Maine Medicare plans have special enrollment rules which are specific only to the state of Maine. All states follow federal requirements to give beneficiaries a 6-month Medigap open enrollment period when they first get Medicare Part B. However, Maine goes a step further.
State law requires that each insurance company offer Medigap Plan A for sale to anyone, regardless of health conditions, for one month each year. This “guaranteed-issue” period is determined by the insurance carrier. Each carrier gets to choose which month they want to assign this period to.
It’s important to understand that the carriers are not required to offer more comprehensive plans, like Medigap Plan F, during this one-month window.
Creditable Coverage for Maine Medicare Supplements
Another unique rule that is in place, in Maine, is that 90-day creditable coverage window. If you have never gone without Medicare supplemental coverage for more than 90 days, then the insurance companies must provide you a supplement policy if you apply for one. For this reason, it is advisable never to have any significant gaps in coverage.
Maine residents who have creditable coverage with no breaks longer than 90 days can change your Medigap policies as well. The beneficiary must move to a policy with equal or lesser benefits than the current policy.
For example, if you have Maine Medicare Supplement Plan F (the most comprehensive supplement), you could change to a Medicare Supplement Plan G or N, which have lesser benefits, or change to a different Plan F. In reverse, however, it’s different. When you apply to increase benefits, you need to pass the carrier’s medical health underwriting.
Switching from Medicare Advantage to Medigap in Maine
Some Medicare beneficiaries enroll in a Maine Medicare Advantage plan during their initial enrollment period for Medicare. These folks get an easy-out clause under limited circumstances. State law considers that initial enrollment a one-time trial period. During the next 36 months, the beneficiary can return to Original Medicare and get a guaranteed right to buy a Medigap plan. No health questions will be asked.
Likewise, a similar rule exists if you first enrolled in a Medigap plan, and then you terminate that plan to enroll in a Medicare Advantage plan. If you leave the Advantage plan within 36 months to return to Original Medicare, you will be given the right to buy another Medigap plan of equal or lesser benefits. You must still live in Maine. You must also apply for the new Medigap plan within the 90 days after you leave the Advantage plan.
Quotes for a Medicare Supplement in Maine
Need Medigap insurance rates in Maine? Several Maine Medicare plan companies offer competitive policies. It is in your best interest to research rates offered by each carrier before making your selection. Choosing a carrier is easier if you find out about each company’s financial ratings and a history of rates increases ahead of time.
For information like this about Maine Medicare plans contact a Boomer Benefits representative today for quotes and information. We have the knowledge you need to make an informed decision.