Maine Medicare Supplement Plans (Medigap)

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Maine Medicare Supplement Plans were created to work with Medicare to add additional benefits to your traditional Medicare coverage. These policies provide coverage for what is not covered by your Original Medicare. This will include out-of-pocket expenses such as: deductibles, copayments, and even coinsurance.  

Medigap insurance plans are the same as Medicare Supplement plans, however they are sold by private insurance companies. Maine Medicare options can be categorized into separate parts and plans.  

Maine Medicare Plans Explained Maine Medicare

There are four different parts of Medicare available for Maine: 

  • Part A : Maine Medicare Part A will cover inpatient procedures and hospitalization. 
  • Part B : Part B focuses on any additional medical expenses that occur outside of the hospital setting. Such as doctor visits, testing, and any outpatient procedures. Part A and Part B work together to create the Original Medicare plan. 
  • Part C : Also known as “Medicare Advantage”, Part C refers to plans that come directly from Medicare approved private health insurance companies. This plan replaces Part A and Part B, but may contain some limitations. 
  • Part D : Medicare Part D covers prescription drug plans. 
  • Maine Medicare Supplements Plans: These plans assist with costs in healthcare that Original Medicare will not cover. This was created solely to aide your current Medicare plan. 

Qualifying for Medicare Coverage in Maine

For eligibility in Maine Medicare Supplement Plans, you must be 65 years of age or older and be enrolled in Medicare Part B. 

It is important to note that there is a Part B Late Penalty if you do not sign up when you are first eligible. If you enroll when you are first eligible, you will not be penalized. If you enroll after the initial 12-month period, your Medicare Part B premium will increase by 10% each year thereafter. 

Maine Medicare for the Disabled, Under 65

If you are currently receiving disability benefits from Social Security in Maine or Railroad Retirement benefits, you automatically receive Part A and Part B.  

Receiving Medicare in Maine if you are disabled, will be relatively easy, as Medicare supplement policies are available throughout Maine.   

Enrolling in Maine Medicare Supplement Plans

As a Maine resident, the Open Enrollment Period (OEP) will begin on the first day of the month that you are at least 65 years old and when your Part B Medicare has become effective. 

For example, if you turn 65 on January 31st of 2018, and your Medicare Part B effective date is March 5th, then your Open Enrollment Period begins the same year, on April 1st. 

After you’ve determined when your OEP begins, it will be in effect for the following 6 months. At which point you are granted Guaranteed Issue (GI). 

If you are a Maine resident with Guaranteed Issuance, you cannot be turned down for Maine Medicare Supplement Plans or Medigap policy. You may also be entered into a Special Enrollment Period (SEP) with Guaranteed Issuance (GI) if your employer sponsored plan benefits are reduced by a substantial amount. 

Maine Medicare Supplement Plans Premiums

Cost becomes a big factor when it comes to health care. You never want to be left with high medical bills, with no coverage. Most assume cost is determined by the state. However, cost will be determined by your insurance carrier.   

When determining cost, the provider will take into consideration your location, age, and sex. Essentially, Medicare costs for Bangor, Maine, will vary from costs in Lewiston, Maine. 

Medigap carriers classify costs into three different pricing methods.

  1. Attained Age Rated: Age attained rated Medigap is calculated by your current age. It is usually the lowest-priced option at the beginning, but will increase as you get older. This increase could be anywhere from 1.5%, up to 5% each year.
  2. Issue Age Rated: This pricing method is based on the age you were at the time you purchased your policy. Costs will not increase because of your age. The older you are when you purchase your policy, the higher the cost. 
  3. Community Rated: With Community Rated Medigap, everyone will pay the same amount, regardless of age. Your premium does not go up as you get older.  

Please keep in mind, some policies that may seem great at the beginning. However, in reality, you could end up paying more than originally anticipated. Be sure to do plenty of research when considering a Medicare policy provider.  

When comparing Maine Medicare Supplement Plans, remember each letter plan stays consistent from provider to provider. The only variation is the cost.   

The most commonly chosen, and most popular, Medicare plans are Plan G, Plan F, Plan N, and Plan HDF. 

  • Plan G: This plan is sold by private insurance companies and all providers offer the same benefits. Remember, prices vary with every provider. Plan G and Plan F are the only plans that cover any of your excess charges. 
  • Plan F: Medicare Plan F leaves minimal out-of-pocket expenses to be covered. Regardless of provider, you receive the same coverage. This plan will cover most of the remaining hospital and doctor costs, after Medicare handles their portion of the costs. 
  • Plan N: Medicare Plan N covers expenses not paid by Medicare health insurance coverage. Plan N may not always be full coverage, but is considered one of the more affordable plans available. 
  • Plan HDF: This plan was created specifically to work with Medicare Part A and Part B, the Original Medicare. You will receive full coverage on all out-of-pocket costs. Including co-payments, deductibles, coinsurance, and any additional charges that Original Medicare does not cover. High Deductible Plan F holds you responsible for any medical expenses up to your designated deductible amount. Because of the deductible, the premium for the HDF plan is much less than Plan F. 

It is important to remember, the state of Maine may charge excess charges for your Medicare coverage. Keep in mind, if you want to have coverage for your Part B deductible, it is best to go with Plan F or Plan HDF.  

Maine Medicare Part D Prescription Drug Plan

When it comes to medical expenses, prescription drugs can often add unexpected expenses to your health care bill. Because of this, most people gravitate toward purchasing a Part D Prescription Drug Plan. Having this coverage helps beneficiaries to avoid paying the full cost of prescribed medicine.  

Don’t forget, there are some plans that already include drug coverage and benefits. For example, Medicare Part C or Medicare Advantage may assist with it.  

If you do not hold prescription drug coverage when you first become eligible for Medicare, you may be subject to a Part D penalty. This penalty is usually determined by multiplying 1% of the national base beneficiary premium by the number of months you did not carry this coverage.  

Medicare Advantage Plans in Maine

Medicare Advantage, or Medicare Part C, is one of the more full coverage plans. If you choose a Medicare Advantage Plan, you will be automatically forfeit your Part A and Part B coverage. Once you choose a provider for your primary coverage, you will no longer have Medicare Part A and B. Medicare Part C (Medicare Advantage) takes the place of those plans.

Medicare Advantage is a great option for many people. While it is popular, Medigap may give you a bit more freedom. If you choose Medigap, you are not limited to where you seek health care in Maine. With Medicare Advantage, there are restrictions on where you receive health care.

Medicare Advantage and Medigap both have their benefits and perks. However, a major concern for those seeking health care is cost. We usually find that Medigap is less expensive, and has less out-of-pocket risk. Medigap, along with Original Medicare, gives you the best coverage opportunity during emergency medical situations.  

Compare Medicare Plans in Maine Online

Once you’ve made the decision to move forward, or even gather more information on Medicare options including Medigap, Medicare Advantage, PDP plans, we suggest giving us a call! One of our agents would be happy to assist you to help get the process started. 

You may also fill out the form at the top of this page for a quote, or compare rates here. 

Medicare Resources in Maine

We understand that sometimes the cost of health care can seem intimidating and create stress. It is important to be aware that there are other options for extra help available. 

With the Medicare Savings Program (MSP), there are currently four types of programs available to those who may require extra financial aid. 

Additionally, some may also opt for SHIP, a Senior Health Insurance Counseling program. Each state has their own individual program. Each provides assistance to those who currently have, or are eligible for, Medicare, Medicare Supplements, and Medicare Advantage. 

Medicare FAQs in Maine

  1. Is a Maine teacher eligible for Medicare? Anyone who meets the qualifications for Medicare is eligible. In this case, the person should be over the age of 65, or disabled and under the age of 65.
  2. Does Anthem offer Medicare Supplemental Plans in Maine? Yes, Anthem currently provides Medicare supplement plans for Maine residents. For more information on Anthem, contact us today! 
  3. Where can I find a Medicare agent licensed in Maine? If you are looking for licensed Medicare agent in Maine, you’ve come to the correct place! We can help set you up with a plan that best suits you, and your medical situation.