Medicare Supplement Plans in Maine

Medicare Supplement plans in Maine cover some medical expenses not paid by Original Medicare (Part A and Part B). After Medicare pays 80% of the approved amount on a claim, you are responsible for the following out-of-pocket costs:

Medigap policies are designated by a letter:

  • Each letter offers the same benefits regardless of the Medigap insurance company selling the policy.
  • Benefits differ between plans.
  • Plan options depend on when you are first eligible for Medicare benefits.
  • Seniors eligible before Jan. 1, 2020, can choose from 10 plans: Plans A, B, C, D, F, G, K, L, M, and N.
  • Seniors eligible starting Jan. 1, 2020, can choose from eight plans: Plans A, B, D, G, K, L, M, and N.

You might also have to pay other costs, such as Part B excess charges, if you see a doctor who does not participate in Medicare or expenses related to a foreign travel emergency when traveling abroad. Medicare Supplement plans in Maine pay for some or all of these costs and help you curb high medical expenses.

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Medicare Supplement Plan G

  • Medigap Plan G offers the highest benefit level for those with Medicare effective date Jan. 1, 2020, and after
  • It covers everything except the Part B deductible.
  • Lower premiums compared to Plan F outweigh the cost of paying the deductible.

Medicare Supplement Plan N

  • Medigap Plan N has copays: $20 office visit, $50 ER
  • ER copay waived if you are admitted
  • Much lower premiums than Plans F or G due to higher cost-share

High Deductible Medigap Plan G

  • Requires annual deductible ($2,490 in 2022) to be met before coverage starting
  • Significantly lower-priced than the original Plan G
  • Lower premiums can offset the cost of the deductible
  • Substantially lower premiums than High Deductible Plan F

Medicare Supplement Plan F

  • Highest benefit level
  • Medigap Plan F covers all of the Medicare coverage gaps
  • Must have a Medicare start date before Jan. 1, 2020

Medicare Supplement Insurance cost in Maine

The cost for a Medigap plan in Maine depends on the plan, the age of the beneficiary, and the location. Here are sample costs for a 65-year-old nonsmoker in Maine zip code 04240 (Lewiston):

65-Year Old Female Non-tobacco

Plan F $239.12 - $323.83

Plan G $206.25 - $318.54

Plan N $168.85 - $216.30

When can I apply for a Medicare Supplement plan?

When you first sign up for Medicare Part B, you have a six-month Medigap Open Enrollment Period. Most beneficiaries enroll in Part B when they turn 65 and enroll in Social Security. However, if you are still working, you might choose to delay enrolling in Part B.

In Maine, individuals under 65 also have an Open Enrollment Period when they first enroll in Part B. Then, they have another Open Enrollment Period when they turn 65.

Joining a Medigap plan in Maine during open enrollment is preferred because you have guaranteed issue rights:

  • The insurer must provide coverage for the plan you choose.
  • The insurance company must cover pre-existing conditions.
  • Carriers cannot charge you more because of your health condition.

Outside open enrollment

Maine Medicare beneficiaries have a few other opportunities to join a supplement plan outside of open enrollment and still have guaranteed issue rights:

  • Each Medicare insurance company must designate one month each year when it will accept registration in Plan A. Plan A only covers the primary benefits:
  • Part A coinsurance
  • Part B coinsurance (after meeting the deductible)
  • First 3 pints of blood
  • Hospice care coinsurance
  • If you lose coverage for one of the following health plans and apply for a Medicare Supplement insurance plan within 90 days: Individual health plan, Group health coverage, MaineCare
  • If you change to another supplement plan that has equal or lesser benefits: Can keep the same insurer or switch carriers,
  • You must not have had more than a 90-day gap in supplemental coverage since your Open Enrollment Period.

Medicare Advantage

You will also have guaranteed issues in some situations regarding Medicare Advantage:

  • You switch from Medicare Advantage to Original Medicare within three years after open enrollment (You must buy the supplement plan within 90 days after your Advantage plan ends.)
  • Your Advantage plan is terminated through no fault of yours
  • You enroll in a Medicare Supplement plan, disenroll to join Medicare Advantage, and then return to Original Medicare within three years (You must buy a supplement plan with equivalent or lesser coverage.)

Guaranteed issue can be complicated. However, our licensed insurance agents can provide you with specific information about your situation.

FAQ:

When can I change Medigap plans?

Unlike Advantage and Medicare Part D plans, there is no annual election period where you can change your Medicare Supplement plan and be guaranteed coverage. However, you can submit a switch in plans; it will be subject to underwriting and could have a higher premium. Maine law does provide guaranteed issue rights in limited situations where you can change plans.

Can I be denied Medigap coverage?

Coverage is guaranteed if you join during your Open Enrollment Period or qualify for special enrollment. Otherwise, private insurance companies can deny coverage or charge you more.

Ready to Learn More?

We help educate Medicare beneficiaries on their Medigap options and help them go through the process of reviewing and comparing plans. We work with most of the nation's top-rated Medigap carriers, such as Aetna, Cigna, Mutual of Omaha, and Florida Blue Medicare plans. So give us a call or request a quote online to learn more about Aetna Medicare Supplement plan G and Mutual of Omaha Medicare Supplement plan G in your state. We educate you on the best Medicare Plans for your situation, then let you decide.

Key Takeaways

  • Medicare Supplement insurance, also called Medigap insurance, is extra health care insurance that adds to your Medicare coverage. It pays for costs such as Part A deductible and Part A and B coinsurance. Private health insurance companies sell Medigap policies in Maine.
  • There are 10 Medicare Supplement plans in Maine to choose from.
  • In Maine, Medicare Supplement Plan G is the most popular plan for 2022.
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