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Maine Medicare Insurance

Medicare in Maine

Medicare offers healthcare coverage to Maine residents age 65 or older, or to those Maine residents that suffer from certain medical disabilities. In 2015, 306,420 people are enrolled in Medicare in Maine, accounting for 23% of the population in Maine. In 2009 about $8,821 was spent per Medicare enrollee in Maine, approximately 14.9% lower than the national average of $10,365. Between 2015 to 2030 the number of seniors in Maine is expected to rise by an estimated 49.49% according to calculations based off of the 2000 Census. Thus, the number of Medicare beneficiaries in Maine is also projected to grow.

Local Medicare Resources

Medicare beneficiaries and their caregivers in Maine can receive free, confidential, and unbiased one-on-one health insurance counseling through the State Health Insurance and Assistance Program (SHIP). Senior Medicare Patrol (SMP) is another program which aims to educate consumers about Medicare and MaineCare. A goal of Maine’s SMP is to assist individuals on identifying, preventing, and reporting instances of Medicare waste, fraud and/or abuse.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

Maine 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in Maine is $45.27, 27.54% less than the national average of $62.48. 34.74% of 2017 Medicare Part C insurance plans in Maine have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in Maine the average annual drug deductible for Medicare Part C insurance plans with drug components is $71.59. 75.16% of 2017 Medicare Part C insurance plans with a drug component in Maine have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in Maine is $11.96. 75% of 2017 Medicare Part C insurance plans without a drug component in Maine have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in Maine is $5,575.69. 6.57% of 2017 Medicare Advantage plans in Maine had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in Maine was 4.1 stars in 2017.
  • Among Maine's 2017 Medicare Advantage plans with CMS star ratings:
    • 71.83% earned a score of 4 or 4.5 stars
    • 15.02% earned a score of 3 or 3.5 stars
    • 13.15% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

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Maine Medicare Insurance Companies

There are 17 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in Maine. Of these, the companies that offer the largest variety of plans to choose from are UnitedHealthcare, Aetna, and Anthem BCBS. In Maine,. The following are all medicare insurance providers in Maine:

Aetna

5 Plans

Humana

3 Plans

WellCare

2 Plans

Universal American, A WellCare Company

2 Plans

Universal American, A WellCare Company

2 Plans

Empire BlueCross BlueShield

2 Plans

Magellan Rx Medicare

1 Plans

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2018 Best Medicare Plans in Maine

There are 46 medicare plans in Maine. The following are the 10 highest rated medicare plans in Maine based on their CMS rating for the plan's overall quality.

Monthly CostPlan NameCMS Rating
from $0Martins Point - Martin's Point Generations Advantage Value Plus (HMO) - Androscoggin County
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from $0Aetna - Aetna Medicare Value Plan (HMO) - Cumberland County
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from $0UnitedHealthcare - AARP MedicareComplete Choice Plan 1 (PPO) - Androscoggin County
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from $10Aetna - Aetna Medicare Elite Plan (HMO) - Aroostook County
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from $23UnitedHealthcare - AARP MedicareComplete Choice Plan 2 (PPO) - Androscoggin County
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from $26Aetna - Aetna Medicare Select Plan (HMO) - Aroostook County
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from $44Martins Point - Martin's Point Generations Advantage Prime (HMO-POS) - Aroostook County
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from $0Arcadian Health Plan - Humana Gold Plus H5619-001 (HMO) - Androscoggin County
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from $0Arcadian Health Plan - Humana Gold Plus H5619-066 (HMO) - Androscoggin County
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from $0Empire BlueCross BlueShield - Anthem MediBlue Plus (HMO) - Androscoggin County
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Best Maine Medicare Plans for Managing High Blood Pressure

The following are the 5 highest rated medicare plans in Maine based on their CMS rating for the plan's ability for controlling high blood pressure.

Monthly CostPlan NameCMS Rating
from $26Aetna - Aetna Medicare Select Plan (HMO) - Aroostook County
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from $10Aetna - Aetna Medicare Elite Plan (HMO) - Aroostook County
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from $0Aetna - Aetna Medicare Value Plan (HMO) - Cumberland County
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from $47Empire BlueCross BlueShield - Anthem MediBlue Choice (HMO-POS) - Penobscot County
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from $24Aetna - Aetna Medicare Freedom Plan (PPO) - Aroostook County
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Best Maine Medicare Plans for Managing Diabetes

The following are the 5 highest rated medicare plans in Maine based on their CMS rating for the plan's ability for diabetes care including: eye exam, kidney disease monitoring, blood sugar controlled and cholesterol controlled.

Monthly CostPlan NameCMS Rating
from $24Aetna - Aetna Medicare Freedom Plan (PPO) - Aroostook County
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from $26Aetna - Aetna Medicare Select Plan (HMO) - Aroostook County
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from $10Aetna - Aetna Medicare Elite Plan (HMO) - Aroostook County
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from $0Aetna - Aetna Medicare Value Plan (HMO) - Cumberland County
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from $44Martins Point - Martin's Point Generations Advantage Prime (HMO-POS) - Aroostook County
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Best Maine Medicare Plans for Managing Rheumatoid Arthritis

The following are the 5 highest rated medicare plans in Maine based on their CMS rating for the plan's ability for rheumatoid arthritis management.

Monthly CostPlan NameCMS Rating
from $67Universal American, A WellCare Company - Today's Options Advantage Plus 150A (PPO) - Androscoggin County
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from $47Empire BlueCross BlueShield - Anthem MediBlue Choice (HMO-POS) - Penobscot County
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from $24Aetna - Aetna Medicare Freedom Plan (PPO) - Aroostook County
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from $19Universal American, A WellCare Company - Today's Options Advantage Plus 550B (PPO) - Cumberland County
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from $0Empire BlueCross BlueShield - Anthem MediBlue Plus (HMO) - Androscoggin County
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Best Maine Medicare Plans for Managing Osteoporosis

The following are the 5 highest rated medicare plans in Maine based on their CMS rating for the plan's ability for osteoporosis management.

Monthly CostPlan NameCMS Rating
from $48Martins Point - Martin's Point Generations Advantage Select (PPO) - Aroostook County
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from $24Aetna - Aetna Medicare Freedom Plan (PPO) - Aroostook County
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from $9Arcadian Health Plan - Humana Gold Plus H5619-040 (HMO) - Penobscot County
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from $0Arcadian Health Plan - Humana Gold Plus H5619-066 (HMO) - Androscoggin County
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from $0Arcadian Health Plan - Humana Gold Plus H5619-001 (HMO) - Androscoggin County
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Most Popular Medicare Doctors in Maine

The following are the most popular medicare doctors in Maine based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
OphthalmologyPORTLAND, ME
Neurological SurgerySCARBOROUGH, ME
SurgeryPORTLAND, ME
OphthalmologyPORTLAND, ME
Orthopaedic SurgeryAUBURN, ME
OphthalmologySANFORD, ME
Internal MedicineKENNEBUNK, ME
Internal MedicineSCARBOROUGH, ME
OphthalmologyPORTLAND, ME
OphthalmologyPORTLAND, ME
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Browse Medicare Plans by Cities

  1. Portland, ME
  2. Lewiston, ME
  3. Bangor, ME
  4. Auburn, ME
  5. Brunswick, ME
  6. Biddeford, ME
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