Medicare is an essential program that provides health coverage for many Americans over 65 and others with health conditions. Almost one quarter of the state’s total population receives Medicare coverage! Medicare in Maine offers plans to match your needs so you can be healthier and happier in the years ahead.
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Maine Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2024 Medicare trends in Maine:
- As of 2024, 368,336 residents of Maine are enrolled in Medicare.
- Maine’s average Medicare Advantage monthly premium increased from $11.94 in 2023 to $13.90 in 2024.
- In 2024, there are 55 Medicare Advantage plans available.
- All Maine Medicare recipients can purchase a Medicare Advantage plan, including those with $0 premiums.
- There are 21 different Medicare prescription drug plans offered in Maine for 2024.
- The lowest monthly premium for a Medicare prescription drug plan in Maine in 2024 is $0.50.
Medicare Offered in Maine
Medicare is a federal program that helps pay for the costs of healthcare services. Most beneficiaries of this program are over the age of 65, but some workers with disabilities may qualify as well. The program is not as expensive as private insurance plans, and the state of Maine also offers various public assistance programs to assist Medicare beneficiaries.
Original Medicare
Original Medicare comprises Part A, Part B. Medicare Part A deals with hospital services and services in similar healthcare facilities and covers inpatient hospital care. Medicare Part B enables beneficiaries to receive medical treatments, durable supplies, and preventive services that are all regarded as medically necessary.
Medicare Part A typically does not require beneficiaries to pay monthly Medicare premiums, although there are some exceptions to this. With Medicare Part B, you usually pay a monthly premium, but the amount depends on the annual income of the Medicare beneficiary. Both Medicare Parts A and B have deductibles, coinsurance, and copays.
Medicare Advantage
Medicare has authorized some private health insurance carriers in Maine to offer Medicare Advantage Plans, also known as Medicare Part C. This plan provides the same coverage as the combined Medicare Part A and Part B. It also generally covers some other services Original Medicare does not cover, such as prescription drug coverage, vision, and dental.
By mid-2020, enrollment in private Medicare plans had grown to 43% of Maine’s Medicare population. Depending on your coverage, the cost of your Medicare Advantage plan will vary.
Maine Medicare Advantage options typically include plans from the following private insurance companies:
- Aetna
- AMH Health
- Harvard Pilgrim Health Care Inc
- Martin’s Point Generations Advantage
- UnitedHealthcare
- WellCare
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Medicare Supplement Plans
Health insurance is an essential element of a complete retirement plan, and with the many different options available to people today, it can be challenging for Medicare recipients to choose. Some beneficiaries may also opt for supplemental plans that provide more coverage benefits to add to Original Medicare. These plans may even cover the cost of deductibles, coinsurance, and copayments. Like Medicare Advantage, These plans will also require an additional premium.
Maine’s Medigap regulations are designed to protect consumers and ensure greater access. The state’s Consumer Guide to Medicare Supplement Plans contains Maine’s extensive guidelines for these plans, which is a great resource for both current enrollees as well as those looking to enroll in the future.
Maine Medicare Advantage options typically include plans from the following private insurance companies:
- AARP – UnitedHealthcare
- Anthem Blue Cross Blue Shield – Maine
- Colonial Penn
- Harvard Pilgrim
- State Farm
- USAA
Maine Medicare Enrollment
Maine citizens are eligible for Medicare if they are U.S. citizens above 65 years old or under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
Requirements
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Maine Enrollment Tips & Advice
If you’re a resident of Maine and have difficulties covering the cost of Medicare, the state offers two Medicare Savings Programs (MSP) to alleviate the financial burden. Qualifying for any of these MSPs will require meeting income and asset limits.
The Qualified Medicare Beneficiary Program or QMB will pay for all Medicare premiums. This also covers coinsurance and deductibles and reduces the cost of generic prescription drug copayments.
The other program is the Specified Low-Income Medicare Beneficiary (SLMB) program, also called the Qualified Individual (QI) program. The SLMB or QI program covers the premium for Medicare Part B and Part D, along with the deductibles and coinsurance. Generic drug copayments are also reduced.
Some additional resources you can access include:
How Do I Enroll in a Medicare Plan?
If you’re looking for an affordable plan to supplement your Medicare coverage, speak with one of our agents today! Our licensed experts will help you find the perfect option that’s right for you.
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