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Maine
The following information details health insurance and assistance programs available to uninsured people in Maine.
Maine Bureau of Insurance - (800) 300-5000
Residents of Maine cannot be turned down from purchasing an individual health insurance policy regardless of any health conditions they may have. This is called guaranteed issue. In addition, residents cannot be charged a higher rate for their policy because of their health status. This is called community rating. The Maine Bureau of Insurance may be able to help you locate names and phone numbers of possible insurers.
If you are self-employed with no employees, you can purchase a small group policy on your own. However, if the insurance company offers policies to both small groups and individuals, insurers can choose to offer you an individual health plan instead.
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Bureau of Insurance. They may be able to provide you with assistance in reaching a conclusion.
Maine Medicaid (MaineCare)- (207) 287-9202
Medicaid is available to anyone who meets income and eligibility criteria. Even if your income meets the criteria, you must fall into one of the eligibility categories in order to qualify. Contact your state Medicaid program for more information.
The Dirigo Health Plan - (877) 892-8391
Maine residents now have an additional option for purchasing health insurance coverage in their state. The Dirigo Health Plan is designed to give businesses with fewer than 50 employees, the self-employed, and other uninsured individuals a new health insurance option. Enrollment in Dirigo will be phased in throughout the next few years. To find out if you are eligible to enroll, contact The Dirigo Health Plan directly.
MaineCarefor Children (Cub Care) - (877) 543-7669
State Children’s Health Insurance Program - Contact your regional office of the Department of Human Services. Check online for phone numbers. Cub Care is the children’s health insurance program designed to provide health insurance to children and teens up to age 19, pregnant women, and some parents whose families may have too great an income or assets to qualify for Medicaid, but who may not be able to afford health insurance. Visit the Web site to find out if you or your child meets the income guidelines.
Pre-Existing Condition Insurance Plan (PCIP)
Through the Affordable Care Act, uninsured people with diabetes who have been continually uninsured for six months or more will be able to access insurance through a new program called the Pre-Existing Condition Insurance Plan (PCIP). PCIP, which is administered by either your state or the U.S. Department of Health and Human Services, will be available until the provisions banning discrimination based on pre-existing conditions are fully implemented in 2014.
PCIP will be available in every state, but the program may vary depending on the state. Currently, many states run programs, often called “high risk pools,” to offer insurance for those with pre-existing conditions. To build on what states are already doing, states can either run a new program with resources from the Affordable Care Act or rely on the U.S. Department of Health and Human Services to provide coverage. Please check out the State Plans page to learn more about how PCIP works in your state. http://www.pcip.gov/StatePlans.html
Local Community Health Clinics
If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.
