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Maine.gov > PFR Home > Insurance Regulation > FAQ > Medicare

Frequently Asked Questions - Medicare

I will be turning 65 in a few weeks. Can you please explain the open enrollment for Medicare supplement (Medigap) insurance policies?

If you are turning 65, your first priority is to make sure you are enrolled in Medicare Part B (contact the Social Security Administration at 1-800-772-1213 or www.ssa.gov for information on enrollment procedures). Federal law gives you a 6-month "open enrollment" period to apply for a Medicare supplement insurance policy, beginning with the first month that you enroll for benefits under Medicare Part B. For information on available Medicare supplement plans, see: Medicare supplement plans. To see exactly what Maine law says on this issue, check out: Bureau of Insurance Rule 275 Section 11. For other questions about Medicare or Medicare Supplement policies, contact the Maine State Health Insurance Assistance Program at 1-800-262-2232 (within the state) or www.maine.gov/dhhs/beas/hiap/.

Are there any alternatives to original Medicare (Parts A and B) available in Maine?

Yes, Medicare Advantage PPO and Medicare Advantage fee-for-service plans, with or without prescription drug coverage, are currently available in Maine. See your current edition of "Medicare and You" for a list of plans available in Maine, or call 1 -800 Medicare. For other questions about Medicare or Medicare supplement policies, contact the Maine State Health Insurance Assistance Program at 1-800-262-2232 (within the state) or www.maine.gov/dhhs/beas/hiap/.

Can I change from one Medicare supplement plan to another?

If you have had a Medicare supplement plan since you turned 65, in most cases you can change to the same or a lower plan (e.g., from plan "G" to plan "A") at another company without having to wait for open enrollment. However, you must obtain your new plan within 90 days of leaving the old plan. To see exactly what Maine law says on this issue, see: Title 24-A M.R.S.A. §5002-B. For other questions about Medicare or Medicare supplement policies, contact the Maine State Health Insurance Assistance Program at 1-877-353-3771 (within the state).

I enrolled in a Medicare Advantage plan and I want to go back to "original" Medicare Part A and Part B. Will I be able to get a Medicare supplement policy?

Maine Medicare beneficiaries who enroll in a Medicare Advantage plan during their initial six month open enrollment period now have up to three years to drop their Medicare Advantage plans, revert to "original" Medicare Part A and Part B, and purchase a Medicare supplement plan of their choice. Similarly, Maine Medicare beneficiaries who drop their Medicare supplement coverage and enroll in a Medicare Advantage plan for the first time now have up to three years to drop their Medicare Advantage plan, revert to "original" Medicare Part A and Part B, and purchase Medicare supplement plan similar to the Medicare supplement plan they previously had. (In most other states you only have 1 year, not three.) If you have been enrolled in the Medicare Advantage plan for more than three years some Medicare supplement carriers may still offer you a Medicare supplement policy (especially if you do not have serious health issues) even though the carrier may not be legally required to do so. In addition, all Medicare supplement carriers are required to provide a one month open enrollment period for Plan A.

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If you have any suggestions for things to be included here, please send them to Thomas.R.Michaud@maine.gov. Thank you for your suggestions and thank you for your patience.

 

Last Updated: November 18, 2009