Maine receives federal approval for State-based health insurance marketplace

Mon, 10/04/2021 - 10:15pm

AUGUSTA — Governor Janet Mills and Department of Health and Human Services Commissioner Jeanne Lambrew announced Monday that Maine’s State-based Health Insurance Marketplace has been approved by the federal government, allowing Maine to run the online health insurance market to “make it easier and more convenient for Maine people to get affordable, quality health insurance coverage.”

Individuals and families will be able to use the Marketplace, called CoverME.gov, beginning November 1 to explore health plan options, shop, and enroll in private insurance, with most people qualifying for Federal financial assistance to make premiums more affordable.

Since additional financial assistance was authorized by the American Rescue Plan Act earlier this year, nearly 25 percent of consumers in Maine have enrolled in a Marketplace plan in 2021 with a monthly premium of $10 or less, a news release stated.

The Department of Health and Human Services took the first step in the transition to a State-based Marketplace during the 2021 Open Enrollment Period (from November 1, 2020 to December 15, 2020), by launching a hybrid Federal-State Marketplace, following Maine’s use of a fully federal system since 2014. The hybrid Federal-State Marketplace allowed the State to assume greater responsibility for some Marketplace functions, such as marketing, outreach, and consumer assistance, while continuing to use the Federal HealthCare.gov platform to process applications, determine eligibility, and enroll participants.

For the 2022 open enrollment period that runs November 1, 2021 to January 15, 2022 and in future years, CoverME.gov will serve as Maine’s fully state-based marketplace platform. The Department launched the website in October 2019 as a resource for Maine people to explore affordable health insurance options. With the new State-based Marketplace, CoverME.gov will expand to become the official platform where Maine people can shop for and enroll in private coverage.

This fall, the Department plans to launch a marketing campaign to raise awareness of the transition and Maine consumers’ options for coverage through the State-based Marketplace. In mid-October, Maine residents will be able to see the plan options for 2022 on CoverME.gov so they can begin thinking about their options.

Currently, 15 other states run a State-based Marketplace, including all other New England states except New Hampshire. The ongoing operation of Maine’s State-based Marketplace is funded by a user fee charged to health insurance companies that use the platform to sell their plans.

As in previous years, those who already have a Marketplace plan will be automatically re-enrolled in their current plan or the most similar offering from their health insurance carrier. Consumers will receive information about the re-enrollment process directly from CoverME.gov in October. People who apply through CoverME.gov who are eligible for MaineCare will have their application sent to MaineCare for review. Eligible Maine people can enroll in MaineCare at any time of year.