Coverage Team | Health Insurance Marketplace

The Access to Care Coverage Team helps to educate and enroll people in health insurance through the ACA - Health Insurance Marketplace and MaineCare, including full MaineCare, the MaineCare Limited Benefit, and the MaineCare Deductible/SpendDown, and Private Health Insurance Premium (PHIP).  

ACA - Health Insurance Marketplace

Most people in the U.S. are now required to have health insurance under the Affordable Care Act. We educate and enroll people in plans during the annual Open Enrollment (November 1-December 15th), and also are available throughout the year to assist people who have had a life-changing event and qualify for a Special Enrollment Period.

For more information see the Health Insurance Marketplace, or contact Lauren Farnsworth at 662-2364 or 1-877-626-1684

MaineCare Connecting Kids to Coverage & the Private Health Insurance Premium

Thousands of Maine children are eligible for MaineCare but go without coverage. If you are a parent, pregnant, or 19 or 20 years old, we may be able to help you get MaineCare for yourself and/or your children.

 

To qualify for the Private Health Insurance Premium, someone in the household, usually a child, meets the eligibility requirements for MaineCare and a parent has health insurance through an employer.

 

With the Private Health Insurance Premium, MaineCare becomes secondary insurance coverage to the employer coverage and pays the portion of health care costs that the employer coverage does not. It also pays the monthly premiums (via reimbursement) for the employer coverage.

For more information, contact Karen Bilodeau at 662-7947 or 1-833-284-8816.

MaineCare Limited  Benefit

MaineCare’s Limited Benefit covers yearly physicals, birth control, and many reproductive/sexual health care services.  People with individual annual income (spousal income is not counted) under $25,800 are eligible.

For more information, contact Cory Greenleaf at 662-7957 or 1-833-284-8816.

MaineCare Deductible/SpendDown & Medicare Savings Programs

A SpendDown is a deductible provided by MaineCare when you are in a MaineCare category (parent, pregnant, disabled) but you are over the income limit for eligibility. Once you spend a certain amount on medical expenses (the deductible), you become eligible for full MaineCare for a six-month period.

Medicare Savings Programs provide low-income elderly people help with their Medicare monthly premiums and copays.

For more information, contact Lauren Farnsworth at 662-2364 or 1-833-284-8816.

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