Medicare Supplement Plans in Maine

Summary: Medicare Supplement plans in Maine can help cover costs that Original Medicare leaves behind. There are various Medigap plans in Maine to meet a range of healthcare needs and budgets. Learn about the available options and find the right Medicare Supplement plan for you. Estimated Read Time: 12 mins

Table of Contents:

1. 1. Best Medicare Supplement Plans in Maine
   2. Eligibility for Medigap Plans in Maine
   3. Medicare Supplement Plan Costs in Maine
   4. Companies Offering Medigap Plans in Maine
   5. Medigap Plans in Maine for the Disabled Under 65
   6. Medicare Supplement Plan Rating Methods in Maine
   7. Medigap Guaranteed Issue Protections in Maine
   8. When to Enroll in Medigap Plans in Maine
   9. Does Maine Allow Medicare Excess Charges?
   10. Alternative Medicare Coverage Options in Maine
   11. How to Apply for a Medicare Supplement Plan in Maine

Medicare Supplement plans in Maine help cover out-of-pocket expenses left behind by Original Medicare (Medicare Part A and Part B) benefits. These plans are also known as Medigap plans and are available through private insurance carriers.

There are 12 Medicare Supplement insurance plans Maine residents have access to, but their availability may change depending on your ZIP Code.

In Maine, your medical needs will dictate which Medicare Supplement plan you should enroll in. For some, there are also Medicare Advantage plans available that may better suit your needs, as well as Medicare Part D which covers prescription drugs. Discover the many Medigap plans in Maine and which plan is right for you.

Best Medicare Supplement Plans in Maine

Are you wondering which Medigap plan in Maine is the best? Well, you’ll need to start by looking at your healthcare needs. Everyone needs different health benefits, which is why there isn’t a single best plan. The best Maine Medicare Supplement plan for you will provide adequate healthcare benefits for your needs while also fitting your budget.

Maine Medicare Supplement plans are standardized. This means that Medigap plan benefits are the same among carriers. However, the amount you pay will be different. So, for example, if you enroll in Plan G with Humana or UnitedHealthcare the benefits will be the same with either insurance company. Yet, their monthly premiums may be different.

While there are 10 standard Medigap plans and two high deductible plan options throughout the state, three remain the most popular among eligible beneficiaries. These three are Plan F, Plan G, and Plan N, and many seniors in Maine find them to be comprehensive and affordable.

Medicare Supplement Plan F Maine

Medicare Supplement Plan F in Maine delivers some of the most comprehensive coverage of any option. You’ll enjoy having your Original Medicare deductibles, copayments, and coinsurances completely paid for by your Plan F benefits.

If you are looking to enroll in Medigap Plan F, you’ll need to understand whether or not you qualify. The plan is only open to those eligible for Medicare before January 1, 2020. If you qualify Medicare benefits after this date, you will not be eligible to enroll in Plan F.

Medigap Plan F in Maine covered services include:

• Part A deductible, coinsurance and hospital costs, and hospice care coinsurance
• Part B deductible, copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan G Maine

For those who are not eligible for Medigap Plan F, Medicare Supplement Plan G is the most comprehensive. It offers almost identical coverage to Plan F, but with a lower monthly premium.

However, Medigap Plan G does not cover the Medicare Part B deductible. So, you will be responsible for this cost. Once you meet the annual deductible – which is the same for all enrollees and changes each year – Plan G covers the rest of your Medicare costs.

Medigap Plan G in Maine covered services include:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan N Maine

Another popular coverage option is Medicare Supplement Plan N. With Plan N, you receive some of the same great benefits as other Medigap plans. However, you pay lower premiums.

When enrolled in Plan N you are responsible for copayments at the doctor’s office or Emergency Room ranging from $20-$50. Due to these costs, the plan boasts a lower monthly premium compared to other top plans.

Enrolling in a Medigap Plan N will also mean you’ll need to cover your Part B deductible or any excess charges out of pocket. Excess charges occur when healthcare providers don’t accept Medicare assignment; however, this is rare. But your Emergency Room copayment is waived if you are admitted into a hospital.

Medigap Plan N in Maine covered services include:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays/coinsurance
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan N is a popular option for people looking to save on premiums and don’t require healthcare outside of annual checks ups and minimal visits each year. If you need frequent healthcare procedures, Medigap Plan G or Plan F are likely better options depending on your eligibility.

Eligibility For Medicare Supplement Plans in Maine

To be eligible for Medicare Supplement plans, Maine residents must meet the eligibility requirements of Original Medicare. The requirements are generally as follows:

• Being at least 65 years old
• Being a United States citizen for at least five years

There are a few exceptions to these requirements that may allow some disabled individuals to qualify for a Medigap plan at an earlier age. These exceptions include:

• Being diagnosed with end-stage renal disease (ESRD)
• Being diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease
• Receiving Social Security Disability Insurance (SSDI) for at least 24 months.

It’s also important to know that if you’re currently enrolled in a Medicare Advantage plan (Medicare Part C) and want to enroll in a Medigap plan, you will need to choose one form of coverage or the other. You cannot have a Medicare Advantage plan and a Medigap plan at the same time.

Before you apply for a Medigap policy, you must disenroll from your Medicare Advantage plan first. This can only be done during valid election periods which include the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period.

The Cost of Medicare Supplement Plans in Maine

The cost you’ll pay for Medicare Supplement Plans in Maine comes down to many factors. Some of the biggest are your age, gender, the amount of coverage you require, and whether or not you use tobacco.

In general, men, older beneficiaries, smokers, and those who need more benefits can expect to pay more.

By taking a closer look at the averages in your state, you can better understand how much you can expect to pay for your coverage. Our chart for Medigap plans in Maine compares rates for both a 65-year-old male and female and a 75-year-old male and female in the same ZIP Code of Maine. No one’s rate reflects that of a smoker:

* If on Medicare before 01/01/2020

* Sample rates sourced from Medicare.gov

It’s important to note that the range of premiums shown are just averages in Maine. Your actual costs could be higher or lower due to the previously mentioned factors or other personal health factors.

Companies Offering Medigap Plans in Maine

Your journey to find affordable Medicare Supplemental Insurance plans in Maine means looking through many different companies. Remember, Medigap comes from private insurance companies, so choosing a carrier that suits your needs is essential. Here are several of the top carriers providing Medicare Supplement plans Maine residents can enroll with:

• Mutual of Omaha
• Anthem Blue Cross Blue Shield (BCBS) of Maine
• Cigna
• Humana
• AARP/UnitedHealthcare

Each company has something to offer its clients, but it’s important to do your due diligence on each carrier. Besides the cost of monthly premiums, while very important, you should consider other factors too.

Independent credit agencies, such as A.M. Best and S&P, assess the financial stability of insurance providers. Their assessments can help you gauge the carrier’s ability to effectively cover your healthcare expenses.

Furthermore, consumer agencies like the Better Business Bureau (BBB) look at customer service based on complaints, offering valuable insights into the overall consumer experience. Taking these factors into consideration will enable you to make an informed decision when selecting a Medigap insurer for your supplemental coverage.

Maine Medicare Eligibility Under 65

In Maine, state law requires insurance companies to offer at least one Medicare Supplement plan for people with disabilities that are under the age of 65. If you qualify, you’ll have a Medicare Supplement Open Enrollment Period during this time as well as when you turn 65.

However, premiums for Medigap plans for those under 65 can be very high so a Medicare Advantage plan may be a good option for those under 65. Contacting a licensed Medicare agent can help educate you so you can make the best choice for your needs.

Medigap Plan Rating Methods in Maine

Maine is one of the few states where insurance companies use the Community rating to determine Medigap premiums. This means that Medicare beneficiaries in Maine will be charged the same premium for the same coverage. Premiums will not increase due to age, and they won’t cost more because of gender.

However, smokers and tobacco users may pay higher premiums than non-smokers for the same coverage. Premiums may also still increase due to external factors such as inflation.

Medigap Guaranteed Issue Protections in Maine

Under federal law, Medicare Supplement plans in Maine are required to provide guaranteed issue protections, also known as guaranteed issue rights. These protections ensure that individuals can enroll in a Medigap plan without being denied coverage or charged higher premiums based on pre-existing conditions. The goal of these protections is to ensure access to Medigap coverage when it is needed.

A guaranteed issue right unique to Maine is a statewide Open Enrollment Period in June. However, during this time, you will only be able to enroll in another Medigap plan of equal or lesser value to the one you’re currently enrolled in. You will be able to do so without being subject to medical underwriting and potentially losing coverage or getting charged higher premiums.

Another significant guaranteed issue right is the Medicare Advantage trial period. If you initially joined a Medicare Advantage (Part C) plan when you first became eligible for Medicare and decide to disenroll within the first year, you have a one-time guaranteed issue right to enroll in a Medigap plan. This allows you to obtain Medigap coverage without going through medical underwriting.

Furthermore, protection is available for those who experience a loss of coverage. If you lose employer-based retirement coverage or if your current Medigap plan is terminated or discontinued, you have a guaranteed issue right to enroll in another Medigap plan.

This guaranteed issue right also applies if you move out of state and your Medigap carrier is no longer available. To qualify for this protection, you must apply for a new Medigap plan within 63 days of the termination of your existing plan.

Additionally, there are guaranteed issue rights associated with Medicare Advantage plans. If your Medicare Advantage plan is terminated, you move out of its service area, or you lose coverage due to circumstances beyond your control, you have a guaranteed issue right to enroll in a Medigap plan. To be eligible for this protection, you must apply for a Medigap plan within 63 days of the termination of your Medicare Advantage plan.

When to Enroll in Medigap Plans in Maine

The best time to enroll in a Medicare Supplement plan in Maine is as soon as you’re eligible during your Medigap Open Enrollment Period. Once you enroll in Medicare Part B, this period lasts six months, and you are guaranteed coverage with the Medigap plan and company of your choice during this time. You have the option to choose from a list of standardized plans labeled A through L.

If you don’t enroll during your 6-month open enrollment period or during the annual open enrollment period for Maine residents in June, you may have to undergo medical underwriting. Insurance companies could charge you higher premiums or deny you coverage altogether for pre-existing conditions.

Does Maine Have Medicare Excess Charges?

Medicare Part B excess charges are a rare, additional cost on top of the Medicare-approved amount (also called Medicare Assignment) for a service. These charges occur when you receive services from a healthcare provider who doesn’t accept Medicare assignment as full payment.

In some states, Medicare excess charges are prohibited, but Maine is not one of those states. Healthcare providers in Maine can charge up to 15% more than the Medicare-approved amount for a service. However, the majority of physicians in Maine do accept Medicare assignment, so it shouldn’t be difficult to find one who won’t charge extra for health care.

Alternative Medicare Coverage Options for Maine

Medicare Supplement plans are great options, but that doesn’t mean they are the best solution for everyone. There are several other options for beneficiaries that require more coverage than Original Medicare alone will provide:

• Medicare Advantage (Medicare Part C) helps beneficiaries receive coverage that can save on premiums. But it’s important to note that you’ll still have to pay out-of-pocket costs and deal with plan restrictions. Just note that you cannot have a Medigap plan and a Medicare Advantage plan at the same time.
• Medicare Part D plans offer prescription drug coverage which can help with the cost of expensive medication. Before enrolling, you’ll want to check your plan’s formulary to ensure it covers the prescriptions you need.
• Last but not least, ancillary policies cover care for things such as dental, vision, and hearing for a more comprehensive form of coverage.

How to Apply for a Medicare Supplement Plan in Maine

When it comes to Medicare Supplement plans in Maine, our licensed agents are here to help you find the best benefits for your healthcare needs. Medicare insurance can be tough to navigate, and at MedicareFAQ, our services are always free and our agents are ready to answer any of your questions.

Call us at the number above and let us help you save time, effort, and money to find you the right coverage. Call us at the number above and discover the coverage you deserve or fill out the online rate form to see our rates today!

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