Maine Individual Health Insurance
Health insurance is an essential defense that no person or family should be without. If you don't get group health insurance through your employer, then you should look into purchasing Maine individual health insurance from a private insurer. Finding out more about the rules and regulations regarding these individual health insurance plans is the most important step when determining if this opportunity is right for you.
Eligibility: How Am I Evaluated?
Individual health insurance applicants in Maine cannot be turned down for a health insurance policy. All policies sold in the state must be sold on a guaranteed issue basis. Factors such as your age, health status, and lifestyle habits will not hold you from getting the insurance policy of your choice from the provider of your choice. This also allows the state to stay in accordance with HIPPA Group-to-Individual Portability Coverage regulations.
Maine Guaranteed Benefits & Pre-Existing Conditions
The state of Maine does require insurers to carry standardized policies; however, they may carry additional policies to choose from as well. Standardized policies must cover things such as hospitalization, office visits to your doctor, prenatal services, prescription drugs, lab testing, rehabilitation services (limited), and a deductible of no more than $1,500 (can be as little as $250 depending on the provider and your own circumstances).
The laws in Maine allow individual health insurance providers to apply an exclusionary period (not to exceed 12 months) for pre-exiting conditions. Insurers can look back up to 12 months prior to your health insurance application to determine what, if any, pre-existing conditions you may have. Pregnancy is also considered a pre-existing condition under many policies and be excluded for up to 10 months. HIPPA customers cannot have exclusionary periods imposed on their policy and elimination riders (which exclude a condition from a policy for an indefinite amount of time) are not allowed on policies sold in the state.
Maine Individual Health Insurance Premiums
Premiums are limited in Maine and cannot vary based on your gender, health, claims experience, or policy length. Premiums can vary by 20% from the community rate based on your age, occupation, or tobacco use. How much you pay will also depend on how many people are applying under your policy, where you reside, and which plan you are applying for.
In conclusion, Maine individual health insurance plans are guaranteed renewable, so your insurer cannot cancel your policy because you got sick. They also cannot raise your premiums to offset these costs or new risk factors. The laws within the state keep you well protected from paying more just because the deck has been stacked against you.