Maine Health Insurance

The state of Maine imposes certain key restrictions on health insurance companies that operate here, and knowing what they are and how they affect your options can be highly advantageous to anyone who is currently planning to buy new health coverage.  The following list outlines many of the critical pieces of information you should have if you plan to buy health insurance in Maine.

• Maine requires any health insurance sold here to include a clause guaranteeing the policy’s indefinite renewability.  This means that, provided you have kept to the terms of your contract and paid your premiums in full, you are entitled to renew your coverage as many times as you see fit.  In addition, your insurer cannot terminate your policy unless you also wish to end it.
• Pre-existing conditions are defined by Maine’s insurance regulations as health conditions for which you were diagnosed or treated within the twelve months before entering into a new health plan.  Insurers here are permitted to set up their policies to exclude pre-existing conditions from your health coverage for a certain period of time, generally measured in months.  When switching from one Maine health insurance company to another, assuming that you have maintained continuous coverage, you are allowed to credit any elapsed exclusion period toward any exclusion that your new insurer wishes to impose for the same pre-existing condition.
• Unlike most states, Maine forbids its insurers to take health, age, or risk into account when deciding whether to sell health insurance to a new applicant.  Insurance companies are also prohibited from charging you more for coverage on the basis of your health or gender, although this does not mean that they must also disregard other traits like age, family history, and so on.  Finally, Maine requires insurers to offer two state-standardized health plans to new applicants alongside its other insurance policies.  Taken together, this means that you can operate from a fairly strong bargaining position when shopping for health insurance here.
• As long as you can maintain at least a certain minimum level of employee participation, Maine’s health insurance companies are required to offer your small business the same group health plans that are offered to other small businesses in this state.  Coverage may be contingent on a requirement that the employer pay a certain portion of each employee’s premiums, however.
• Pricing of group coverage for small businesses can vary on the basis of the age, family history, and other risk factors of participants, but never on the basis of gender or health status.  Failing health among the insured can also never be used as grounds for cancelling any small business’s health coverage.
• A self-employed person in Maine is eligible to purchase group health coverage as a small business, even if there are no other employees; this is available as an alternative to purchasing individual health coverage.  If you choose to do the latter, you may be able to deduct a sizable portion of your premiums from your tax liability.

Although Maine is one of the more consumer-friendly places to buy health insurance, it’s still very important to carefully examine the provisions of any health plan carefully before you decide to sign on.  There are also bargains to be had by those that choose to look for them, so you should be sure to compare any offer you receive against similar offers by competing companies.  If you take advantage of the information available to you, you’ll have a much better chance of finding appropriate health insurance at a good price.

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