Two real changes are hitting Maine’s individual market for 2027, and if either one touches your plan you’ll get a letter about it that is easy to misread.
Mending Health, the carrier formerly known as Taro Health, is leaving the Maine market after 2026. Its members will need a different carrier for 2027.
Anthem is discontinuing its individual PPO plans on CoverME.gov. A PPO is a plan type that lets you see providers outside the network, usually at a higher cost, without needing a referral first. Anthem is continuing to sell PPO coverage off the marketplace and to small groups, so the plan type isn’t gone from Maine. It’s gone from the marketplace, where financial help lives.
That leaves three carriers offering individual coverage in Maine for 2027: Anthem, Harvard Pilgrim and Community Health Options.
What automatic re-enrollment actually does
If you don’t take any action, CoverME.gov will generally move you into a plan for the coming year rather than leave you uninsured. That is a good safety net and a poor decision.
The match is made by a system comparing your old plan to what’s available now. It isn’t looking at which oncologist you see, whether your daughter’s pediatric practice is in the new network, or which tier your prescriptions land on. It’s looking for a plan that resembles the one you had.
So being placed in a plan tells you only that you’re covered. It doesn’t tell you the coverage fits, and it isn’t a reason to keep it.
There’s a second reason to look. The Maine Bureau of Insurance approved a 14.8 percent average increase for the individual market in 2027, down from the 16.8 percent the carriers had requested. An average is an average, so your own plan may move more than that or less.
What to check before January 15, 2027
January 15, 2027 is the last day of open enrollment for 2027 coverage. The date matters because after it passes you can’t switch plans for the rest of the year without a qualifying life event. That’s the whole reason to deal with this in the window rather than in March.
Before then, check these four things:
- Whether the plan you’ve been placed in still includes your doctors, your specialists and the hospital you’d use
- Whether every prescription in your household is on that plan’s drug list, and at what tier
- What the new deductible and out of pocket maximum are, not just the premium
- Whether your financial help carried over correctly, since a plan change can change the amount
Losing your carrier is a qualifying event
If your coverage ends because your carrier left Maine, that’s a loss of coverage, which is a qualifying life event. It opens an enrollment period for you outside the normal window, so a member of a departing carrier isn’t locked out.
We would still rather choose your 2027 plan with you before January 15 than sort it out after the fact.
Request a review and send us your letter from the carrier, or call (207) 304-2909, and we’ll tell you what you’ve been moved into and whether it holds up against your doctors and your prescriptions.
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Our services are 100% FREE and there is no extra cost or mark-up. Whether you get your individual/family health insurance through us, another agent/broker or directly from the insurance carrier or CoverME.gov, you’ll pay the exact same monthly premium for the same plan.