Maine Health Insurance

According to the Center for Disease Control, an average of 10.7% of Maine residents per year were uninsured for Maine health insurance between 2001 and 2003.

Maine Health Insurance Regulations

There are some Maine health insurance regulations that all Maine health insurance companies must follow. Every Maine health insurance policy must include a guaranteed renewability provision which guarantees any individual the right to renew his or her existing Main health insurance plan. The guaranteed renewability provision only holds true for those individuals who have paid all premiums and have not provided false information during the term of their existing Maine medical insurance policy.

Maine health insurance plans can contain pre-existing condition exclusion periods for any condition diagnosed or treated within the 12 months prior to the beginning of the new Maine health insurance plan. Previous Maine medical insurance plans can credit new plan pre-existing exclusion periods provided there is no break in coverage.

Regulations of Maine health insurance are stricter than most states. Maine health insurance companies cannot deny access to medical insurance on the basis of health, age or risk-value. Maine medical insurance rates are regulated and cannot cost an individual more based on their gender or health. This is called “community rating”. Maine health insurance rates can, however, vary depending on age, demographics, and family size.

In addition to their other medical insurance plans, Maine health insurance companies must provide every applicant the option of one of two state-standardized Maine health insurance plans. Any individual who belongs to an employer Maine health insurance plan cannot be denied coverage nor can that coverage be limited. Self-employed individuals can purchase small group Main health insurance.

Alternative Maine Health Insurance Options

Those individuals who do not qualify or are unable to afford individual Maine health insurance may find assistance through state-sponsored programs:

• MaineCare is the Maine Medicaid program that is designed to help qualifying individuals who meet eligibility criteria. MaineCare has taken over the former CubCare program and provides Maine health insurance to children up to age 19, pregnant women and some parents whose families do not qualify for the Medicaid programs but may be unable to afford Maine health insurance.
• The Dirigo Health Plan is another option for purchasing Maine health insurance. This plan helps small business (with fewer than 50 employees), self-employed, and other individuals obtain Maine medical insurance.

Maine Bureau of Insurance

Maine Bureau of Insurance:

Department of Professional and Financial Regulation
Bureau of Insurance
#34 State House Station
Augusta, ME 04333-0034

Telephone: (207) 624-8475.
Toll Free (800) 300-5000 (in state)
Fax (207) 624-8599

More information on Maine Health Insurance can be found on HealthInsuranceWeb.

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