Best Health Insurance in Maine
Best Overall for Health Insurance in Maine
With a MoneyGeek rating of 68 out of 100, Harvard Pilgrim Health Care is Maine's top health insurance provider. This provider offers low claims denial rates and maximum out-of-pocket (MOOP) costs. This data translates to paying less when requiring health services and having fewer of your claims denied after the fact. These factors are crucial for a reliable insurer.
We evaluated 119 PPO and 441 HMO Silver health plans in Maine for our rankings in this category.
Low MOOP costs
Rarely denies claims
MoneyGeek found that Harvard Pilgrim Health Care is Maine’s best health insurance provider. It has the lowest MOOP cost of any provider we analyzed, at an average of $8,793. Its claims processing is efficient, and the company nearly never denies a claim that has passed its conditions. However, the biggest downside of this insurer is that it has one of the most expensive policies at an average of $504 per month.
Although Harvard Pilgrim Health Care doesn’t provide PPO plans, which typically have broader coverage, it offers the most HMO plans (210) among the insurers we surveyed. This variety gives you more options as a consumer.
MoneyGeek suggests the following plans from Harvard Pilgrim Health Care:
- Clear Choice Maine's Choice Plus HMO HSA Silver 3000: $475 per month ($7,000 MOOP)
- Clear Choice Maine's Choice Plus HMO Silver 5500: $455 per month ($8,500 MOOP)
Best Health Insurance in Maine for Low Out-of-Pocket Costs
Community Health Options is our top pick for health insurance providers offering low out-of-pocket expenses in Maine. This relatively affordable insurer provides low MOOP costs and rarely denies claims. These metrics point to a reliable company that ensures its policyholders have uncomplicated access to health care.
We evaluated Gold and Platinum plans for this category and discovered 85 available Gold HMO plans and 139 available Platinum PPO plans.
Low MOOP cost
Accepts most claims
Offers PPO plans
Relatively expensive premiums
Community Health Options Maine’s best health insurance company if you seek health insurance with low maximum out-of-pocket (MOOP) expenses. It offers Gold and Platinum PPO plans at an average premium of $570 per month and a MOOP cost of $4,667. While the MOOP cost is the lowest compared to any other provider, the trade-off is in the relatively expensive rates. These rates may be worth it if you want to minimize out-of-pocket costs and enjoy the benefits of a PPO, which typically includes a broader network of providers.
Additionally, the company approves the majority of insurance claims, so it's likely that your requests for coverage will be met without any unnecessary issues.
We recommend Community Health Options' following plan if you're looking for low-MOOP costs:
- Health Options Clear Choice Platinum PPO NE: $664 per month ($3,000 MOOP)
Best Cheap Health Insurance in Maine
Taro Health earned the highest MoneyGeek score of 74 out of 100 in this category, making it the best affordable health insurance company in Maine. Its plans have the lowest average monthly cost of the four companies we surveyed, at $441.
When choosing the winner in this area, MoneyGeek gave more weight toward affordability, but it’s worth noting that low-premium plans typically have higher out-of-pocket expenses. We examined Silver-tier plans for this category, including 441 HMOs and 119 PPOs.
If you're focused soley on cost, MoneyGeek also determined the cheapest health insurance in Maine.
Most affordable health insurance in Maine
0% claims denial rate
High MOOP cost
Relatively few plan type offerings
We found that the cheapest health insurance company in Maine is Taro Health. It provides plans with an average monthly cost of $441 and a $9,100 MOOP cost. While inexpensive, Taro Health only offers 11 Silver HMO plans as coverage options, limiting your options for different types of health care plans. However, this insurer has a stellar track record of efficient claims administration and infrequently raises coverage objections. Taro Health will likely keep your premiums low and approve your coverage claims quickly.
For affordable health insurance in Maine, MoneyGeek recommends the following plans from Taro Health:
- Taro Health Clear Choice Silver 3000 Plan: $441 per month ($9,100 MOOP)
- Taro Health Silver $0 Direct Primary Care + $0 Copays Plan: $441 per month ($9,100 MOOP)
Best Health Insurance for Young Adults in Maine
With a 65 out of 100 MoneyGeek rating, Community Health Options is Maine's best health insurance company for young adults. For this review, we researched health insurance companies that provide Catastrophic or Bronze plans. These plans typically have higher deductibles and out-of-pocket costs but cheaper monthly premiums. Catastrophic plans are only available to people under 30 or those who meet the requirements for a hardship exemption.
We found 140 PPO plans and 363 HMOs in Maine in our review for this category.
Low denial rate
Offers diverse plan types
High MOOP cost
More expensive premiums than other providers in this category
Community Health Options is the top health insurance company in Maine for young adults. On average, it costs $321 monthly for policyholders 26 and under and offers an $8,764 MOOP. This provider rarely denies requests for coverage due to its negligible claims denial rate of 0% (from the quotes we gathered).
Community Health Options offers 88 HMO plans in this category. HMOs are frequently less expensive than other plan types. It also provides 120 PPO plans, which are generally more expensive than HMOs but have the advantage of a broader, more flexible network.
For young adults in Maine, we recommend the following Community Health Options plan:
- Health Options Clear Choice Bronze $7000 HSA Plus PPO NE: $349 per month for 26-year-olds and $311 per month for 18-year-olds ($7,000 MOOP)
Best Health Insurance by Plan Type in Maine
Health insurance companies typically offer different plan types, each with a particular set of benefits, coverage, cost-sharing and network choices. According to our review of health insurance companies in Maine, Community Health Options offers the best PPOs, while Harvard Pilgrim Health Care provides the best HMO plans.
We only reviewed Silver plans for this category because these plans usually offer the best combination of affordable premiums and low out-of-pocket expenses. MoneyGeek examined 441 HMOs and 119 PPO plans in Maine for this analysis.
Best for HMO: Harvard Pilgrim Health Care
MoneyGeek determined that the best HMO provider in Maine is Harvard Pilgrim Health Care. It doesn't have the most affordable premiums but offers the cheapest MOOP cost in exchange. Its plans cost an average of $504 monthly and an average MOOP of $8,793. The company also has an excellent record for claims administration and is unlikely to deny a legitimate claim for coverage.
Harvard Pilgrim Health Care offers 210 HMO Silver plans with monthly premiums ranging from $453 to $550. Its MOOP costs range from $7,000 to $9,100.
For those looking for HMO plans in Maine, we recommend the following:
- Clear Choice Maine’s Choice Plus HMO HSA Silver 3000: $475 per month ($7,000 MOOP)
- Clear Choice Maine’s Choice Plus HMO Silver 5500: $455 per month ($8,500 MOOP)
Best for PPO: Community Health Options
Community Health Options emerges as the best PPO provider in Maine. It’s the most affordable option at an average monthly rate of $484 and offers a relatively low average MOOP of $9,100. This provider features a low denial rate, so policyholders who need medical attention shouldn’t have to go through the extra trouble of defending their claims.
Community Health Options has more diverse plan types than the other companies we surveyed in Maine, offering 100 HMOs and 80 PPO plans.
Consider the following plans if you’re looking for a PPO plan in Maine:
- Health Options Clear Choice Silver $4200 PPO NE: $467 per month ($9,100 MOOP)
- Health Options Clear Choice Silver $3000 PPO NE: $483 per month ($9,100 MOOP)
How to Find the Best Health Insurance for You in Maine
Your health care requirements and budget will determine which Maine health insurance policy best suits you. It's crucial to balance manageable monthly premiums and out-of-pocket costs. Below, we've outlined two points to consider before purchasing health insurance.
Understand when a health insurance plan will cover you
HMO plans typically have the smallest network of doctors and hospitals, while PPO plans provide more leeway but are more expensive overall. However, if you need to see a doctor outside your HMO's network, your out-of-pocket costs could nullify your premium savings. The state of Maine offers 889 HMO plans and 398 PPO policies.
Weigh the cost of premiums vs. the cost of care
Health insurance policies with low premiums appear appealing for saving money. But these plans typically come with higher out-of-pocket costs, which can raise total annual medical spending. In Maine, Health Options Clear Choice Silver $4200 PPO NE from Community Health Options costs about $467 per month and has a maximum out-of-pocket cost of $9,100. However, the Health Options Clear Choice Platinum PPO NE plan is more expensive at $664 a month, but it has a MOOP cost of only $3,000.
Consider Maine Medicare or Medicaid if You’re Eligible
Medicare is available to residents of Maine who are 65 or older or have a disability or sickness that meets specific requirements. It's a federal program that can help with the costs of some medical care, but you may still have to pay for it. These are some of the benefits provided by the plan:
- Part A: Hospice, skilled nursing facility and some home health care services are covered. Medicare provides these services at no cost.
- Part B: Your health insurance pays for services like visits to the doctor, treatment outside of the hospital, prescription drugs and wellness checks. Your premiums may be different depending on your income level.
- Part D: Part D, or prescription drug coverage, fully covers prescription medications and required immunizations. The price of this component will vary depending on the plan you select.
Meanwhile, if you qualify for Medicaid, your medical coverage is provided at no cost to you. Since Maine has adopted Medicaid expansion, low-income Mainers can now access the program. Medicaid is available to those with incomes at or below 138% of the federal poverty threshold.
Frequently Asked Questions About Health Insurance in Maine
Questions concerning pricing and availability often arise while searching for health insurance in Maine. To help you find the best plan for your needs, MoneyGeek answered some of your commonly asked questions.
About Mark Fitzpatrick