Know your options

Maine Individual Health Insurance

Health insurance is important for the physical well-being of your family. 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 gender, 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 requires all private insurers to offer at least two policies to those who are HIPPA eligible. However, these two health policies must be comparable to other policies on the market.

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 patient care costs for clinical trials, screening for breast, prostate and cervical cancer, care for pregnant women, contraceptives and hearing aids for children.

The laws in Maine allow individual health insurance providers to apply an exclusionary period of 12-months for pre-existing 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 state mandates health insurance companies to provide equal health coverage maximums and limits for mental and physical conditions.

Maine Individual Health Insurance Premiums

Premiums are limited in Maine and cannot vary based on your age, gender, health, claims experience, or policy length. Premiums can vary by 20% from the adjusted 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. 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.

Having a suitable health insurance policy can protect your financial future and secure the wellness of your family. Get in touch with a qualified broker/agent near you to avail the benefits of health insurance alternatives.