health care accessible to everyone. Our group of elite Maine health insurance advisors is dedicated to helping match the right coverage to fit the unique needs of all families, individuals and groups. Not a resident of Maine? Find your state here.

Maine Health Insurance Facts & Statistics

Total Maine Residents – 1,288,300

Total Health Insurance Coverage In Maine:
Employer – 47%
Individual – 4%
Medicaid – 22%
Medicare – 14%
Other Public – 2%
Uninsured – 10%

Average Individual Monthly Premiums – $282

Average Annual Single Employee Contribution for Employer-Based Health Insurance Plan – 22%

Average Annual Single Employee Premium for Employer-Based Health Insurance Plan – $1,207

Average adjusted hospital cost per inpatient day – $1,881

Source data according to the Kaiser Family Foundation (http://www.kff.org/) (2009-2012 data) and http://www.statehealthfacts.org/

Maine Medical Insurance Laws, Regulations & Policies

There are several Maine health insurance laws and regulations that are put in place to protect policyholders living in the state. Maine medical insurance plans are guaranteed issue, which means insurance companies are not allowed to turn down any application for any reason. Health care plans in Maine are also guaranteed renewable, which means that insurance companies cannot cancel coverage if a policyholder gets sick or injured.

Maine insurance providers are allowed to set monthly premiums according to health history and pre-existing health conditions. However, insurance providers are not allowed to impose waiting periods or exclusion periods for pre-existing conditions for residents who are HIPAA-eligible.

Maine health insurance law requires all health plans to cover certain medical care services:

  • Patient care costs for clinical trials
  • Screening for breast, cervical, and prostate cancer
  • Care for pregnant women
  • Hearing aids for children
  • Contraceptives

Also, mental health conditions must have the same coverage as physical conditions under Maine health insurance law. This means that coverage maximums and limits must be the same for both mental and physical conditions.

Maine Health Insurance Resources

Maine Health Insurance High Risk Pool

The Patient Protection and Affordable Care Act established temporary national high risk pools to provide health insurance to those with pre-existing conditions. Residents in Maine with pre-existing conditions are able to get health insurance coverage through the Pre-Existing Condition Insurance Plan (PCIP). This works similar to regular Maine health insurance plans and require enrollees to pay monthly premiums and out-of-pocket costs.

Enrollees in the Maine program pay around the same amount that people without pre-existing conditions pay for health insurance. The estimated monthly premium costs for Maine residents range from $438 to $658. The out-of-pocket limit is $3,500 for a $1,750 deductible plan and $5,600 for a $2,500 deductible plan. Those eligible for the Maine health insurance program will have access to health insurance coverage for prescription drugs, doctor and hospital visits, emergency services, and more.

Individuals may apply for the Maine plan if they are a United States’ citizen, have an existing medical condition, have been without health insurance for six months. For more information on the Maine health insurance high risk pools visit http://www.healthcare.gov/index.html.

To stay up-to-date on the latest health care reform news, visit: http://healthreform.kff.org/

Maine Medical Insurance and Health Care Programs

The state of Maine offers residents quite a few public health insurance programs to assist low-income residents in getting access to affordable health care and insurance coverage. These programs include:

  • Medicaid
    The Medicaid program in Maine is known as MaineCare. It provides some low-income residents, children, and disabled citizens health care coverage for no cost. To learn more about MaineCare, visit the program online.
  • Dirigo Health Program (DirigoChoice)
    This program is designed to provide health coverage to uninsured individuals, small businesses workers and employers, and self-employed residents. To get more information about this Maine medical insurance program, visit online.
  • Maine Breast and Cervical Cancer Health Program
    Low-income women in Maine can receive free screening for breast and cervical cancer, and get full health care benefits through Medicaid with this program. Find more information about this Maine medical insurance program here.
  • Maine Medicare
    Seniors can find Maine health insurance through Medicare Advantage, Medicare Supplement and Original Medicare.

Another health care assistance program is the Federal Health Coverage Tax Credit, which pays for 65 percent of insurance premiums for Maine trade workers and early retirees.

Maine Insurance Providers

Assurant Health Insurance

Assurant Health, headquartered in Milwaukee, has been offering quality insurance products and coverage to more than 1 million members since 1982. Assurant is committed to providing health insurance plans that have broad coverage while providing valuable protection.

Time Short Term Health Insurance

Today, Time Short Term health insurance is offered through the Assurant name. Time short-term health plans provide comprehensive coverage for a temporary period of time at affordable rates.

Important Contacts and Links

Maine Bureau of Insurance and Department of Health and Human Services

Find the contact information for the Maine health insurance and health and human services departments at:

Maine Bureau of Insurance
124 Northern Avenue
Gardiner, Maine 04345
Phone: (207) 624-8475
http://www.maine.gov/pfr/insurance/

Maine Department of Health and Human Services
221 State Street
Augusta, ME 04333
Phone: (207) 287-3707
http://www.maine.gov/dhhs/