Information about Medicare Advantage Plans in Maine

Quick links:

• Average 2019 Costs
• Eligibility & Enrollment
• Finding Top-Rated Plans
• List of Plans Available
  • Plans by Carrier
  • Plans by County
  • Plans by Type
• Local Resources

33 percent of Medicare beneficiaries in Maine were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.¹

There are 310 different Maine Medicare Advantage plans in 2019.¹

A licensed insurance agent can help you compare the availability, benefits and costs of Medicare Advantage plans in your area of Maine. Read below to learn more about Medicare in your state.

Average costs of Medicare Advantage in Maine

The average monthly premium paid by a Medicare Advantage beneficiary in Maine was low in 2019, at $10 per month.

This weighted average was affected by the 140 available plans that feature $0 monthly premiums.

• Average monthly premium cost in 2019 (weighted): $10
• Average in-network out-of-pocket spending limit: $5,136
• Average deductible in 2019 (weighted): $111.23¹

The premiums and other costs of Medicare Advantage plans may vary depending on where you live and the plan you have.

Refer to the chart included lower in this guide to view the 2019 average Maine Medicare Advantage plan premiums listed by county.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Medicare Eligibility & Enrollment

Before you’ll be able to sign up for a Medicare Advantage plan in Maine, you’ll need to enroll in Original Medicare (Medicare Part A and Part B).

In order to sign up for Medicare at age 65, you must meet the following requirements:

• You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.
  
  
• You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.
  
  
• You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible for Medicare before age 65 if:

• You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
  
  
• You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).
  
  
• You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

You may not qualify for most Medicare Advantage plans if you have ESRD. You may be able to enroll in a Maine Medicare Special Needs Plan (SNP), however, that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Maine

Your first opportunity to enroll in a Maine Medicare Part C plan is typically during your Medicare Initial Enrollment Period (IEP).

Your seven-month Medicare IEP begins three months before you turn 65, includes the month of your birthday and continues for three more months after your birthday.

Once your IEP ends, you may be able to sign up for a Medicare Advantage plan during one of the following enrollment periods:

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you're already enrolled in a Part C plan, you may switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare from January 1 to March 31 every year.

If you return to Original Medicare during this period, you'll be able to join a Medicare standalone prescription drug plan (Medicare Part D).

Medicare Annual Enrollment Period (AEP): October 15 – December 7

You may be able to enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another from January 1 to March 31 every year, 

This period is sometimes also referred to as the Annual Election Period. During AEP, you may also drop your existing Medicare Advantage plan and return to Original Medicare.

You may also join, switch or drop a Medicare Part D plan during Medicare AEP. 

Medicare Special Enrollment Periods (SEP)

You may qualify for a Medicare Special Enrollment Period (SEP) if you meet certain specific requirements. If you qualify for a Medicare SEP, it could potentially happen at any time during the year.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Maine 2020

Every year, the Centers for Medicare & Medicaid Services (CMS) issues Star Ratings for all Medicare Advantage plans. The Medicare Star Ratings use a system of one to five stars.²

If a Medicare Advantage plan has four or more stars out of five stars, it may be considered a top-rated plan for that year.

There are 223 top-rated 2019 Medicare Advantage plans in Maine that are rated four stars or higher, which is 72 percent of all MA plans in Maine in 2019.

Medicare Advantage plans are rated in the following five categories:

• Preventive care and health maintenance (screenings, tests, vaccines, etc.)
• Management of chronic conditions
• Member experiences and ratings of the plan
• Member complaints, problems receiving services and member retention
• Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in Maine in 2020

To view a list of plans offered in your area within Maine, use our plan comparison tool.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Maine

Depending on where you live in Maine, you may have access to one or more insurance carriers that may offer Medicare Advantage plans in your area.

Private insurance companies offer Medicare Advantage plans that are typically unique to the plan area they serve.

A licensed insurance agent can help you compare Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in Maine, you can also consider some of the following information:

• The Medicare Star Ratings can give you an idea of a plan’s overall quality.
  
  
• Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.
  
  
• Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.
  
  
• You can read through Medicare Advantage plan reviews and testimonials from customers.

Maine Medicare Advantage plans by county

The chart below provides some more information about 2019 Maine Medicare Advantage plans by county.¹

• Cumberland County had the highest number of Medicare Advantage plan enrollees in 2019.
  
  
• Androscoggin County had 14 $0 dollar premium plans in 2019, which was the most out of any county in Maine that year.

ME Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Maine Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.¹

The major types of Medicare Advantage plans include:

• Health Maintenance Organization (HMO) 
• Preferred Provider Organization (PPO)
• Private Fee-For-Service (PFFS)
• Special Needs Plan (SNP)

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Maine Medicare Advantage plans that are available where you live.

Local health insurance resources in Maine

• The State Health Insurance Assistance Program of Maine offers free health insurance counseling and assistance to Maine residents who have Medicare.
  
  The trained staff can help answer questions about benefits in order to help people better understand and optimize their Medicare coverage. The program may be reached at 877-353-3771 (or 800-750-5353 for TTY users). 
  
  
• You can also explore more information about the insurance industry in Maine by visiting the state’s Department of Insurance website.
  
  
• Maine Prescription Drug Assistance Programs
  The state of Maine has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

¹ MedicareAdvantage.com's The Best States for Medicare in 2021 report. (Oct. 27, 2020).

² Medicare evaluates plans based on a 5- star rating system.