Medicare in Maine
This article was updated on: 09/16/2018
Shopping for a Medicare plan in Maine? Medicare.com may be able to help you locate a Medicare plan option that works for you. It may be a good idea for you to explore all available choices before enrolling in a plan, and that’s where I come in. Here’s an overview of the types of Medicare coverage that may be available in Maine.
About Medicare in Maine
If you’re a Medicare beneficiary in Maine and have Original Medicare, Part A and Part B, your Medicare coverage will work in the same way as in the rest of the United States. Medicare Part A covers inpatient hospital services, skilled nursing care, hospice care, and limited home health care. Medicare Part B covers services and items such as (but not limited to) doctor visits, preventive care, and durable medical equipment.
Original Medicare doesn’t come with prescription drug coverage (Medicare Part D), which is optional. If you’re enrolled in Original Medicare, prescription drug coverage is available through a stand-alone Medicare Part D Prescription Drug Plan. You might also decide to enroll in a Medicare Supplement (Medigap) policy to get help with Original Medicare out-of-pocket costs like copayments, coinsurance, and deductibles.
Another option is Medicare Advantage, also known as Medicare Part C. Medicare Advantage is another way to receive your Medicare Part A and Part B benefits — through private Medicare-approved insurance companies instead of directly from the government. Medicare Advantage plans are required to provide at least the same level of coverage as Original Medicare (with the exception of hospice care) and may include other benefits such as routine vision and dental, hearing, and prescription drug coverage.
Types of Medicare coverage in Maine
Maine beneficiaries may have choices in addition to Original Medicare, described above. There may be other Medicare plan options available to you, depending on where you live. Your choices may include:
Medicare Advantage (Part C): Medicare Advantage provides an alternative way to receive your Original Medicare coverage; some plans include additional benefits. To enroll in a Medicare Advantage plan, you’ll need to be enrolled in Medicare Part A and Part B. If you’re interested in prescription drug coverage, you can obtain this coverage through a Medicare Advantage Prescription Drug Plan, which provides both your health and prescription drug benefits in one plan. Availability of Medicare Advantage plans in Maine will depend on where you live. You’ll need to continue paying your Medicare Part B premium when you’re enrolled in a Medicare Advantage plan.
Medicare Part D Prescription Drug Plans: If you’re enrolled in Original Medicare and want to add drug coverage, you can enroll in a stand-alone Medicare Part D Prescription Drug Plan. These plans work alongside Part A and/or Part B and are available through private insurance companies that contract with Medicare. As with other Medicare plans, costs and coverage may vary from plan to plan.
Medicare Supplement (Medigap): Medigap plans help pay for out-of-pocket costs that Original Medicare does not, including deductibles, copayments, coinsurance, and certain emergency care during foreign travel. You need to be enrolled in Part A and Part B to get a Medicare Supplement plan.
Local resources for Medicare in Maine
Medicare Savings Programs in Maine: If you are a Medicare beneficiary in Maine and have limited income and assets, you may be eligible for financial help with out-of-pocket Medicare expenses. You’ll need to meet income and asset requirements to qualify.
Maine State Health Insurance Counseling and Assistance Program (SHIP): People in Maine who have Medicare can get complimentary health insurance counseling through the State Health Insurance Assistance Program (SHIP). Specially trained staff members can answer your Medicare questions, either on the phone or at one of their local offices.
How to apply for Medicare in Maine
The Original Medicare application process in Maine is the same as in any state. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. Residents are enrolled automatically at age 65 if they already receive Social Security or Railroad Retirement Board benefits. Disabled residents are enrolled before age 65 if they receive disability benefits from Social Security or receive certain disability benefits from the Railroad Retirement Board for more than 24 consecutive months.
If you don’t qualify for automatic enrollment, you can manually enroll in Original Medicare through your local Social Security Administration (SSA) office. This can also be done online at the SSA’s website or over the phone.
- Call Social Security at 1-800-772-1213 (TTY users call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
- If you worked for a railroad, call the RRB at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.
You can enroll in Original Medicare during your Initial Enrollment Period, which starts three months before you turn 65, includes the month you turn 65, and ends three months after you turn 65. Failure to enroll in a Medicare plan when you’re first eligible may result in a late enrollment penalty for as long as you have Medicare unless you qualify for a Special Election Period.
When looking to enroll in a Medicare Advantage or Medicare Part D plan, you may apply by contacting the plan directly, or by calling 1-800-MEDICARE (TTY users call 1-877-486-2048), 24 hours a day, seven days a week.
As you can see, you may have many options available as a Medicare beneficiary in Maine. I’m here to answer any questions you may have. To learn more about me, simply follow the “View profile” link beside my photo below. You can also set up a phone appointment or have me email you some Medicare plan options by clicking on the other links below. Ready to compare plans on your own? Simply click on the Compare Plans button on this page.