Medical insurance is essential to protect your family's health
against unpredicted events of sickness or injury. Before opting for
health coverage, you should go through your family's medical needs
and your budget. Being a Maine resident, you can choose from
various product alternatives. The Maine Bureau of Insurance
supervises the legislature under which the Maine health insurers
can sell private health plans to individuals and families.
Insurance laws in Maine require that all individual healthcare
insurance policies be written on a guaranteed issue basis, meaning
insurance carriers are not permitted to deny you coverage due to
unfavorable current or past health history. In addition, Maine
requires that insurance carriers, who opt to sell individual
policies, including HMOs, must offer a standardized policy.
Regulated by the state, standard policies are required to offer
specific benefits and the coverage, benefits co-payments and
coinsurance percentages must be identical from all carriers. These
same insurance carriers are also permitted to sell other health
plans that are non-standardized. There is a 12 month look-back
clause and exclusionary period allowable for pre-existing
conditions, with credit for prior creditable coverage being
required. Elimination riders are not permitted and may not be added
to any policy. Insurance rates can be adjusted by geographical
region, age, health, occupation and smoking history.
Search for
plans and the costs associated with them using the search box
above. We provide individual, family, group and student health plan
quotes for you to compare on all states and zip codes. Remember
that having coverage leads to a healthier lifestyle as you are able
to get regular doctor checkups and therefore a low-cost premium.
In Maine a group is defined as 1 - 50 employees. Small group medical insurance in Maine is guarantee issue, which means that no group can be declined health coverage based upon its health status. Each qualified employee may be required to satisfy a waiting period prior to entering the group plan. Once eligible, the insurance company may impose a 6 month look back / 12-month exclusionary period for pre-existing conditions on applicants not able to provide proof of prior creditable coverage. The use of medical underwriting to determine group rates is not permitted, but they may be adjusted based on age of employees, location of business, work field of business and the smoking history of the employees. Regardless of these rating factors, the most an insurance company can charge a small employer for plan coverage is 20% of the standard rate.
Since Maine is a state the requires the insurance companies to
insure all applicant's continuation of group coverage under COBRA
regulation is of less importance than in most states. Federal COBRA
options are still available to persons that work for a company with
more than 19 employees. Any employee can remain on the group health
plan for 18 months after leaving employment with the company,
regardless of the reason they are leaving. In some cases, a person
may be eligible to remain on COBRA for 36 months. This includes
person that meet disability guidelines, a widow and the deceased
member's children. The insured would be responsible for premium
payment of the coverage along with 2% administrative fees.
However, Maine offers mini-cobra option to individuals who are
leaving a group plan with fewer than 20 members and are not
federally eligible for COBRA may still be able to continue coverage
under their group plan for up to 18 months. Individuals have to
elect this option within 31 days. An administrative fee of 2% of
the premium amount is added to the amount paid by the employer, and
any individual accepting continuation of coverage is fully
responsible for the paying the premium. After exhausting COBRA
coverage, individuals have option of transferring to an individual
conversion product.
