Maine Health Insurance

By wp-imp   |   August 7, 2014

Under the Affordable Care Act, everyone in Maine is required to have health insurance or pay a tax penalty for not having coverage. If you don’t have insurance and employer-based coverage isn’t an option, we’re here to help you avoid the penalty and get the best insurance for your health, as well as your budget.

So, what do Maine residents need to know about their health insurance options?

To start, it’s important to understand that you can purchase health insurance through a couple online marketplaces, referred to as the public and private exchanges. These exchanges allow you to research, compare, and buy health insurance.

The public exchange is the online marketplace offered by the government. Each state can choose to run its own marketplace, or default to the federal marketplace: You can also choose to purchase health insurance through the private exchanges – either through a private insurance company, an online insurance seller, or an agent or broker. Start shopping here.

From cost, coverage options, and eligibility, here’s some useful information to help you find the coverage you need to protect your health.

Maine Health Insurance at a Glance, 2014

Marketplace Type Federally-facilitated
Marketplace Name N/A
Marketplace Link
Number of Insurers in the Individual Health Insurance Marketplace 2
Total Number of Individuals Determined Eligible to Enroll in a Marketplace Plan 68541
Number of Individuals Eligible to Enroll in a Marketplace Plan with Financial Assistance 48531
Determined or Assessed Eligible for Medicaid/CHIP by the Marketplace 7103
Individuals Potentially Eligible for Premium Tax Credits through Marketplace 77000

Average Premium Cost in Maine

Monthly premiums are based on a single 40-year-old at 250 percent of poverty in a major city.

Major City Portland
Second-Lowest Cost Silver Plan Before Subsidies

(Benchmark Plan)

$ 295.00
Second-Lowest Cost Silver Plan After Subsidies $ 193.00
Lowest-Cost Bronze Plan Before Subsidies $ 235.00
Lowest-Cost Bronze Plan After Subsidies $ 132.00

Want to see if you qualify for savings through a health insurance subsidy? Click here to learn more.

Medicaid in Maine

Medicaid is a state program partially funded through the federal government to assist low-income families with their health insurance costs.

Medicaid eligibility is typically based on how your household income stacks up against the federal poverty level, though the income limit does vary in every state.

Medicaid Expansion in Maine

Thanks to the Affordable Care Act, states have been given additional federal funding to increase their Medicaid eligibility pool to include individuals (under 65) with an income up to 138 percent of the federal poverty level (FPL).

However, not all states have expanded Medicaid – and there’s no deadline for when they need to do it.

In Maine, Medicaid has not been expanded. To learn more about Medicaid costs, coverage, and eligibility in Maine visit


  1. Information for Maine Health Insurance at a Glance, 2014, is from The Kaiser Family Foundation State Health Facts:
  2. Average premium information is from The Kaiser Family Foundation State Health Facts: Premiums will vary based on city of residence, age, family size, and tobacco use.
  3. 2014 Poverty Guidelines are from the U.S. Department of Health & Human Services: