Yea, we know - buying health insurance probably isn’t one of the more exciting purchases you’ll ever make…but for better or worse it’s often one of the most important. So, we want to make sure you get it right.
When most people start looking at health insurance, the first thing they do is check the price. This makes sense, of course, but just like buying a car or a house – price doesn’t tell the whole story. The “sticker price” you see for health insurance is usually the amount of the premium you pay each month for coverage. Depending on your health needs and your budget, what you actually pay could be pretty different. That’s because most plans also include a deductible, which is the amount you pay out-of-pocket before some, or possibly all, of your coverage kicks in.
As a rule, the lower the premium, the higher your deductible, and the more you’ll pay for out-of-pocket costs when using your healthcare. In the health insurance world, deductible costs are designated by metal levels, with Bronze plans having lower premiums but higher deductibles and Silver, Gold, and Platinum having higher premiums and lower deductibles. For a closer look at these metal levels, read this: Health Insurance Metals Explained.
If you are healthy and take few or no medications, you might want to consider a lower-premium option; for example, we offer Bronze plans with co-pays and no deductible for primary care, behavioral health, and generic medications. If you or your dependents have some ongoing medical conditions and need medications on a regular basis, you may want a health insurance plan with a higher premium and/or with specific benefits for chronic illness support. Lower deductible plans in the Silver, Gold, or Platinum levels will cost more each month, but they will cover more of your medical needs with lower cost-sharing and often predictable co-pays.
Speaking of costs, another big factor in purchasing health insurance is whether you are eligible for cost-sharing assistance. Maine people who do not have health insurance from employer plans may be eligible for financial assistance through Maine’s new online Health Insurance Marketplace. There are two forms of financial assistance. The first is advance premium tax credits (APTC), which offset your premium costs. A second is a type of credit called a cost-sharing reduction credit (CSR), which helps reduce your out-of-pocket expenses. To search plan options and get a cost estimate, including an estimate for APTC and CSR, check the Find a Plan section of our website. To qualify for APTC and CSR and to purchase a plan go to CoverME.gov from November 1, 2021, to January 15, 2022, or call (866) 636-0355.
Although CoverME.gov determines eligibility for tax credits, we are here to help answer any questions you may have about our plans. Please call Member Services at (855) 624-6463 or contact a trusted broker for help choosing the right plan for you or your family.
As we head into the winter months and spend more time indoors, it’s vital to get up to date on the seasonal flu vaccine, as well as COVID-19 vaccines and boosters. We’ve pulled together the latest information from the Maine Center for Disease Control and Prevention (Maine CDC), so you know where, when, and how to get the protection you need to stay healthy.