Medicare Advantage Plans in Maine

Also referred to as Medicare Part C, Medicare Advantage plans in Maine are designed to add to the benefits you receive from Original Medicare, including inpatient hospital stays outpatient care and medical supplies. When you choose a Medicare Advantage plan, the insurance provider you select will take care of all administration services, claims, and customer service. To join a Medicare Advantage plan, Medicare beneficiaries must pay their Part B premium.

The essential components of a Medicare Advantage plan include:

  • These plans have been increasing in popularity over the past decade
  • An insurance company provides your benefits
  • The plan you sign up for and the benefits you obtain from the plan are associated with a network of hospitals, doctors, and other medical facilities
  • When a plan is designated as an “MAPD” plan, this refers to Medicare Advantage Prescription Drug plans that can provide coverage for prescription drugs
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Top-rated Medicare Advantage Providers in Maine

  • Aetna: A handful of Aetna’s Medicare HMOs have earned the highest star ratings for quality in the state in past years.
  • Martin’s Point: This isn’t a national insurer, but they account for 46 percent of the state’s enrollment in Medicare Advantage plans. The insurer has provided some HMO-POS and HMO-SNP plans with high star ratings.
  • Other notable companies to look for in your area are Humana and Cigna.

Popular Medicare Advantage Plan Types in Maine

Best Network Freedom: Medicare Advantage PPO

  • The monthly premiums for a PPO plan can be anywhere from $0-$100 each month
  • Primary PPO benefits include no need for referrals and access to an extensive network

Best for Lowest Out-of-Pocket: Medicare Advantage HMO Plan

  • Your HMO monthly premiums should be around $0
  • Your out-of-pocket costs will be lower since you’re using a referral network

Best for Low Income or Health Conditions: Medicare Advantage D-SNP

  • If you are currently suffering from chronic health problems or have limited income, D-SNP (dual eligible special needs plan) is a plan specifically designed to accommodate these issues
  • Possible to have Medicaid and Medicare at once, which reduces out-of-pocket expenses for deductibles, coinsurance, monthly premiums, and copays

Maine Enrollment Facts:

Number of people enrolled in a Maine Medicare Advantage plan – 100,278

Number of members for each type of Medicare Advantage plan –

  • Local HMO – 57,612
  • Local PPO – 37,748
  • Regional PPO – 1,017

Percentage of Medicare Advantage members in Maine – 30%

Number of members enrolled in Medicare Advantage throughout the U.S. – 19,838,319

How much does Medicare Advantage in Maine cost?

You’ll discover that most states offer HMO plans with monthly premiums of $0. Although rare, PPO plans may also have $0 monthly premiums. The average premium for Maine Medicare Advantage plans is $25.41.

How much do Advantage Plans cost in Idaho?

PPO Plan $0.00 to $25.42

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

You could have access to six enrollment periods if you want to enroll in a Medicare Advantage plan in Maine.

Initial Enrollment Period

  • This enrollment period is available for seven months, which begins three months before your birthday month and concludes three months following your birthday month
  • You can enroll in Medicare Part C after enrolling in Part B
  • This enrollment period is specifically open for new Original Medicare beneficiaries, during which you can choose a Medicare Advantage plan.

Annual Election Period (AEP)

It runs from October 15 until December 7.

This is the Annual Election Period, during which people enrolled in one plan can sign up for another. You can switch back to Original Medicare from your current Medicare Advantage plan, add prescription drug coverage to Original Medicare via a Part D plan, or switch from one Medicare Advantage plan to another. Keep in mind that Original Medicare includes Medicare Part A and Part B.

Medicare Advantage Open Enrollment Period

It runs from January 1 to March 31.

You can choose to switch from one Maine Medicare Advantage plan to another this time. If you switch from Medicare Advantage back to Original Medicare, you could add to your Medicare coverage with a Part D plan.

Special Enrollment Periods – Special Circumstances

The circumstance determines when you can enroll.

The primary special circumstances include:

  • Losing coverage with an employer plan or Medicaid
  • The plan you’re enrolled in is ending its current contract with Medicare
  • Moving to a new area in Maine that offers other coverage options

5-Star Special Enrollment Period

It runs from December 8 until November 30.

You can change your Medicare Cost Plan, Medicare Advantage Plan, or Part D plan to another health insurance plan that has a five-star rating. Performance assessments and member feedback play a role in these health plans' ratings.

Special Enrollment Periods if You Get “Extra Help”

The reason you qualify for this program will determine when you can enroll. Qualifying for this enrollment period is possible if you are:

  • Eligible for both Medicaid and Medicare
  • Currently enrolled in or about to lose eligibility for an SPAP plan
  • Eligible for drug plan assistance

The special enrollment period typically occurs from January-March, April-June, and July-September.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Give us a call today, or request a quote online to learn more about plan options.

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