Maine Health Insurance

Maine has more insurance regulations than most states. It's hard to know the details of every law, so we've outlined the most important ones. Familiarize yourself with them so your rights should the need to exercise them ever arise.

This guide:

  • Describes important Maine health insurance policy regulations.

  • Lists rules Maine health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. Maine health insurance companies and policyholders alike must abide by established insurance laws.

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Maine health insurance policy provisions

Some of the most important Maine health insurance laws are the ones that influence the health insurance policy specifically. These health insurance laws are pretty restrictive and mostly benefit you.

First, a guaranteed renewability provision is included in every policy issued in Maine. This provision states that as long as premiums have been met, your health insurance company cannot deny you continued coverage.

Second, Maine health insurance policies can include a exclusion period for pre-existing conditions, but there are limitations. The definition of a pre-existing condition varies from state to state. In Maine, it refers to a condition you have received medical treatment for or were diagnosed with in the 12 months before your plan starts.

If you switch Maine health insurance companies, you can avoid having a second exclusion period imposed by making sure your health insurance coverage is continuous. If you have no break in between policies, your old coverage credits your new plan's exclusion period.

Regulating Maine health insurance companies

Understanding the laws limiting Maine health insurance companies is especially important in making sure your health insurance company continues to honor your original contract. Maine health insurance companies are more strictly regulated than most states.

For instance, Maine health insurance companies cannot deny your application for health insurance because of your health, your age or your risk to them. Additionally, your policy cannot cost more because of your gender or health. However, family size, age, and demographics can all affect your cost.

Also, as stated earlier, Maine health insurance companies must honor your request to renew your existing health insurance policy each year as long as you have done nothing to jeopardize the contract.

Finally, and most importantly, Maine health insurance companies must offer you the option of buying one of two state standardized health insurance policies in addition to any other available Maine health insurance policies they may be offering.

With these regulations in effect you, as a consumer, have less to worry about during your search for a good health insurance policy. Still, its good to know when Maine health insurance laws start to exercise control.

More ME health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to Maine small business health insurance.


To find out more about ME health insurance laws and regulations, visit the official website of the Maine Department of Professional and Financial Regulation, Bureau of Insurance.