Maine Bureau of Insurance
The Maine Bureau of Insurance is responsible for regulating all types of insurance sold in the state of Maine - including health insurance policies.
If you are looking for health insurance coverage, the Bureau of Insurance can help you find an insurance agent or insurance company that is licensed to do business in Maine. You can contact them at the phone number listed below, or conduct your own search online.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Bureau of Insurance. Contact the Bureau of Insurance at the phone number listed below, or complete the online complaint form.
Maine Department of Professional & Financial Regulation
Bureau of Insurance
#34 State House Station
Augusta, ME 04333-0034
Phone: 800.300.5000 (toll free in Maine) or 207.624.8475
http://www.maine.gov/pfr/insurance/index.shtml
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees - for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage - for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan - contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Boston Regional Office
J.F.K. Building, Room 575
Boston, MA 02203
James Benages - Director
Tel 617.565.9600
Fax 617.565.9666
http://www.dol.gov/ebsa/
Buying Individual Policies in Maine
Insurers in Maine ARE NOT PERMITTED to reject your application for coverage based on your health status. However, they may impose a pre-existing condition exclusion period of up to twelve months upon those individuals who do not have prior continuous coverage.
"HIPAA-eligible" individuals are exempt from these pre-existing condition exclusion periods. You may be HIPAA-eligible if you:- had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
- you have exhausted all COBRA continuation coverage which was available to you.
If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Bureau of Insurance can help you find out.
Dirigo Choice Health Coverage
Dirigo Choice offers affordable coverage to small businesses, the self-employed, and other individuals. Insurance premium rates in Maine are higher than average, most likely because insurers are not permitted to reject applicants based on their health status. The state created Dirigo Choice to provide an affordable option for people who do not have access to job-based coverage and are ineligible for government assistance programs like Medicaid.
Dirigo Choice members receive discounts on their health coverage based on their income level. The coverage under Dirigo Choice is similar to what is available in the private market.
Dirigo Choice Health Coverage
Dirigo Health Agency
53 State House Station
Augusta, Maine 04333
Phone: 877.892.8391 (toll free in Maine only) or 207.287.9900 Fax: 207.287.9922
Email: DHA@Maine.gov
Maine State Health Insurance Assistance Program(SHIP)
SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the new Part D prescription drug benefit, or Medigap coverage.
Maine State Health Insurance Assistance Program
Phone: 877.353.3771 or 800.262.2232
http://www.maine.gov/dhhs/beas/hiap/purpose.htm
MaineCare
MaineCare is Maine's Medicaid program. Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about MaineCare program, including , contact MaineCare at the number listed below.
MaineCare
Phone: 207.624.7539 or 800.321.5557
http://www.maine.gov/bms/member.htm
