State of Maine
12/04/2024 | Press release | Distributed by Public on 12/04/2024 13:14
Maine Bureau of Insurance Urges Consumers to be Cautious When Selecting Health Plans During ACA Open Enrollment
Maine Bureau of Insurance Urges Consumers to be Cautious When Selecting Health Plans During ACA Open Enrollment
December 4, 2024
Professional and Financial Regulation
Consumer caution is encouraged while shopping for health plans during Affordable Care Act open enrollment period.
Maine Superintendent of Insurance Bob Carey encourages Maine consumers to be cautious when shopping for health plans during the annual Affordable Care Act (ACA) open enrollment period. Open enrollment for plan year 2025 is open now. For coverage to begin on January 1, 2025, Maine people must enroll by December 15, 2024. The final deadline to enroll is January 15, 2025 for coverage to begin on February 1, 2025.
The Maine Bureau of Insurance wants consumers to be aware that many legitimate-looking health plans they may see when doing an internet search may not offer comprehensive coverage and may not be authorized to be sold in Maine.
Consumers are urged to shop for plans at CoverME.gov, Maine's health insurance marketplace, which offers health plans that have been reviewed and approved by the Bureau of Insurance and is the only place Maine residents can get financial savings to lower monthly premiums. Consumers can also call CoverME.gov at 1-866-636-0355; TTY: 711, Monday-Friday, 8 am - 8 pm during the Open Enrollment Period.
Consumers can also purchase plans from a licensed insurance broker or from the following health insurers: Anthem Blue Cross Blue Shield Harvard Pilgrim Health Care/Point32Health UnitedHealthcare (this company does not offer coverage through CoverME.gov) Community Health Options Taro Health (available in Cumberland, Lincoln, Sagadahoc and York counties)
"Unfortunately, every year during open enrollment, some consumers are misled into purchasing what they think are ACA plans, which have comprehensive benefits and strong consumer protections. But they are actually purchasing plans with limited benefits or just plain scams," said Superintendent Carey. Also, only plans sold through CoverME.gov are eligible for premium tax credits, which can significantly reduce the cost of coverage.
Online searches for health insurance, even ones that use seemingly precise search terms such as Maine ACA plans or ACA plans, often return results for lead generating websites, not the official governmental website. A lead generating website asks consumers for their contact information so a salesperson can contact them. The salespersons contacting the consumer are not always licensed to sell insurance.
If a consumer purchases a non-regulated plan, the Bureau of Insurance may not be able to help if the company does not pay claims as promised.
Some warning signs that a consumer is not dealing with a licensed insurance company or agent are: The person on the phone will not identify the name of the company. The agent will not provide their insurance producer license number. The consumer is not given an opportunity to review the plan details prior to purchase. The salesperson insists that the consumer make a purchase right away. The consumer is required to join an association or pay an application fee to purchase the plan.
Mainers who are concerned that they may be dealing with a questionable salesperson or company should contact the Bureau of Insurance at 207-624-8475; TTY: 711 or 800-300-5000 (toll free), Monday-Friday, 8 am 5 pm, before providing any personal or credit card information. Bureau staff will be able to confirm whether a consumer is dealing with a licensed agent or insurance company. Consumers can also confirm whether a company or agent is licensed in Maine on the Bureaus website -- https://www.maine.gov/pfr/insurance/licensee-search. Or find a trained and certified local broker or Maine Enrollment Assister at no cost to them by searching on CoverME.gov. Consumers with questions about insurance matters can obtain information and assistance from the Maine Bureau of Insurance by visiting www.maine.gov/insurance, calling 800-300-5000 (TTY call Maine Relay 711), or e-mailing [email protected].
Related Documents
PDF version of Press Release regarding ACA open enrollment period.