AUGUSTA – Most Maine people shopping through the Health Insurance Marketplace can pay less than $75 per month for health coverage in 2021, according to new federal data released ahead of the start of open enrollment on Sunday, November 1.
Sixty percent of Maine HealthCare.gov customers qualify for a plan costing under $75 a month, while 40 percent can pay under $10 a month.
The average individual market health insurance premium in Maine will be 13 percent lower next year. Maine is one of four states where average premiums are dropping more than 10 percent from 2020 to 2021 – the third year in a row of premium declines in Maine.
Open enrollment on the Health Insurance Marketplace begins Sunday, November 1 and ends on Tuesday, December 15. Eligible Maine people can sign up for MaineCare (Medicaid) at any time during the year. Maine people can explore both options at CoverME.gov.
“No one should have to live in fear of not being able to see a doctor, fill their prescriptions, or receive life-saving care, especially in the middle of a pandemic,” said Governor Mills. “I encourage Maine people who need affordable insurance to visit CoverME.gov to learn about coverage options, find local assistance, and consider applying when open enrollment begins on Sunday.”
“As we continue to respond to the COVID-19 pandemic, health insurance is more important than ever,” said Maine Department of Health and Human Services Commissioner Jeanne Lambrew. “We encourage anyone in need of affordable health insurance to visit CoverME.gov to explore their options. Even if you may only need coverage temporarily or your employment or coverage situation remains uncertain, it’s worth signing up to make sure you and your family can get a checkup, afford your medications, and access other needed health care.”
This year, Maine is taking a greater role in running the Marketplace, where people buying insurance on their own can compare health plans, see if they qualify for extra financial help, and sign up for coverage. Consumers will still shop and apply for coverage through HealthCare.gov, however the Maine Department of Health and Human Services (DHHS) is taking over enrollment assistance and outreach thanks to the Governor’s Made for Maine Health Coverage Act of 2020, which passed with bipartisan support and was signed into law in March. As a result of this transition, DHHS has doubled the grant award for Navigators, who provide free, unbiased assistance to consumers applying for both Marketplace coverage and MaineCare. Additionally, DHHS will launch a campaign utilizing digital, TV, and radio advertising to make sure Mainers are aware of their coverage options. DHHS continues to pursue the option to fully run an independent State-based Marketplace in the future.
This new law also is improving coverage for Maine residents with state-regulated private insurance, including those who shop on HealthCare.gov: In 2021, all traditional individual and small group plans will cover the first primary care visit and first behavioral health visit with no out-of-pocket cost. Additionally, the second and third of each of those visits will be covered without being subject to the plan deductible.
While open enrollment starts on Sunday, people can preview the health plans available on the Marketplace for 2021 now at HealthCare.gov. In Maine, three insurance companies are offering 56 plans through the Marketplace. This “window shopping” opportunity allows consumers and navigators to browse options early without logging in, creating an account, or filling out the official application.
Last year, roughly 107,000 or 8 percent of Maine residents were uninsured. People with income less than 138 percent of the Federal poverty level ($17,609/year for a single person, $36,156 for a family of four) are eligible for MaineCare, which provides no-cost, comprehensive coverage. People with income between 139 and 400 percent of the federal poverty level (under $51,040 for a single person, $104,800 for a family of four) can get reduced premiums through the Marketplace. This year, 86 percent of Mainers buying coverage through the Marketplace qualified for reduced premiums.
Under Governor Mills’ first executive order, DHHS expanded MaineCare for low-income residents, with up to 90 percent of the cost funded by the Federal government. Between March 2 and October 1, 2020, due largely to coverage protections related to the federal COVID-19 public health emergency, enrollment in the Medicaid expansion increased by 40 percent to 62,896.