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From rocky coastlines and forested mountains to peaceful rural towns, Maine remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances.
As of 2025, the uninsured rate in Maine reflects progress in improving access to affordable care. If you’re currently without coverage, here’s what you need to know about getting insured in Maine.
Health Insurance Options in Maine
Maine offers a variety of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common types of coverage available:
Employer-Sponsored Insurance
Many people in Maine receive health insurance through their employer. If your workplace offers coverage, this is typically the most convenient and stable option.
ACA Marketplace Plans (CoverME.gov)
The Affordable Care Act (ACA) allows individuals and families to buy health insurance through state Marketplaces. Maine’s official health insurance exchange is CoverME.gov.
These ACA plans provide essential health benefits, preventive care, and protections for preexisting conditions. If you don’t have employer-sponsored coverage, you can shop for insurance through the Marketplace. You may also qualify for financial assistance to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.
ACA Plan Types
ACA plans come in four metal tiers with varying levels of coverage and out-of-pocket costs:
- Bronze: Low monthly premiums and higher out-of-pocket costs; suitable for those who use healthcare infrequently.
- Silver: Moderate premiums and out-of-pocket costs; may include cost-sharing reductions (CSRs) if eligible.
- Gold: Higher premiums and lower out-of-pocket costs; ideal for those who expect regular medical care.
- Platinum (if available): Highest premiums, lowest out-of-pocket costs; best for those needing frequent or extensive care.
Metal Tier Breakdown:
| Metal Tier | Insurance Company Pays | Consumer Pays |
|---|---|---|
| Bronze | 60% | 40% |
| Silver | 70% | 30% |
| Gold | 80% | 20% |
| Platinum | 90% | 10% |
Medicaid
Maine’s Medicaid program is known as MaineCare, offering free or low-cost coverage for eligible low-income residents. Benefits typically include preventive care, hospital services, prescriptions, mental health treatment, and more.
Maine has expanded Medicaid to include more residents under updated income guidelines. You can apply for MaineCare at any time through My Maine Connection.
Student Health Insurance
College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans, making Maine student health insurance accessible and flexible for a wide range of needs.
Children’s Health Insurance Program (CHIP)
Maine’s CHIP program is known as CubCare, offering affordable health insurance for children and pregnant women in families who earn too much to qualify for Medicaid. You can enroll in CubCare year-round.
Medicare
Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:
- Medicare Advantage (Part C)
- Medicare Advantage is an alternative to Original Medicare offered by private insurers to those enrolled in Parts A and B. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
- Prescription Drug Plans (Part D)
- Medicare Part D provides prescription drug coverage for anyone with Medicare, helping pay for medications and many vaccines. Offered by private insurers, these plans vary in cost and coverage and can be joined during specific enrollment periods.
- Medicare Supplement (Medigap)
- Medicare Supplement plans, or Medigap policies, help cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare (Parts A and B) lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.
COBRA Coverage
If you’ve recently lost job-based health insurance, COBRA allows you to temporarily continue your employer coverage, usually at full cost. This option helps bridge the gap until new insurance starts.
Short-Term Plans
Short-term medical (STM) plans offer flexible, low-cost coverage for up to four months, ideal for healthy individuals in transition. However, STM plans aren’t guaranteed issue, lack subsidies, and may exclude key benefits like maternity, mental health, and pre-existing conditions, making them less suitable for long-term or comprehensive needs.
Explore all non-ACA health plans that may fit your needs and lifestyle.
Note: As of now, no short-term medical plans are available in Maine due to regulatory changes and lack of participating insurers.
Enrollment Periods in Maine
Open Enrollment for 2025 Coverage:
November 1, 2025 – December 15, 2025
During this time, all eligible residents can apply for, renew, or change their health plans.
Special Enrollment Period (SEP)
You can enroll outside of Open Enrollment if you experience a qualifying life event (QLE), such as:
- Job loss
- Marriage or divorce
- Birth or adoption
- Relocation
- Change in income
You typically have 60 days from the event to enroll in a new plan.
Health Insurance Providers in Maine
As of 2025, these insurers typically offer individual and family plans through CoverME.gov:
Availability of plans may vary by region or ZIP code. Some carriers may also offer standardized plans under state guidelines.
Understanding Health Insurance Costs
It’s important to understand the following cost terms when choosing a health plan:
- Premium: Your monthly payment to maintain your coverage
- Deductible: The amount you pay before the plan starts to share costs
- Copayment (Copay): Fixed fee for specific healthcare services
- Coinsurance: Your share of the cost for services after meeting the deductible
- Out-of-Pocket Maximum: The most you’ll pay in a year for covered care
- In-Network vs. Out-of-Network: Choosing in-network providers helps control costs
Understanding health insurance doesn’t have to be overwhelming. This glossary offers clear definitions of key terms—from agents to costs like copayments, coinsurance, and deductibles—to help you make confident coverage decisions.
Bottom Line
Health insurance in Maine includes a broad range of choices—whether through your job, the state’s ACA Marketplace, or public programs like MaineCare and Medicare. By exploring your options and staying informed about enrollment periods, you can secure dependable coverage for your health and peace of mind.
Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for ACA plan financial aid or speak with a licensed insurance agent about all your options.
