Health Insurance Carriers in Maine (ME)
Different options apply to different states when it comes to health insurance plans and providers. To make it easier for you, we have compiled some details particular to Maine below. Also, check out the links for more information on recommended carriers available to you.
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Health Insurance Providers in Maine
Assurant Health (Formerly Fortis)
Fairmont Specialty Group / TIG
Individual Health Insurance in Maine
- Coverage may not denied eligible applicants due to a health problem.
- Family coverage must be offered as well.
- A standardized policy must be offered as required by the state.
- Providers may review medical records for the six months prior to the beginning of coverage and may impose an exclusion period for up to 12 months.
- Providers may not attach an elimination rider to a policy.
- Pregnancy may be classified as a pre-existing condition for up to 10 months.
- If previous coverage was maintained through employment voluntarily left for over 90 days (or for 180 days if due to unemployment), creditable coverage will apply to any exclusion period on your pre-existing condition.
- Coverage may not be cancelled because of sickness, but premiums may vary according to the modified community rating system.
Group Health Insurance in Maine
- Group coverage may not be denied to eligible applicants based on a health problem, nor may they be charged more.
- Life changes dealing with family or loss of job, creates additional enrollment opportunities.
- New employers may withhold offering coverage for a short period.
- HMOs may review six months of an applicant’s medical records for pre-existing conditions and require up to 12 months of an exclusion period if a condition exists.
- Certain regulations protect applicants from exclusion periods for pre-existing conditions if continuous health coverage was maintained for a certain period before application.
Small Business Health Insurance in Maine
- Businesses employing up to 50 employees may not be denied small group coverage or be cancelled due to illness in the employee group.
- Premiums costs for small businesses is rated according to the modified community rating.
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Self-Employed Health Insurance in Maine
- The self-employed may purchase group health insurance, but some providers will limit them to individual policies only.
- If enrolling in a professional or trade association to get group health insurance, you should contact the Maine Bureau of Insurance for applicable regulations.
Maine Bureau of Insurance
34 State House Station
Augusta, ME 04333
(207) 624-8475
www.state.me.us/pfr/ins/ins_index.htm
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