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Maine Health Insurance (ME)


Choose from the list below to learn more about specific health insurance providers in Maine. Read on to learn about health insurance regulations in your state. Or enter your zip code in the box to the right to request a health insurance quote.

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Health Insurance Providers in Maine (ME)

Anthem Blue Cross and Blue Shield of Maine
Fairmont Specialty Group


Individual Health Insurance in Maine (ME)

The rules governing individual health insurance in Maine are different from many other states. If you apply for individual coverage, you cannot be turned down because of a health problem. In addition, family coverage must be offered also. Federally eligible individuals can also purchase individual insurance. A standardized policy must be offered by insurance companies and HMOs, as required by the state.

New insurance plans can review your medical records for the six months prior to your acceptance of individual insurance and can impose a maximum of 12 months as an exclusion period for a pre-existing condition. They are not allowed to restrict insurance on a pre-existing condition with an elimination rider. Pregnancy can be considered a pre-existing condition in Maine, but for a maximum exclusion time of 10 months. If you have voluntarily changed jobs and have had no break in insurance coverage for over 90 days (or for 180 days if due to unemployment), credit will be given for your exclusion period on your pre-existing condition. Your individual insurance coverage cannot be cancelled due to sickness, but the premiums can vary according to the modified community rating system.

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Group Health Insurance in Maine (ME)

Group health insurance in Maine cannot be denied if you have a health problem, nor can you be charged more, provided you can qualify. Due to life changes dealing with children, marriage, death, or loss of job, you may be eligible for additional enrollment opportunities. New employers may withhold offering their group insurance for a short time. A new insurance company can check back six months into your medical records for a pre-existing condition and can impose a maximum of 12 months for an exclusion period for that condition. There are regulations which protect you from exclusion periods for pre-existing conditions if you have had continuous health coverage and when you are joining a new group plan.


Small Business Health Insurance in Maine (ME)

A small business employing two to 50 employees cannot be denied small group health insurance coverage and it cannot be cancelled because of illness in your group. The cost of the premiums for small businesses is rated according to the modified community rating.

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Self-Employed Health Insurance in Maine (ME)

The self-employed are allowed to buy group health insurance, but some insurance companies will limit policies to individual plans only. If interested in enrolling in a professional or trade association for the purpose of group health insurance, you should contact the Maine Bureau of Insurance for the regulations that will apply.

Maine Bureau of Insurance
34 State House Station
Augusta, ME 04333
(207) 624-8475
www.state.me.us/pfr/ins/ins_index.htm

Maine Programs (ME)

Assistance with Medicaid is available in Maine, as well as Cub Care for children who are 19 years and younger and are not eligible for Medicaid.

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