When & How to Enroll

Enrollment Basics

Your options for obtaining Health Insurance in Maine are limited if you didn’t enroll during open enrollment. The next open enrollment period will start in November for coverage effective January 1, 2021.

The November 1 – December 15 enrollment window is for people who buy their coverage in themselves. If you have employer-sponsored coverage or if you’re covered by Medicare, different enrollment windows apply for your coverage.

Medicare’s enrollment window is similar, but it ends on December 7th. And your employer’s enrollment window may very well happen during this time of year, but it will have its own dates. (If you think you’re eligible for Medicaid or MaineCare you can enroll at any time during the year.)

If you missed Open Enrollment

If you have a Qualifying Life Event you can enroll in a new health insurance plan or change your existing plan. Here are the most popular qualifying events:

• Loss health insurance with your employer or loss of MaineCare
• Change in primary residence (moved to Maine)
• Change in household size (Got married, had a baby, divorce)
• Change in eligibility for Marketplace coverage or for help paying for coverage
• Enrollment or insurance company error

There are also some exceptional circumstances that can count. You can see that full list here. If you’re not sure if you meet any of these requirements, use this simple tool to see if you’re eligible for a special enrollment period in Maine.

Shopping for Health Insurance in Maine

If you are eligible to enroll during a special enrollment period have several options for buying health insurance in Maine:

Option 1: Through a marketplace – your state’s exchange or HealthCare.gov. These exchanges vary by state, so check with your state’s government website for to know which site you have to use.

Option 2: (The easier option) You can also use this site on your own or get help from a local agent in Maine who is certified by the government to help explain health insurance options, determine your eligibility for subsidies, and make plan recommendations based on your situation.

Premium Subsidies

These subsidies are actually called Advance Premium Tax Credits (APTC) and can lower the costs of any health insurance plan bought through this website or the healthcare marketplace exchange.

Household Modified Adjusted Gross Income
Income % of FPL	Single Individual	Family of Four
Under 100%	Less than $12,490	Less than $25,750
100% – 133%	$12,490 – $16,612	$25,750 – $34,248
133% – 150%	$16,612 – $18,735	$34,248 – $38,625
150% – 200%	$18,735 – $24,980	$38,625 – $51,500
200% – 250%	$24,980 – $31,225	$51,500 – $64,375
250% – 300%	$31,225 – $37,470	$64,375 – $77,250
300% – 400%	$37,470 – $49,960	$77,250 – $103,000
Over 400%	More than $49,960	More than $103,000

Here’s how to find out if you’re eligible for a subsidy.

If you think it’s likely you’ll be eligible for a subsidy, be sure to familiarize yourself with the basics of tax subsidies. You can view those rules here on the irs website.

One of our agents can also explain how these work and can help you qualify. Just schedule a phone call at the bottom of this page to talk to someone.

How much will health insurance cost?

The cost of your plan will depend on a number of factors, including some that are specific to you (your household income, zip code, tobacco use, and the number of people who will be covered under your plan).

People who don’t get subsidies pay full price, and this includes anyone who buys their coverage outside the exchange. But some of these people may have employers who cover some or all of the cost via a health reimbursement arrangement.