Medicare in Maine
Key Takeaways
- Medicare in Maine is health insurance for Americans age 65 and older. You must be a legal U.S. citizen or have been a legal resident for at least five years.
- Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). provides some hospital and medical coverage. Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Maine bundles the coverage you’d get from Parts A and B with other services. This can include Part DMedicare Part D is prescription drug coverage for people enrolled in Medicare. Part D is optional and is offered by private insurance companies. .
- The cost of Medicare in Maine starts with standard costs but is adjusted based on details like income and work history. Not enrolling on time can also cause your costs to increase.
New York-born writer E.B. White fell so in love with The Pine Tree State that he once said he’d “really rather feel bad in Maine than feel good anywhere else.”
Fortunately, with several ways to receive Medicare in Maine, you don’t have to make the same choice. Whether you’re approaching 65 or already there, Medicare provides the healthy aging resources and care you need to continue enjoying everything Maine has to offer. To help you take advantage of this program, GoHealth can answer some questions you may have. For example, do you know how much Medicare costs? What are the different options? Can you purchase Medicare Advantage in Maine?
At GoHealth, we want to make sure you feel good. To help that happen, here is GoHealth’s guide to Medicare in Maine.
How Do I Apply for Medicare in Maine?
There are several ways to enroll in Medicare in Maine. Medicare is a federal program, so most people sign up through the Social Security Administration (SSA). Here’s how:
- Online at the SSA website
- In person at a nearby SSA office
- Over the phone at 1-800-772-1213
- Call a GoHealth licensed insurance agent at GoHealth. We’ll tell you what you need to enroll and show you the different Medicare plans in Maine.
Looking for a plan with prescription drug coverage?
Who Is Eligible for Medicaid in Maine?
Medicaid and Medicare in Maine are not the same things. Medicaid is a state and federal program that offers health insurance to disabled and/or low-income residents in Maine. Eligibility is based on the size of your household, the ages of the people who live there, and how much you make each month.
Is Medicare Required When You Turn 65?
You’re not required to enroll in Medicare in Maine. But not enrolling when you’re first eligible can leave you with some serious enrollment penalties when you do sign up. To avoid these penalties, you’ll want to enroll during your Initial Enrollment Period (IEP). If not, you can expect to pay extra for:
If you or your spouse work and receive health insurance through that employer’s plan when you turn 65, you may be able to delay enrollment without a penalty. If you qualify, a Special Enrollment Period will open, during which you can enroll in Parts A and B after your IEP without penalty.Medicare in Maine Enrollment Periods
Your Initial Enrollment Period (IEP) is your first chance to sign up for Medicare the year you turn 65. If you want to change, add or drop your coverage in the future, there are annual enrollment periods. Here are the dates to know about:
- Initial Enrollment Period (IEP): the month you turn 65, plus three months before and after. If your birthday is in June, your IEP opens Mar. 1 and closes Sept. 30.
- Medicare Open Enrollment Period: Oct. 15 to Dec. 7
- Medicare General Enrollment Period: Jan. 1 to Mar. 31
- Medicare Advantage Open Enrollment Period: Jan. 1 to Mar. 31
Can I bundle multiple benefits into one plan?
What Are the Requirements for Receiving Medicare?
Medicare in Maine is available to all Americans age 65 and older who are U.S. citizens, or who have been legal residents for five or more years. You may be eligible before 65 if you’ve drawn disability-based Social Security or Railroad Retirement Board (RRB) benefits for at least 24 months.
You may also qualify for Medicare if you’re living with:
- End-stage renal disease (ESRD)
- Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s Disease
What Are the Parts of Medicare?
Parts A and B make up Original Medicare. Mainers with this form of Medicare also will need to enroll separately into a Part D plan for prescription drug coverage.
Medicare Advantage (Part C) substitutes for Original Medicare, offering the same coverage. Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.
Medicare Supplement Insurance (Medigap) is a set of policies that can be purchased by Original Medicare enrollees to help control out-of-pocket costs like premiums, copayments, coinsurance, and deductibles. As with Part D, Medigap must be purchased and paid for separately from Original Medicare.
How Much Does Medicare in Maine Cost?
How much you’ll pay for Medicare in Maine boils down to standard costs, many of which are adjusted based on personal details like work history and income. To help you budget, here’s a rundown of Medicare costs for 2025:
Medicare Part A
Premium:
- $0 if you or your spouse worked 10 or more years
- $285 a month if you worked between 7.5 and 10 years
- $518 a month if you worked fewer than 7.5 years
Deductible:
- $1,676 for each hospital benefit period
Copayments & coinsurance:
- Hospital stays: $0 copay for Days 1-60 following deductible payment; daily charges for Days 61 and after
- Skilled Nursing Facility: $0 for Days 1-20 (each plan period); daily charges for Days 21 and after
Medicare Part B
Premium:
- $185 monthly and up (income-based)
Deductible:
- $257 for each plan period
Copayments & coinsurance:
- Most preventative services: $0
- Medicare-approved services: 20% coinsurance
Medicare Part D
Premium:
- Income-based; varies by plan
Deductible:
- No more than $590 in 2025
Copayments & coinsurance:
- Plan- and drug-specific
Let’s find your ideal Medicare Advantage plan.
What Is the Best Medicare Plan?
To find the plan that works for you, you’ll want to consider a few things before you enroll in Medicare in Maine. For example, what are your medical needs? Which medications do you take? Which doctor would you like to see?
Sifting through Medicare plans in Maine to find the best fit can be taxing. To help you prepare, here are some resources to show you which questions you should be asking, and where to find the answers.
Enrollment Checklist: Get prepped for Medicare in Maine
Pros & Cons: How to weigh Medicare plans in Maine
Pro Tips: Ways to make Medicare easier
Medicare Star Ratings: See how policyholders grade their plans
Contact GoHealth: Our licensed insurance agents are ready with impartial guidance and the answers you’re looking for
What Are the Disadvantages of a Medicare Advantage Program?
While this really depends on your personal needs and the specific plan you’re looking at, there are some common trade-offs to know about when selecting between Original Medicare and Medicare Advantage plan in Maine.
- Medicare Advantage typically requires you to see doctors and providers within a local provider network, while Original Medicare can be used anywhere that accepts Medicare, even out of state.
- Medicare Advantage typically has lower out-of-pocket costs and includes coverages that Original Medicare doesn’t, including Medicare Part D.
- Along with Part D, Original Medicare beneficiaries often add Medicare Supplement Insurance to help cover the high costs from Parts A and B.
How Do I Speak to a Person at Medicare?
There are two ways to speak to a person at Medicare: over the phone (1-800-772-1213) or in person at a local Social Security Administration office.
Getting personal guidance and answers when you need them can be rare these days. If you’d like to speak to a real person with real knowledge about Medicare in Maine, give GoHealth a call. Our licensed insurance agents can review your needs and options to find a plan that works for you, whether you’re in Bangor or Kennebunkport.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 329,517 people are enrolled in Medicare Part A and B in Maine. The total number of beneficiaries enrolled in Medicare Advantage increased from 129,234 to 155,811 year over year. Medicare Advantage participation in Maine went from 40.21% to 47.28% year over year. If you’d like to dive deeper into how Medicare in Maine breaks down across the state, we provide a glance at who is using Medicare and how.
329,517 Beneficiaries with Part A & Part B
155,811 Medicare Advantage Beneficiaries
47.28% Medicare Advantage Participation Rate
53.19% Female
46.81% Male
95.19% Non-Hispanic White
0.49% African American
0.62% Hispanic
3.70% Other/Unknown
31.55% Eligible for Medicaid
0.94 Average HCC Score
$8,936.07 Actual Per Capita Costs
15.44% Hospital Readmission Rate
29.38% % of Beneficiaries with an Emergency Department Visit
129,234 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
40.21% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Maine Bureau of Insurance
1-800-300-5000
https://www.maine.gov/pfr/insurance/home
What should I know about the Maine Bureau of Insurance?
Apply for the state’s Medicare Savings Programs or file an insurance complaint.
Office of MaineCare Services (OMS)
1-800-977-6740 (Member Services)
https://www.maine.gov/dhhs/oms
What should I know about MaineCare?
See if you qualify for the state’s Medicaid program for those with low incomes.
Maine Department of Health and Human Services
Maine relay 711 (TTY)
https://www.maine.gov/dhhs/
What should I know about the Maine Department of Health and Human Services?
See if you qualify for financial help from the Maine State Health Insurance Assistance Program (SHIP).
Maine Bureau of Veterans’ Services
https://www.maine.gov/veterans/
What should I know about the Maine Department of Military & Veterans Affairs?
Manage and enroll in your veterans’ benefits.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Maine about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Office of MaineCare Services (OMS). Maine.gov.
- Special Needs Plans (SNP). Medicare.gov.
- Costs. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.