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Maine Health Insurance

 

All health insurance policies in Maine are considered guaranteed renewable as long as your premiums are paid up to date.  So this means your health insurance can not be canceled because you become sick.

 

Maine mandates that health insurance companies cover newborns and adopted children for the first 30 days, on their parent’s policies.

 

Maine has a Division of Health Insurance that as a consumer you might find helpful when looking for Health Insurance in Maine.

 

                              Request a Maine Health Insurance Quote

 

Maine Small Business Health Insurance

 

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In Maine, a group health plan, can not base your health insurance premiums on your health.  This is called non discrimination.  Small Business Health Insurance in Maine is also guaranteed issue, meaning that you can not be turn down for coverage.  Large companies, on the other hand, can be turned down due to health status.

 

Pre-existing exclusions are limited on the amount of time they can exclude coverage.  Also if you have current coverage, without lapses, that will be credited against

your pre-existing period.  Pregnancy is not considered a pre-existing condition on a group health plan.

 

The maximum pre-existing waiting period is 12 months for an employee. If you are a late enrollee your maximum waiting period is 18 months.  Any pre-existing periods must be applied only after written notice.

 

Maine insurance companies use a modified community rating when figuring out small business premiums.  This means premiums can not vary due to health status or gender.  They can vary due to age, location and smoker status.

 

For additional information about Small Business Health Insurance in Maine click here.

 

                              Request a Maine Small Business Health Insurance Quote

 

 

Maine Individual Health Insurance

 

Maine mandates that all insurance companies, offering individual policies, must offer a standard and basic policy.  This makes it easier for the consumer to buy a policy with comfort in the coverage.  Insurance companies are also allowed to offer other policies.

 

All Maine Health Insurance Policies have to cover disabled children on their parent’s policy into their adulthood.

 

In Maine, unlike most states, individual health insurance plans are guaranteed issue.  This means that you can not be turned down, or refused, because of your health.

 

Maine allows health insurance companies to include pre-existing conditions clauses for up to 12 months.  Insurance companies will look back 6 months to see what treatments etc you have received.  Pregnancy is considered a pre-existing condition, but genetic information is not.

 

Since Maine is a guaranteed issue state, premiums can vary up to 20% depending on location, age, family size and smoker status.

 

Relative to Pre-Existing Conditions, Insurance companies in Maine must give credit to prior credible coverage as long as there was not more than a 90 day lapse in coverage.

 

CubCare was started a few years ago because Maine wanted to make sure that Families, Children, and Pregnant Women had access to affordable health care.

 

For additional information about Individual Health Insurance in Maine click here.

 

                              Request a Maine Individual Health Insurance Quote

 

 

Maine Self Employed Health Insurance

 

In Maine, self employed people are able to buy health insurance like any other small business.  Some insurance companies in Maine will refuse to sell self employed health insurance, in this case the self employed business owner is recommended to buy an individual policy.

 

Another option for affordable Maine Self Employed Health Insurance is often associations or self employed groups.  Just keep in mind that not all of these groups or associations are regulated by the state.

 

One benefit for Self Employed people is that they are able to deduct 100% of their health insurance premiums from their taxes!

 

For additional information about Self Employed Health Insurance in Maine click here.

 

                               Request a Maine Self Employed Health Insurance Quote

 

 

Temporary Maine Health Insurance

 

Many situations may arise where you find yourself without health insurance, or about to be without health insurance.  These reasons could range from graduating college to being in-between jobs.  Instead of going without health insurance you should look into getting a Maine Temporary Health Insurance Policy.  These policies will be cheap, with high deductibles and low coverage, but getting a Maine Temporary Health Insurance Policy is much better than going with out health insurance. 

 

For additional information about Temporary Health Insurance in Maine click here.

 

                              Request a Maine Temporary Health Insurance Quote

 

 

What types of Maine Health Insurance are there?

 

HMO- Health Maintenance Organization.  This type of insurance is called managed care.  This means you have certain network of doctors and hospitals in Maine that you have to go to for care.  Most Maine HMO’s have office visit co-payments that range from $10 to $35, and hospital deductibles that range from $250 to $1,500.  Often the most affordable health insurance plans are HMO’s due to the fact they are managed care.

 

PPO-Preferred Provider Organization.  This type of insurance is also called managed care but it gives the consumer much more freedom; they allow you to visit any doctor or hospital in or out of network.  Most Maine PPO’s have an in network and an out of network charge.  If the in network co-insurance is 100% then the out of network co-insurance would be 80%.  If the in network co-insurance is 90% then the out of network co-insurance would be 70%   Typically Maine PPO’s offer co-payments for doctor visits as well as hospitalization. 

 

Indemnity Plan - In Maine, as health insurance rates continue to rise, many people are finding it more affordable to drop their health insurance and buy a Maine Major Medical Health Insurance Plan.  An Indemnity plan can also be called a major medical plan or catastrophic health insurance.  Whatever you call it, typically a Maine Indemnity Plan would cover more “major” claims.  An Indemnity plan has an annual deductible and will usually allow you to pick different co-insurance options.  Indemnity plans allow you access to any doctor or hospital, and for this reason they are typically very expensive.

 

Discount Medical Plans – In recent years many Discount Medical Plans have started to surface.  These plans have relatively inexpensive, but consumers must realize that this is not insurance.  All these companies do is to get their customers discounted rates (20-50% off) on certain procedures at certain physicians and hospitals. 

 

Federal Mandated Health Insurance Laws

 

HIPAA

Along with Maine Health Insurance Laws, there are Federal Laws that regulate Health Insurance companies.   HIPAA (Health Insurance Portability and Accountability Act of 1996). This act mandated federal standards for individual and group health insurance plans.  Some of the standards that it established were relative to guaranteed renew ability, crediting for prior health coverage and pre-existing condition waiting periods.

 

ERISA

Large corporations do not have health insurance policies.  Typically they are self funded, meaning the corporation pays for all of their employee’s medical bills instead of buying health insurance.  Most of these “self funded” companies are regulated by the federal government under ERISA (Employee Retirement Income Security Act)

 

COBRA

In Maine it is mandated, by the state, that all companies that offer an Maine Group Health Insurance Policy must also enable their employees to extend their health coverage temporarily; called Cobra.  A Maine Cobra Insurance is typically available for a time period under 18 months.   In Maine you are given 60 days to decide if you are going to take Maine Cobra Insurance or not.  Once you have passed on the opportunity to take Cobra, you are not eligible to receive it.

 

Cobra Insurance was introduced in 1985.  Cobra stands for Consolidated Omnibus Budget Reconciliation Act.  If you would like more information about your Cobra Insurance options please contact your companies HR department.

 

Often employees are surprised at the cost of a Maine Cobra Insurance.  The reason for this is that they are now responsible for 103% (100% of the premium plus a 3% administration fee) of a monthly health insurance premium when they probably only paid 20% while employed. 

 

Whether nor not to take Cobra is an important question, and you should realize there are alternatives to a Maine Cobra Insurance Policy.  One should realize what they plan to do in the future.  If you are looking for another job, and it will be a few months before you get a job, it might make sense to look for a Maine Temporary Health Insurance Plan.  If you are contemplating working at a consultant, it would be in your best interest to look into a Maine Self Employed Health Insurance Policy.   

 

 

                           Request a Health Insurance Quote from one of QuicklyQuoteMe’s Agents

 

 

If you are a health insurance agent looking for Maine Health Insurance Leads click here

 

 

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