Maine Health Insurance Laws

Health Insurance Online ->Maine Health Insurance Laws

Anyone looking to buy health insurance in the state of Maine needs to approach the process with a good understanding of the legal framework governing health insurance in the state. And while there is a labyrinth of pieces of legislation governing health insurance in the state of Maine, what a consumer should focus on is their rights and obligations under Maine health insurance laws.

According to Maine health insurance laws, for example, a individual health insurance policy must be sold to an individual who applies for it. In additionan, Maine health insurance laws provide continued coverage for dependents up to the age of 25. This continued coverage comes with conditions though – that the ‘dependent’ in question must be single (unmarried) and without children (or other dependents), must be a resident of Maine (or a student) and must not have another form of coverage.

Maine health insurance laws also address the subject of the effect of pre-existing conditions on health insurance, which tends to bring a lot of contention in health insurance circles. According to Maine health insurance laws, you may be subjected to pre-existing health conditions exclusions if you had a certain condition before your new policy took effect, but this exclusion can only go on for a maximum of 12 months. The application of pre-existing condition exclusion is not absolute, however. If you had other form of health insurance cover for 90 days before the new policy kicked in, then you are protected by a regulation called the ‘continuity law’, which forces the insurer to maintain the same level of coverage for the pre-existing condition as you had under your old health insurance plan (but not beyond).

Maine health insurance laws even go further to specify how much you can be charged for health insurance in the state. In this regard, the state’s health insurance laws specify the conditions that can be legally used to justify extra health insurance costs and those that cannot. Unlike in many other jurisdictions, when purchasing individual health insurance in Maine, you cannot be charged higher health insurance premiums by virtue of your gender, policy duration, claims experience or, notably, health status. You can however be charged higher health insurance costs based on your age, geographical area and the industry in which you work.

In any case, whatever the legal reason established for charging your higher health insurance premiums (whether it is age, industry you work in or your geographical area), the charges cannot be higher than 20% more than the ‘community’ health insurance rate. ‘Community rates’ will vary from group to group and includes groups like smokers/non-smokers, singles and married couples and so on.

More information on the legal framework governing health insurance in the state of Maine can be found from Maine’s Bureau of Insurance or from independent health insurance advisors in the state.

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