Maine Medigap Plans, available in our northernmost state, offer a unique advantage compared to other states in the USA. Maine has enacted Med Supp rules not available in most states that allow for easy switching and guaranteed enrollment. If you are considering enrolling in a gap plan, you should read this Maine Medigap Overview article first.
In ME, Medigap plans are sold by private insurance companies, not the government directly. The cost and availability of Medigap plans may vary depending on your insurance company. Get a comparison Medsupp quote here to explore your options in Maine! Click here to get a general overview of how Medigap works but read below to learn about Maine’s unique Medigap rules.
Maine Medigap Year Round Switching Rule
If you currently have a Medigap plan, you have the flexibility to switch at any time in Maine and be guaranteed approval for a new Medigap plan. This is available in Maine due to a state law that allows you to switch regardless of your health condition. Switching Medigap plans without going through medical underwriting is not available in most states but Maine makes it easy. If you are thinking about changing your policy, read this Senior65.com Maine switching article and follow the step by step. Just remember, don’t cancel your old policy until your new one is in place.
Medigap Free Switching Restrictions: The new Medigap plan you choose in Maine must have the same or fewer benefits than the one you are leaving to qualify for switching without health review. For example, if you currently have Plan F, you can switch to Plan G since it offers fewer benefits. On the other hand, you cannot switch from Plan G to Plan F since Plan F provides more benefits than Plan G. Also to qualify for switching without medical review, you must never have had a gap in coverage that supplements Medicare of more than 90 days. (Source)
Maine 3 Year Medigap Trial Right Rule
Most states let you try out Medicare Advantage for one year and if you don’t like it, you can switch to Medigap. Maine has extended that “Trial Right” to 3 years! If you start with Medigap, then switch to Medicare Advantage, you also have 3 years to go back to your old Medigap plan using the Medigap Trial Right Rule in Maine. Check out our page dedicated to ME Medigap Medicare Advantage Trial Right.
Maine Medigap Community-Rated Rule
Maine´s community-rated Medigap rules require insurance providers to charge the same rate to everyone, regardless of age or gender. This means your plan’s premium should not go up just because you get older like it does in most states. Insurance companies are allowed, however, to give a discount to new customers. As this discount goes away, it can feel like the price is going up each year. Also, your policy can receive a “rate action” each year which means that everyone gets a price increase.
Remember: Insurance providers set their own community-rated price, so it’s important to see prices from multiple insurance carriers before you buy. You can get instant Medigap ME prices here without speaking to a representative.
“The cost for Medicare Supplement policies cannot vary based on your age or gender; however, some companies charge a higher rate if you smoke. Rates may vary depending upon where you live. If you have a Medicare Supplement policy and change your address, your renewal rate may change depending upon the insurer’s claims experience within that location”, as stated on the official website of the Maine Bureau of Insurance.
Maine Medigap Free Look Rule
All Medicare Supplement policies (MedSup) sold in Maine have a 30-day Free Look period. This means that if you are not happy with the policy you bought for any reason, you can return it within 30 days and receive all your money back.
Maine Guaranteed Medigap Plan A Rule
With Maine’s guaranteed issued state law, you can be approved for Medsupp plan A if you apply outside your initial open enrollment period regardless of your health condition. Each insurance provider must offer a one-month guaranteed issue period each year for Plan A. (Source)
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Maine Medicare Excess Charges
Part B Excess charges occur when doctors exceed Medicare-approved rates. If doctors don’t accept Medicare assignment, they CAN charge you up to 15% extra in Maine. Fortunately, Medigap plan G covers 100% of excess charges, relieving you from paying these additional fees. Learn more in our article “How to Avoid Medicare Excess Charges“.
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Maine Medigap Plans: A Basic Guide
There are 10 standardized Medigap plans available in Maine, labeled with letters A, B, C, D, F, G, K, L, M, and N. Each plan offers distinct benefits and covers different cost-sharing expenses. Plan F and C are no longer available to those who became Medicare eligible after Jan 1, 2020.
Comparing Maine Medigap Plans
Plans available if you qualified for Medicare after January 1, 2020:
| Benefits | A | B | D | G** | K | L | M | N |
|---|---|---|---|---|---|---|---|---|
| Medicare Part A Deductible ($1,676) | 100% | 100% | 100% | 50% | 75% | 50% | 100% | |
| Part B Deductible ($257) | ||||||||
| Medicare Part A Hospital Coinsurance and 365 additional hospital days | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |
| Medicare Part B Coinsurance | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| First 3 Pints of Blood for a Transfusion | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Medicare Part A Hospice Coinsurance or Copay | 100% | 100% | 100% | 100% | 50% | 75% | 100% | 100% |
| Skilled Nursing Facility Coinsurance | 100% | 100% | 50% | 75% | 100% | 100% | ||
| Medicare Part B Excess Charges | 100% | |||||||
| Foreign Emergency Healthcare | 80% | 80% | 80% | 80% | ||||
| Max Out-of-Pocket | $7,200 | $3,610 |
**Medigap Plan G High Deductible is identical coverage with a high deductible of $2,870.
If you were Part B eligible before January 1, 2020, you may be able to enroll in Medigap Plan F.
Maine’s Most Popular Plan
According to the latest data released by America’s Health Insurance Plans (AHIP), over 55,000 Maine residents have purchased a Medigap policy.
As you may be aware, there have been changes in Medigap plans since 2020, which means that the plans worth considering have also changed. Plan F used to be the most popular option in Maine. Although it still has the largest number of clients, it does not receive more beneficiaries. Therefore, the option most chosen by the new insured is Plan G, for which around 16,000 people have selected.
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Maine Medigap Discounts
To learn more about Maine discounts click on the following links:
Discounts vary by state, county, and insurance providers so give us a call to review options in your area.
Medigap Under 65
Disabled Medicare beneficiaries who enroll in Medicare Part B before turning 65 have an initial Medicare Supplement open enrollment period at that time. Additionally, they get an extra six-month Medicare Supplement open enrollment period when they reach age 65. Learn more here.
Next Step
Take action now and obtain a Medigap quote for Maine by contacting our licensed agents at 800-930-7956. It’s as simple as making a call!
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