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New Health Insurance Exchanges are Limited in Smaller States Like Maine

Like other states Maine is preparing for the health insurance Exchange and new changes coming in next year. So far only two companies are going to be providing health insurance and that is if they get approved from federal government.

The Patient Protection and ACA, the Affordable Care Act were created to provide individuals as well as other smaller groups the opportunity to buy affordable health insurance. The health exchange is a marketplace for various insurance companies to provide their services and they are in the process of sending in their proposals for approval for next year. On top of services provided by the insurance exchange government will provide subsidies to those individuals who meet certain criteria in respect to their income levels or those who don’t meet the guidelines.

On the record there almost 800,000 people in Maine who are covered by Medicare, military, self-insured or other plans. The insurance exchange is for those who don’t have these coverages, almost 130,000 people in Maine don’t have any insurance at all. And there is a group of almost 125,000 who  have individual coverages or small –group health coverages. The combination of the latter groups are those who will be eligible for the new services and benefits through the health insurance exchange. The new system does not go into effect until beginning of the year 2014 but enrollment for these coverages will begin probably as early as October 2013. Each state has different insurance companies applying and there seems to be more choices in larger states. So far in Maine two companies have applied for the services to be provided through the exchange. Of course Blue Cross and Blue Shield which are the largest provided not only in Maine but probably nationally and Maine Community Health Options, which is a  co-op insurance service are the insurance companies who will be participating in the application process which has to go through an approval. Each insurance provider will provide variety of plans to meet the demands of individuals in Maine. Most plans have different coverages and usually costs vary based on the age group.

Once the applications are reviewed by the Maine Bureau of Insurance, by July 31 of this year, the applications will then be forwarded to U.S. Department of Health and Human Services for final approval. Other plans may be offered in Maine but not through the exchange. However, there are other inter-state insurance providers who can and there is rumor that one such insurance company is interested to provide services throught the health insurance exchage in Maine but no formal application has been received. It is critical for the Maine Insurance Board to review and forward the applications to the Federal Government or individuals and small groups in Maine will be left with very limited choices for next year which means situations may not improve in comparison to this year. This is critical in fact due to a recent lawsuit filed against the Main Insurance Bureau by Central Maine Healthcare which if entangles the processes in the court it could drastically eliminate choices and insurance coverage opportunities for the next year.

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