If you live in Maine and have low income, you could qualify for free or low cost health insurance through the Affordable Care Act Marketplace. Use our Maine health insurance calculator to see if premium tax credits may apply to you.
When searching for health insurance in Maine, take your individual needs and risks into consideration when identifying an ideal plan tier that can keep costs at a minimum.
Bronze
The Affordable Care Act (ACA) has significantly expanded health insurance options for millions of Americans, including self-employed and those without employer-sponsored coverage. Maine residents can obtain compliant ACA health coverage via the Health Insurance Marketplace, their employer or by purchasing individual plans outside open enrollment period. If they meet financial and non-financial eligibility requirements they may also apply for Medicare or Medicaid programs.
Bronze health insurance plans provide low monthly payments with higher deductibles, making these plans ideal for individuals or families expecting minimal doctor visits and looking to save on healthcare services costs. Furthermore, if your income falls within 400% of the federal poverty level you may qualify for cost-sharing reductions that reduce coinsurance payments making a Bronze plan even more cost-effective.
Silver health insurance plans typically have higher monthly payments than Bronze plans, yet have lower deductibles. They’re ideal for individuals and small families with average healthcare needs who qualify for cost-sharing reductions to lower deductible payments further. Depending on your income level, cost-sharing reductions could further lower deductible payments.
Gold and Platinum health insurance plans feature high monthly premiums but low deductibles, making them ideal for individuals and families who require average or above-average healthcare needs. They may even qualify for cost-sharing reductions such as lower deductibles or coinsurance premiums.
Finding health insurance in Maine can be challenging, so it is wise to do your research prior to making a decision. HealthCare.gov is an invaluable resource that offers price and coverage comparison, or speak with an independent insurance agent directly for more advice.
As a small business owner, you can affordably insure your employees through the Small Business Health Option Program (SHOP). This option is open to companies with 50 or fewer full-time-equivalent employees (FTEs). Or you may purchase commercial insurance through an individual market or private exchange – open enrollment typically runs between November 1 and January 15; enrollment outside this window requires proof of an eligible life event.
Silver
Maine citizens have several options when it comes to health insurance coverage: They could receive coverage through an employer, purchase private health insurance on their own, qualify for public assistance programs like Medicaid and Medicare or qualify for public assistance plans like state-run plans such as VA. When looking at health plans it is important to assess all of their costs – deductibles, copays and monthly premiums should all be factored in when selecting one – this will also have an effect on what level of coverage one receives; plans are generally organized into metal tiers where bronze offers minimal coverage while platinum offers maximum coverage levels of coverage based on its selection criteria.
Maine residents looking for their ideal health plan should visit the health insurance marketplace and compare rates. When registering, individuals will be asked for personal data including name, address, place of employment, social security number, family income and any other pertinent personal information. After registration they can view as many as three health plans at once while comparing features like premiums, out-of-pocket costs and deductibles to find one best suited to them.
Though short term health insurance plans are available in Maine, they should not be seen as an economical solution or one which offers minimal coverage. A 24-month short term plan must end by December 31st of the year in which it was purchased.
Individuals looking for health insurance coverage can do so during open enrollment on the health insurance marketplace, which runs annually between November 1 and January 15 each year. If a qualifying life event such as marriage or birth occurs outside this period, please reach out to your local Department of Health and Human Services for further guidance.
Gold
Maine provides people looking for health insurance many options when purchasing coverage, whether directly from themselves, through the Health Insurance Marketplace, their employer or both. In addition, those meeting certain criteria can obtain no cost or low cost health coverage through Medicare or the Children’s Health Insurance Program (CHIP). Furthermore, Maine operates several federally qualified community health centers which offer high-quality primary care on a sliding fee scale.
Health insurance costs may be on the rise nationwide, yet Maine remains relatively affordable when compared to other states. An average monthly premium for a 40 year old in Maine averages $450; rates can be even more economical for younger individuals. To lower health care expenses further and save money over time consider plans that cover an array of medical expenses; bronze plans tend to cover less while platinum policies offer maximum coverage.
Health Insurance Marketplace allows you to quickly find and purchase Maine health plans that best suit your needs and budget. By comparing prices and benefits of each plan, the Marketplace enables you to compare plans side by side and see if any qualify for subsidies to reduce health insurance costs – provided your income falls under 400% of Federal Poverty Level (FPL). To qualify for these subsidies, your income must fall below 400% of FPL (federal poverty line).
The Centers for Medicare and Medicaid Services issues annual FPL guidelines. In 2019, an individual may earn up to an annual limit of $18,075 while families of three can make an annual total of $30,630. If your annual earnings fall under this amount, MaineCare could become available – you should check eligibility here before enrolling!
If you do not have employer-sponsored health insurance, plans can be purchased via the Health Insurance Marketplace or from private brokers and agents. Small businesses (with 50 or fewer full-time equivalent employees – FTEs) can buy health coverage through SHOP; individuals can receive assistance from federally funded community health centers or Maine AIDS Foundation.
Platinum
Signing up for health insurance plans in Maine varies based on where you live; for instance, residents from Bangor may have different options than those living in Portland. When making your selection, take into account both your current health needs and budget constraints; you can find guidance regarding these choices via Maine State Health Insurance Assistance Program (SHIP). Their counselors are free and unbiased in helping make informed decisions regarding healthcare solutions available to them.
Cost of health plans will depend on where you live and your specific medical needs. When shopping for health insurance on the ACA marketplace, compare costs across plans to find what best meets your needs – plus subsidies may help cover it! It’s an online system designed to match you up with plans tailored specifically to you and meet those needs.
As you shop for health plans, keep in mind that metal levels represent how much money the health plan pays out in medical expenses and do not indicate their quality of services. For example, Bronze plans have low monthly premiums but high deductibles. Silver plans usually have higher premiums but lower deductibles while Platinum plans usually offer the lowest coinsurance payments and deductibles.
Maine citizens who need health insurance may enroll during the open enrollment period from November 1 to January 15; otherwise they can sign up during a special enrollment period.
Low-income individuals may qualify for Medicaid coverage, available to residents of all ages in Maine. There is also Federally Qualified Health Centers offering low or no cost care; additionally, Maine also has their own version called MaineCare that covers adults and children who meet non-financial eligibility requirements.
