Suppose you bought a Medicare Supplement at 65, and twelve years of rate increases later the premium has become one of the larger lines in your budget. You call the carrier and someone tells you that with your health history you can’t move.
In most states that’s the end of it. In Maine it isn’t, and if you own a Medicare Supplement here these are the most valuable rules on this website.
First, the term
A Medicare Supplement, also called a Medigap plan, is a private policy that pays much of what Medicare Part A and Part B leave for you, mostly deductibles and the 20 percent Part B coinsurance. Plans are sold by letter, and every carrier’s Plan G covers the same things, because the benefit packages are standardized under federal law.
What isn’t standardized is who has to sell you one. That’s state law, and Maine’s is unusually generous.
Rule one: one guaranteed issue month a year, per carrier, for Plan A
Every insurance company selling Medicare Supplement coverage in Maine has to designate one month each year as a guaranteed issue period for Plan A. During that carrier’s month, any applicant is accepted. No health questions and no declines.
The month is not the same for every carrier. Each company picks its own, so in any given month some are open and others aren’t.
You don’t have to guess which. The Maine Bureau of Insurance has a chart showing the month each carrier has designated, and we check it before quoting anyone who has had an application declined or who is worried about underwriting.
Plan A is the leanest of the standardized plans, so it isn’t what most people would choose first. But a guaranteed seat beats a theoretical seat on a better plan, and it’s a real answer for someone told no everywhere else.
Rule two: same or lesser benefits, any time, no underwriting
If you’ve kept continuous coverage, meaning no gap longer than 90 days since your Medicare Supplement open enrollment period began, Maine lets you move to a plan with the same or lesser benefits at any time of year. From your current insurer or from a different one. With no medical underwriting.
Same or lesser benefits. Not richer ones. You can move from a Plan G to another company’s Plan G, or from a Plan G down to a Plan N or a Plan A. You cannot use this rule to upgrade from a leaner plan to a richer one and skip the health questions. If you want a plan that covers more than what you hold today, a carrier can still ask about your health and can still decline you.
No gap longer than 90 days. If you dropped Supplement coverage for four months at some point, you may have lost the right. Gaps of 90 days or less don’t break it.
Any time of year. There’s no annual window to wait for, and a Tuesday in July works the same as a Tuesday in December. There’s also no penalty for having used the right before, so someone who moved carriers three years ago can do it again. Get a Medicare Supplement quote today.
Rule three: 90 days of guaranteed issue when other coverage ends
Maine also guarantees Medicare Supplement coverage within 90 days for someone who loses:
- Employer group coverage
- An individual health plan
- MaineCare, which is Maine’s Medicaid program
If one of those ends, you have a 90 day runway to get a Supplement issued without underwriting. That one matters most to people retiring off a group plan, which has its own page at Retiring off an employer plan.
This is a Maine protection, and most states don’t have it
Federal law gives every Medicare beneficiary a six month Medigap open enrollment window when Part B starts, plus a short list of guaranteed issue situations after that. Beyond those, most states let carriers underwrite as they see fit. The three Maine rules above go well past that federal floor, and the large majority of states have no equivalent to any of them.
So in most of the country the Supplement you buy at 65 is close to the Supplement you keep, because your health at 70 decides whether anyone else will take you. In Maine, as long as you’ve stayed continuously covered and you’re not reaching for a richer plan, the door stays open.
Read this twice if…
Your premium has climbed and you’ve stopped opening the bill. Same letter plan, different carrier, potentially a different premium. We’ll price your plan letter across the carriers selling in Maine and tell you whether moving is worth the paperwork. Sometimes it isn’t, and we’ll say so.
You’ve been told you can’t change because of your health. That may be true of a richer plan. It’s very often not true of the same or a lesser plan, and it’s not true at all during a carrier’s designated Plan A month.
You moved to Maine from a state with no rule like this. You may have spent years assuming you were stuck. You aren’t, and nobody is going to mail you a notice about it.
Request a Medicare Supplement quote and send us your plan letter, carrier, county and date of birth, and we’ll tell you what’s available and what it costs.
BEST PRICE GUARANTEE
Maine Health Insurance Brokers. services are 100% FREE and there is no extra cost or mark-up. Whether you get your Medicare coverage through us, another agent/broker or directly from the insurer, you’ll pay the exact same monthly premium for the same plan.