Health Insurance Coverage

Our staff are certified assisters (MEAs & CACs) who offer in-person and phone counseling to help you enroll in the Health Insurance Marketplace/ACA plans. Typically, 85% of Mainers receive financial assistance to make the plans more affordable.

Open Enrollment is November 1 to January 15 each year. If you want coverage to start on January 1st, you must enroll by December 15th. You may be eligible for a Special Enrollment Period during the year if you have a qualifying life event (losing health coverage, moving, getting married, having a baby, or adopting a child). For more information see the Health Insurance Marketplace or email us at getcoverage@mainehealth.org.

How will it help me?

• Medicaid/MaineCare is health insurance for Mainers with limited income. It pays for the care you get when you go to the doctor for a yearly wellness visit or when you are sick. It can also help with prescription drug costs.
• If you have kids, it also covers their dental and vision care.
• Medicaid/MaineCare is free, and most services are covered for free or a small copayment.

How do I know if I am eligible?

• To qualify for Medicaid/MaineCare, your family income must be below a certain level (it also depends on how many people live with you). Call us to find out if you qualify!
• If you think your income is too high, call us anyway. There are other programs that you or your family members may be able to access. We can help you figure that out. 

Medicare Savings Program

This is a program for people with Medicare who have limited income. The Medicare Savings Program pays your Medicare Part B monthly premium, covers Medicare deductibles and co-pays, and reduces your prescription drug out-of-pocket costs.

MaineCare Limited Benefit

MaineCare’s Limited Benefit covers yearly physicals, all types of birth control, and many reproductive/sexual health care services. This benefit is unique in that it has a higher eligibility income threshold and only counts your individual income (spousal income is not counted) to qualify.

Private Health Insurance Premium

To qualify for the Private Health Insurance Premium, someone in the household, usually a child, meets the eligibility requirements for Medicaid/MaineCare and their parent(s) has health insurance through an employer. With the Private Health Insurance Premium, Medicaid/MaineCare becomes secondary insurance coverage to the employer coverage and pays the portion of health care costs that the employer coverage does not cover. It also reimburses parent(s) for the monthly cost of their employer coverage.