Short Term Health Insurance In Maine

According to the law that’s on the books in Maine, short term health plans cannot have a term that runs longer than 12 months. The state intends for these limited-duration plans to fill a short gap of one year or less. s
Despite the state’s legislation on the matter, you can’t currently obtain a one-year short term health insurance plan in Maine. Since 2017, federal regulations have limited the terms of these plans to 90 days or fewer. However, the Trump administration has proposed returning the maximum duration of temporary health insurance plans to 364 days. If that proposal goes through, you would once again be able to subscribe to a short term health insurance policy in Maine that lasted just about one full year.

Maine law specifies that consecutive temporary health plan terms cannot run longer than 24 months. When applying for short term health insurance, the state requires you to provide information about the dates and durations of previous short term plans that you’ve held. Currently, when your three-month temporary health plan ends, you can reapply for another period of coverage. After two years of back-to-back short term coverage, however, reapplication is no longer an option.

This regulation means that even if federal law reinstates a 364-day duration for short term health plans, you would only be able to hold two of these policies successively in Maine. After that, unless you choose to go without health insurance for a time, you would be required to find a new type of coverage, such as an individual plan that’s in compliance with the Affordable Care Act.

Unlike health insurance plans that meet the requirements of the ACA, short term plans do not have to cover pre-existing conditions. If you have experienced an illness or injury in the last few years, the insurer is likely to deny claims related to that condition. In fact, because these plans are medically written, the insurer may choose not to issue you a policy at all if you have pre-existing conditions.

The state’s healthcare legislation requires that insurers be upfront about the ways that their short term plans differ from ACA-compliant major medical plans. When you shop for a temporary health plan, you have the right to be informed that pre-existing conditions are not included in the plan’s coverage. You also have the right to understand from the beginning that renewal is not guaranteed. At the end of the term, you will have to reapply for an additional term, and the insurer may choose not to issue a new policy.

The ACA mandates 10 essential health benefits that all major medical insurance plans must cover. This mandate does not apply to short term health insurance, however, so insurers can pick and choose which types of benefits their temporary health plans cover. In a 2018 survey of temporary health insurance plans, Kaiser Family Foundation found five plans available in Portland, Maine. Only one of those offered any coverage of mental health services, and only one included any care for substance abuse treatment. None of the plans included maternity services or prescription drug coverage.

Carriers Offering Short Term Policies in Maine

The IHC Group (Independence Holding Company)
National General Accident and Health
Everest

Sources:

Marketplaces located at eHealth and Agile Health Insurance websites
http://www.maine.gov/pfr/insurance/glossary.html
http://www.maine.gov/pfr/insurance/regulated/insurance_companies/insurer/data_reporting/pdf/supplemental_health_instructions.pdf
http://legislature.maine.gov/statutes/24-A/title24-Asec2849-B.html
https://www.kff.org/health-reform/issue-brief/understanding-short-term-limited-duration-health-insurance/