The Cheapest Maine Health Insurance for Individuals and Families
The cost of health insurance in Maine is determined by what medical expenses you need to be covered. There are four metal tiers available in the state’s health insurance marketplace. At an average cost of $489 per month, Silver-tier plans tend to best balance low-cost premiums and comprehensive coverage. The most affordable Silver plan in Maine is Maine’s Choice Plus HMO Silver 6500, provided by Harvard Pilgrim Health Care. The average monthly rate for this plan is $414.
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Some people get their health insurance through their employers or a government program, like Medicare or Medicaid. If you aren’t eligible for these options, you can obtain coverage by purchasing a private plan on your state’s insurance exchange.
When looking for the best health insurance in Maine, it’s important to consider both coverage and cost. The most affordable options may have cheap monthly premiums, but these plans also tend to include higher deductibles and out-of-pocket maximums. MoneyGeek found the best health insurance plans for Maine residents of different ages and for various plan types to help you find coverage for your needs.
The Cheapest Health Insurance in Maine by Metal Tier
The cost of health insurance in Maine is based on the metal-tier plan you choose. The Maine Healthcare Exchange currently offers Catastrophic, Expanded Bronze, Silver and Gold tiers.
While Catastrophic and Bronze tiers tend to have the lowest premiums, they also have higher deductibles and out-of-pocket maximums, meaning you’ll pay more for any medical care you need. So, if you want lower out-of-pocket expenses, a higher-tier plan with higher monthly premiums — like Silver or Gold — may suit your needs better.
The average rates for each metal tier are:
- Catastrophic: $250 per month
- Expanded Bronze: $391 per month
- Silver: $489 per month
- Gold: $550 per month
Maine residents who typically have many medical costs may find that a Gold plan is cheaper for them in the long run. Despite having more expensive monthly premiums, you’ll have lower out-of-pocket expenses.
Factors such as the premium, deductible and out-of-pocket max vary significantly within each metal tier in the Maine marketplace. Find the cheapest plan for each metal tier in the table below.
Individuals with low income may be eligible for cost-sharing reductions (CSR). If you qualify, you’ll have access to lower premiums for Silver plans. In some cases, your monthly costs may be as low as those associated with an Expanded Bronze or Catastrophic plan for Silver-tier coverage.
Rates listed in the table are based on plans for a sample 40-year-old male for all plan types available in Maine, including HMO, PPO and POS. The most common plan type in the state is HMO.
Cheapest Health Insurance in Maine by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- CatastrophicAnthem Catastrophic X HMO 8550Anthem Blue Cross and Blue Shield$218$8,550
- Expanded BronzeAnthem Bronze X HMO 7800Anthem Blue Cross and Blue Shield$332$8,550
- SilverMaine's Choice Plus HMO Silver 6500Harvard Pilgrim Health Care$414$7,800
- GoldAnthem Gold X HMO 2000Anthem Blue Cross and Blue Shield$471$8,550
The Cheapest Health Insurance in Maine by Age and Metal Tier
Data from the insurance marketplace shows that age affects the cost of health insurance in Maine. For example, the average price of a Silver plan for a 26-year-old is $392 per month. A 60-year-old pays $1,038 for a similar policy.
Health Insurance Costs in Maine by Age and Metal Tier
These insurance prices are average rates based on sample ages. Other individualized factors, like income, were not taken into account. In some cases, older people may find cheaper health insurance in Maine for an individual because of tax premiums and other regulations. You won’t be able to determine your exact quote until you apply for a plan.
Use the table below to compare rates across metal tiers and ages. To learn more about metal tiers in the state and how to choose the best option for your needs, read MoneyGeek’s guide on health insurance in Maine.
Cheapest Health Insurance in Maine by Age And Metal Tier
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- PlanCompanyMonthly Rate
- CatastrophicHMOAnthem Blue Cross and Blue Shield$155
- CatastrophicHMOHarvard Pilgrim Health Care$177
- CatastrophicPPOCommunity Health Options$191
- CatastrophicPOSAnthem Blue Cross and Blue Shield$193
- Expanded BronzeHMOAnthem Blue Cross and Blue Shield$237
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The Cheapest Health Insurance in Maine by County
Where you live in Maine can affect the cost of your health insurance. Maine is divided into different rating areas, and each calculates health insurance premiums differently.
Maine has 16 counties broken into four rating areas. In Cumberland, the most populous county in the state, the cheapest health insurance plan is Maine’s Choice Plus HMO Silver 6500 at $392 per month. It’s offered by Harvard Pilgrim Health Care.
Use the table below to find the cheapest plans in your county for every metal tier.
All rates included above are for a sample 40-year-old male looking for a health insurance plan in that county.
Cheapest Health Insurance Plans in Maine by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- CumberlandCatastrophicAnthem Blue Cross and Blue ShieldAnthem Catastrophic X HMO 8550$206
- SagadahocCatastrophicAnthem Blue Cross and Blue ShieldAnthem Catastrophic X HMO 8550$206
- YorkCatastrophicAnthem Blue Cross and Blue ShieldAnthem Catastrophic X HMO 8550$206
- KnoxCatastrophicAnthem Blue Cross and Blue ShieldAnthem Catastrophic X HMO 8550$219
- KennebecCatastrophicAnthem Blue Cross and Blue ShieldAnthem Catastrophic X HMO 8550$219
The Cheapest Health Insurance in Maine With High Out-of-Pocket Maxes
Younger Maine residents may opt for low-cost plans with high out-of-pocket maxes, especially if they’re in good health and don’t go to the doctor’s office often. However, keep in mind that while cheap health insurance in Maine can help you save on monthly premiums, you’ll pay more for any medical services you need.
For a plan with high out-of-pocket maxes, the most affordable option in Maine is Anthem Catastrophic X HMO 8550 offered by Anthem Blue Cross and Blue Shield. The average monthly rate of this plan for a 26-year-old is $174.
MoneyGeek defines a high out-of-pocket max as a plan with maximum out-of-pocket expenses of $8,250 or higher.
Anthem Blue Cross and Blue Shield
The cheapest plan in Maine for high out-of-pocket maxes is the Anthem Catastrophic X HMO 8550 plan from Anthem Blue Cross and Blue Shield. This policy falls under the Catastrophic tier, which is only available for people eligible for a hardship or affordability exemption or under 30.
The Cheapest Health Insurance in Maine With Low Out-of-Pocket Maximums
For individuals expecting to have higher medical costs, the best health insurance in Maine may cost more per month. These plans typically have more expensive monthly premiums but lower out-of-pocket maximums. Since you’ll visit the doctor’s office or fill prescriptions regularly, you’ll reach your maximum limit relatively quickly, and your insurance carrier will start covering your health expenses sooner.
The most affordable option for a low out-of-pocket max plan is Maine’s Choice Plus HMO Gold 1200 from Harvard Pilgrim Health Care. This plan costs the average 40-year-old $498 per month.
MoneyGeek typically defines a low out-of-pocket max plan as any policy with max-out-of-pocket costs of $4,250 or less. However, Maine doesn’t have any plans below this threshold. Maine’s Choice Plus HMO Gold 1200, the plan with the lowest out-of-pocket max and most affordable premiums, has a maximum out-of-pocket rate of $5,800.
Harvard Pilgrim Health Care
Harvard Pilgrim Health Care offers the lowest out-of-pocket maximums of any healthcare provider on the Maine insurance marketplace. This plan is in the Gold tier, meaning that monthly premiums can be fairly expensive. That said, you can also expect more covered expenses if you need routine medical care.
Cheapest HMO/PPO/POS Health Insurance Plan in Maine
Your healthcare needs and preferences are among the most important determining factors when choosing what type of insurance plan to buy. Health Maintenance Organization (HMO) plans are the most common plan type in the state. Preferred Provider Organization (PPO) and Point-of-Service (POS) plans are also available.
HMO policies tend to be the cheapest among all plan types. If you choose this, keep in mind that you’ll need to stay within your provider network to have services covered. You’ll also need a referral to see a specialist. On the other hand, PPO policies are a bit more expensive than HMOs, but they have a wider network of providers. POS plans give policyholders coverage both in and out of network. However, the cost for out-of-network coverage is higher.
The most affordable plans for each type are:
Cheapest HMO Silver Plan: Maine’s Choice Plus HMO Silver 6500 provided by Harvard Pilgrim Health Care at $414 per month, on average.
Cheapest PPO Silver Plan: Community Preferred from Community Health Options at a monthly average cost of $491.
Cheapest POS Silver Plan: Anthem Silver X POS 5900 provided by Anthem Blue Cross and Blue Shield costs an average of $517 per month.
Cheapest Plan in Maine With an HSA
Another option for Maine residents is a plan with a Health Savings Account (HSA). These usually appeal to healthy individuals who don’t expect to visit the doctor’s office often. Insurance plans with HSAs tend to be cheaper. They also allow you to make pre-tax contributions you can use toward your health expenses. If you end up not using the money for medical expenses, you can save it.
The cheapest health insurance in Maine with an HSA varies depending on the metal tier. For all available metal tiers in the state, the most affordable plans with an HSA are:
- Cheapest HSA Expanded Bronze Plan: Anthem Bronze X HMO 6700 for HSA plan provided by Anthem Blue Cross and Blue Shield at $332 per month, on average.
- Cheapest HSA Silver Plan: Community Core HSA plan from Community Health Options for $502 per month, on average.
These plans have high deductibles, meaning you may have to pay any major medical expenses with your savings.
What to Know About Health Insurance in Maine
For this analysis, MoneyGeek used average rates based on private plan data from Maine marketplaces. Actual costs may be different, and you may find even cheaper rates when you apply for a plan. Lower-income and older Maine residents may be eligible for Medicaid or Medicare, government programs that are likely to be more affordable than Marketplace options.
Private Health Insurance on the Maine Marketplace
Private health insurance plans in the Maine healthcare marketplace are broken into four metal tiers. These include:
Catastrophic: Catastrophic plans tend to be the cheapest among all metal tiers. Policyholders with these plans pay less on monthly premiums. However, their deductibles and out-of-pocket expenses are higher. Only those who are younger than 30 or facing economic hardships qualify for Catastrophic plans.
Expanded Bronze: Expanded Bronze is the most affordable option for Maine residents who don’t qualify for a Catastrophic plan. It usually has slightly more expensive premiums than Catastrophic coverage, and its out-of-pocket expenses are higher than those associated with Silver and Gold policies.
Silver: Among all metal tiers, Silver tends to offer the best balance between premium costs and coverage. This tier falls between the cheapest and most expensive options. While it has higher premiums than Catastrophic and Expanded Bronze, it’s cheaper than Gold.
Gold: This is the most expensive among all metal tiers in Maine in terms of monthly rates. However, Gold plans provide the most coverage and lowest out-of-pocket expenses. These policies are best for people who regularly visit the doctor or need major medical coverage.
You may find cheaper plans and higher coverage based on your income. Residents earning between 100% and 400% of the federal poverty level are eligible to apply for premium tax credits. For instance, a two-person household with an income ranging between $17,420 and $69,680 qualifies for tax credits in Maine. Use the Healthcare.gov calculator to find out more.
Open enrollment is when individuals can enroll in a new policy or change an existing plan through the Healthcare Marketplace. It’s usually from November to December. However, the government expanded the period due to COVID-19.
Low-income residents who earn 138%–250% of the federal poverty level can get cost-sharing reductions when buying a Silver plan. That means lower deductibles, copayments or coinsurance, and out-of-pocket maximums. In some cases, an eligible individual may get a Gold plan for the price of a Silver plan.
Medicaid in Maine
If you are eligible for Medicaid, your health insurance is free. Maine adopted Medicaid expansion, meaning that you can qualify for the program based on your income. If you earn below 138% of the federal poverty level, you can apply for Medicaid.
Medicare in Maine
Medicare is another form of government-provided healthcare. Unlike Medicaid, Medicare comes with expenses for some coverage. That said, it is still a more affordable option compared to private plans. You are eligible for Medicare if you are 65 or older or have a qualifying disability or illness.
There are three parts of Medicare:
- Part A: Covers inpatient hospital stays, hospice care, nursing facility care, and some home health care services. This part of Medicare is free.
- Part B: This is your medical insurance, which covers some doctor’s appointments, outpatient care, necessary medical supplies and preventive services. Premium costs may vary depending on your income.
- Part D: This is known as prescription drug coverage. Coverage includes the cost of prescription drugs and recommended vaccines. How much this portion costs is based on the plan you choose.
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in Maine for you
MoneyGeek collected plans and premiums for health insurance in Maine from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
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