CheapestHealth InsuranceMaineCheapest Maine Health Insurance Plans (2023)
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Community Health Options offers the cheapest Bronze, Silver and Platinum health insurance plans in Maine. Taro Health has the cheapest Gold plans, and Anthem (BCBS) provides the most affordable Catastrophic plans.
Each metal tier has different premiums, deductibles and maximum out-of-pocket costs. In Maine, HMOs are the baseline health insurance plan type, with premiums varying based on age, income and coverage preferences.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Maine.
CheapestHealth InsuranceMaineMost Affordable Health Insurance in Maine
Cheapest Silver Plan - Community Health Options
Cheapest Gold Plan - Taro Health
Cheapest Bronze Plan - Community Health Options
Cheapest Platinum Plan - Community Health Options
Cheapest Health Insurance in Maine by Metal Tier
Community Health Options offers the cheapest Silver plan in Maine, which is the Health Options Clear Choice Silver $4200 HMO Tiered NE, priced at $439 per month.
As the metal tier increases, the associated health insurance plans usually become more costly but provide more extensive coverage. We have compiled a list of the cheapest health insurance plans for each metal tier, along with their average monthly premiums:
- Catastrophic: Anthem Catastrophic X 9100 ($215 per month for a 26-year-old)
- Bronze: Health Options Clear Choice Bronze $7500 HMO Tiered NE ($356 per month)
- Silver: Health Options Clear Choice Silver $4200 HMO Tiered NE ($439 per month)
- Gold: Taro Health Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance Plan ($478 per month)
- Platinum: Health Options Clear Choice Platinum PPO NE ($664 per month)
Choosing a higher metal tier (such as Platinum or Gold) will result in higher premiums, but it also means that you will receive more benefits and have lower out-of-pocket maximums.
WHAT ARE METAL TIERS?
Health insurance plans on the exchange are classified into metal tiers based on their value, with each tier represented by a different metal. Typically, higher metal tiers like Gold and Platinum have higher premiums but lower out-of-pocket costs.
If you're young or don't expect to need frequent medical care, you could choose a less valuable metal tier. Otherwise, if you anticipate medical expenses or can afford higher premiums, it’s recommended that you opt for a more valuable plan.
You can find a balance between premium costs and coverage by choosing Silver plans. Additionally, low-income individuals may be eligible for lower deductibles with this plan type.
Cheapest Silver Plans in Maine
The most affordable Silver plan in Maine is the Health Options Clear Choice Silver $4200 HMO Tiered NE from Community Health Options, which costs around $439 per month. Here are the three cheapest Silver plans available in Maine:
- Health Options Clear Choice Silver $4200 HMO Tiered NE ($439 per month from Community Health Options)
- Taro Health Clear Choice Silver 3000 Plan ($441 per month from Taro Health)
- Taro Health Silver $0 Direct Primary Care + $0 Copays Plan ($441 per month from Taro Health)
If you want a balance between affordability and coverage, consider choosing a Silver health insurance plan. You can also benefit from cost-sharing reductions that are exclusively available for this plan tier if you are eligible. These can help you lower your monthly expenses.
The recommendations in this section are focused on HMO plans because they are the most accessible type in Maine.
Cheapest Gold Plans in Maine
If you're looking for the most affordable Gold plan in Maine, the Taro Health Gold 0000 $0 Direct Primary Care + $0 Copays 50% Coinsurance Plan from Taro Health is your best option, with a monthly cost of approximately $478. These are the cheapest Gold plans available in the state:
- Taro Health Gold 0000 $0 Direct Primary Care + $0 Copays 50% Coinsurance Plan ($478 per month from Taro Health)
- Anthem Clear Choice Gold X Tiered 2500 ($496 per month from Anthem BCBS)
- Clear Choice Maine's Choice Plus HMO Gold 2500 ($500 per month from Harvard Pilgrim Health Care)
Gold tier health plans will have higher monthly premiums compared to lower metal tiers, but they offer more comprehensive coverage and lower out-of-pocket costs. You should consider getting a Gold plan if you require frequent medical care.
Cheapest Bronze Plans in Maine
When it comes to Bronze plans, the cheapest in Maine is Health Options Clear Choice Bronze $7500 HMO Tiered NE from Community Health Options, which costs approximately $356 per month. These are your most affordable options in Maine:
- Health Options Clear Choice Bronze $7500 HMO Tiered NE ($356 per month from Community Health Options)
- Taro Health Bronze Specialist Saver $0 Direct Primary Care + $0 Copays Plan ($365 per month from Taro Health)
- Anthem Bronze X Tiered 7800 ($369 per month from Anthem BCBS)
If you're young and healthy, Bronze health insurance plans might be a good choice for you. They have lower monthly premiums but higher out-of-pocket costs and less comprehensive coverage compared to other metal tiers.
Cheapest Catastrophic Plans in Maine
The most affordable Catastrophic plan in Maine is the Anthem Catastrophic X 9100 from Anthem (BCBS), which costs around $215 per month for a 26-year-old. If you're searching for comparable plans, here are your cheapest options:
- Anthem Catastrophic X 9100 ($215 per month from Anthem BCBS)
- Health Options Clear Choice Catastrophic HMO NE ($227 per month from Community Health Options)
- Clear Choice HMO Catastrophic 9100 ($244 per month from Harvard Pilgrim Health)
Catastrophic plans are the way to go if you are looking for health insurance with the lowest monthly premiums. However, these plans come with the highest deductibles and out-of-pocket costs. Catastrophic plans are intended to cover emergency situations and are best suited for young and healthy individuals who are willing to accept higher financial risks in exchange for lower premiums.
Cheapest Platinum Plans in Maine
Community Health Options offers the most affordable Platinum health insurance plan in Maine with their Health Options Clear Choice Platinum PPO NE plan, which costs around $664 per month. This is the only Platinum plan available in the state.
Platinum plans have the highest monthly premiums among the metal tiers, but they offer the best coverage and the lowest out-of-pocket expenses. If you require frequent medical care, this plan might be the best option for you.
WHAT IS A COST-SHARING REDUCTION?
If you meet the requirements for premium tax credits, you may qualify for cost-sharing reductions (CSRs) on Silver plans. These reductions won't decrease your monthly premiums, but they can reduce other expenses associated with your health care plan, such as deductibles, out-of-pocket maximums and copays.
By utilizing CSRs, you can make health care more accessible and affordable for yourself, especially if you struggle to cover the out-of-pocket costs of your insurance plan.
Cheapest Health Insurance in Maine by Plan Type
Health maintenance organization (HMO) plans are the most popular health insurance plan type in Maine, but you can also choose from preferred provider organization (PPO) plans.
MoneyGeek found that the most inexpensive Silver plans in Maine include:
- HMO: Health options Clear Choice Silver $4200 HMO Tiered NE from Community Health Options ($439 per month)
- PPO: Health Options Clear Choice Silver $4200 PPO NE from Community Health Options ($467 per month)
While PPO plans offer greater flexibility in selecting health care providers, they usually come with higher premiums and out-of-pocket costs for out-of-network care.
WHAT IS THE DIFFERENCE BETWEEN PLAN TYPES?
If you're considering health insurance options in Maine, you have a choice between HMO and PPO plans. Here are some key details about each plan:
- HMO plans typically require you to choose a primary care physician (PCP) from the plan's network. Your PCP will coordinate your health care services and refer you to specialists as needed. If you seek health care services outside of the HMO network, coverage might be limited except in emergency situations.
- PPO plans offer more flexibility in terms of choosing health care providers. You can see providers both in and out of the network without needing a referral from a PCP. Out-of-network care may result in higher out-of-pocket costs.
Cheapest Health Insurance in Maine by County
If you're looking for health insurance in Maine, certain types of plans may not be available in all areas, and the cheapest plan in one county may not be the cheapest in another.
To simplify your search and help you compare available plans across the state, we listed the cost of Silver plans in various counties.
Health Insurance Costs in Maine by Age and Metal Tier
To illustrate the impact of metal tiers on health insurance premiums, we researched the average monthly cost of health insurance for a 40-year-old in Maine:
- Catastrophic: $229
- Bronze: $388
- Silver: $485
- Gold: $545
- Platinum: $664
We used a 26-year-old sample profile for Catastrophic plans since these plans are not available for individuals over the age of 30.
The cost of health insurance also varies based on age. An 18-year-old can get a Silver plan for around $369 per month, while a 60-year-old may have to pay approximately $538 per month.
What to Know About Maine Health Insurance
MoneyGeek has compiled data from private health insurance plans to help identify the most cost-effective options available during open enrollment. These plans are designed to meet different levels of coverage and needs.
Keep in mind that if you have a low income, Medicaid might be a more cost-effective option, while Medicare may be a better fit if you are a senior or have a disability.
Private Health Insurance in the Maine Marketplace
To obtain private health insurance coverage in Maine, you must enroll during the open enrollment period, which typically runs from November 1 to January 15.
However, it is crucial to keep in mind that if you want to begin coverage on January 1, you must sign up before December 15. Failing to do so may result in a delay in the start of your coverage.
WHAT IF YOU MISS OPEN ENROLLMENT?
If you miss the open enrollment period, there's still a chance to enroll in a marketplace plan during a special enrollment period.
You may qualify for special enrollment if you've experienced life events such as marriage, losing health insurance, having a baby or relocating to an area with different health insurance options. Typically, you have 60 days after the qualifying life event to sign up for a plan.
Medicaid in Maine
If you reside in Maine and meet the requirements, Medicaid can provide you with no-cost coverage, making it the cheapest health insurance option.
Furthermore, as an expansion state, you may qualify for Medicaid in Maine based solely on your income, provided you earn below 138% of the Federal Poverty Level.
Medicare in Maine
If you’re a Maine resident who is 65 years of age or older or has a qualifying illness or disability, you might be eligible for Medicare. Although Medicare is not completely free, it’s still more affordable compared to many private health insurance plans. It has three main parts:
- Part A typically covers your expenses for hospital, hospice care and some types of home health care. It doesn’t require any premium payments.
- Part B pays for preventive care, outpatient services, doctor fees and medical supplies, and it comes with a monthly premium.
- Part D covers prescription drugs.
We’ve recently revised our lists for the best Medicare Advantage and best Medicare Supplement plans in Maine.
Maine Health Insurance Frequently Asked Questions
To provide you with more information about health insurance in Maine, we answered some common questions about the cost and availability of plans in the state.
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