In Maine, your ability to buy individual health coverage may depend on your health status. There are certain circumstances, however, when you must be allowed to buy individual health coverage. In general, companies that sell individual health insurance in Maine are free to turn you down because of your health status and other factors. When applying for individual coverage, you may be asked questions about health conditions you have now or had in the past. Depending on your health status, insurers might refuse to sell you coverage or offer to sell you a policy that has special limitations on what it covers.
If you have had at least 3 months of coverage under a fully insured group health plan and then lose it, you are guaranteed the right to buy a conversion policy. You will not have a new pre-existing condition exclusion period. If you are federally eligible but do not qualify for a conversion policy, you are guaranteed the right to buy an individual health plan from any insurance company that sells such plans in Maine. Insurance companies must offer you a choice of at least two plans.
Health insurers can design different policies and you will have to read and compare them carefully. However, Maine does require all health plans to cover certain benefits – such as childhood immunizations. Check with the Maine Department of Insurance for more information about mandated benefits. If you have an expensive health condition, your individual health insurance premiums may be very high. The law does not prohibit Maine health insurers from charging you more because of your health status, age, gender, and other case characteristics. In addition, when you renew your individual coverage, your premiums can increase substantially as you age.
Health Maintenance Organizations (HMO)
A HMO is the least expensive type of individual health insurance. However, you have to give up some flexibility with HMO health insurance. In order to receive medical services at a discounted rate, you need to use the primary care doctors, specialists, hospitals, etc. included in the Maine HMO health insurance plan’s network; if you use a provider that isn’t in their network, you’ll have to pay full price. Also, you will generally have to see your primary care physician for non-emergency referrals to a specialist. Some HMO networks are larger than others.
VitalOne can help you when buying individual health insurance by comparing the coverage and rates of various health maintenance organization plans.
Preferred Provider Organizations (PPO Plan)
PPO individual health insurance plans are similar to HMOs. There is a comprehensive health care network of medical providers throughout Maine that are covered by the PPO plan, and going outside the network is reimbursed at a far lower rate. The main difference between the two types of individual health insurance is that a preferred provider organization offers you more choice. Selecting a primary care physician isn’t required, and you can visit a specialist without a referral. In general, co-payments are higher than other managed care health insurance for individuals. Some PPO plans also make you pay a deductible. Still, PPOs can be a great way to get affordable individual health insurance with greater freedom.
At VitalOne, we can provide you with individual health insurance quotes from multiple providers.
Point of Service Plans (POS)
A point of service plan is a cross between a HMO and a PPO. Similar to a HMO Maine health insurance plan, you must first select a primary care doctor from their Sitxons network. Your primary care physician can then give you referrals to any specialist, whether or not they are inside the network. POS plans, like PPOs, allow you the freedom to see any medical provider you want. However, going outside the network will cost you more out-of-pocket. In addition, receiving out-of-network health care makes you responsible for keeping track of and submitting paperwork to get reimbursed by your personal health insurance at the lower rate. Point of service plans are usually cheaper than PPO plans, since they force you to give up some control.
In some ways, POS plans are the best of both worlds when it comes to health insurance for individuals. Wondering if a POS plan is right for you? VitalOne has an individual health insurance quote for almost any POS provider in Maine. They can help you decide which individual health insurance plan is appropriate.
Health Savings Accounts (HSA)
Health savings accounts have become increasingly popular in Maine in recent years. HSA plans transfer more of the control and responsibility for your individual health insurance plan to you, as opposed to managed care plans. Pre-tax dollars are deposited into an HSA plan, which can then be used to buy qualified medical products and services. Approved expenses include doctor visits, hospitalization, and both prescription and over-the-counter medications. This type of individual health insurance can save you money when compared to paying for these things with your taxable income.
HSAs are typically partnered with a high deductible individual health insurance plan. The individual health insurance premiums are lower with these plans, since the deductibles can cost several thousand dollars per year. This is because the tax-exempt health savings account is intended to cover most minor and moderate medical expenses. HSA individual health insurance is best for young and healthy Maine residents; their increased out of pocket expenses will most likely be less than their savings on premiums. Ask VitalOne to help you select the best health savings account and high-deductible individual health insurance plan for you.
Guaranteed Issue Health Insurance
If you have a pre-existing medical condition, you may think that buying individual health insurance in Maine is impossible. Guaranteed issue individual health insurance plans may be the solution for you. This type of insurance is required to cover anyone who applies, regardless of health status. People with cancer, diabetes, high blood pressure, or currently pregnant are among those who can benefit from buying individual health insurance with pre-existing conditions. Premiums are typically more expensive, since for-profit individual health insurance providers do not want to cover someone who is already sick. However, VitalOne can still help you find affordable individual health insurance.
Guaranteed issue individual health insurance plans are available in Maine. They allow you to take advantage of comprehensive PPO networks like Multiplan, which saves you money when you use in-network health care providers at lower rates. Compare guaranteed issue individual health insurance quotes with us today.
Life Insurance
Life insurance allows you to care for your family after you’re gone. It pays out a specified lump sum upon an individual’s death. The main types of life insurance are term life, whole life, variable life, and universal life. Term life insurance is the most affordable; it includes coverage for a set time period, usually anywhere from one to 30 years. Face value amounts for term life insurance policies sold in Maine begin at $5,000 and can reach millions of dollars.
How much life insurance do you need? Several factors should be taken into consideration. A life insurance policy should cover at least several years of your annual income. Higher incomes mean greater impact on your loved ones’ financial well-being after they stop coming in. If you have many outstanding debts, including mortgages or loans, you may also want to take those into account when deciding on the amount of your life insurance policy. It is also important that the monthly premiums for your life insurance policy are affordable. VitalOne is there for you during this complex process. Our licensed Maine insurance brokers can help you select the right life insurance plan for your needs.
Critical Illness Insurance
Critical illness insurance pays you a lump sum if you experience a major medical condition covered in the policy. Diseases, surgeries, and injuries included in typical critical illness insurance policies range from cancer (whether or not it has spread), heart attacks, organ transplants and strokes to severe burns, paraplegia, blindness, or deafness. Sometimes, affordable Maine health insurance doesn’t pay for all of the costs associated with a critical illness. For example, patients are sometimes transported to distant hospitals that specialize in certain types of treatment. The payout you receive from critical health insurance could pay for your family and friends to stay with you during your hospitalization. The money can also be used for mortgage payments, or anything else that would help reduce stress and allow you to focus on your recovery.
Several conditions can be bundled together in one individual critical illness insurance policy. A certain percentage of the coverage can be paid out upon initial diagnosis, while more can be paid in the case of a recurrence or developing another condition. The younger you are, the more affordable critical illness insurance is. You also need to be careful to know what conditions are excluded, and how long the waiting period before receiving payment is. Similar to buying a life insurance policy, the amount of coverage you get depends your income and outstanding debts. VitalOne can help you decide which critical illness insurance policy is right for you.
Accident Insurance
There are two main types of accident insurance available in Maine: accidental death and accidental death and dismemberment (AD&D). The former is similar to life insurance, except that it only covers a person’s death that directly results from an accident (such as a car crash) as opposed to health-related deaths. On the other hand, AD&D coverage also pays out upon serious injuries that are specified in the policy. Individual accident insurance is available in higher amounts for a lower cost than standard life insurance because there is a smaller chance that you will die or be severely injured from an accident; therefore, insurance companies can afford to pay several times what you would expect. However, you must be extremely careful when selecting a policy; they do not apply to any medical illnesses, drug overdoses, surgical errors that cause your death.
Accidental death insurance are meant to cover the higher cost resulting from a sudden death, including funeral expenses and emergency medical costs. Accidental death and dismemberment insurance normally pays out 50% of the policy upon losing one member (limb, hand, foot, or eyesight in one eye), with the full payout given upon an individual losing two members. The money will help pay for medical care and accommodations needed after the accident. Accident insurance can be purchased on its own, or as a rider added to any individual health insurance or life insurance policy. VitalOne can explain the benefits and limitations of accident insurance policies and help you decide if an accident insurance plan is best for you.
