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Despite not undergoing Medicaid expansion, Maine remains to have quite the impressive health insurance sector. Low uninsured rating, combined with a lower-than-national-average rate increase, makes it easier for more of its residents to obtain coverage.

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How ME ranks in state-based health studies

It should go without saying that the overall health of the people in the state has a huge bearing on health coverage premiums.

In the 2015 Commonwealth Fund’s Scorecard on State Health System Performance, the state fared pretty well, securing 11th (out of 51) place. Its best performance was for the indicator “Prevention & Treatment,” where the organization gave it a quintile score of 1. It scored quintile 2 for “Access,” “Avoidable Health Costs & Use,” as well as “Equity.” It received a 3 in the “Healthy Lives” category, where the study found the following:

  • Mortality amenable to healthcare: 62 out of 100,000 people

  • Breast cancer fatalities: 18.8 out of 100,000 women

  • Colorectal cancer fatalities: 12.5 out of 100,000 people

  • Percentage of adult smokers: 19%

  • Adult obesity: 29%

  • Obesity in children aged 10-17: 30%

Comparisons related to health insurance in the state are as follows:

  • 14% of adults (19 to 64 years old) don’t have insurance, compared with the national average of 15%

  • 6% of children (infants to 18 years old) are uninsured, as opposed to the countrywide average of 6%

  • 11% of the adult population chose not to obtain insurance due to the high costs associated with it

  • 25% of adults had expensive out-of-pocket medical bills

Metal tiers and the corresponding insurer-covered portion

Carriers offer all the four different types of metal tiers to the residents of The Pine Tree State. The platinum plan provides the greatest coverage, although the silver plan remains the most popular. Here’s how much reimbursement you can expect based on the tier:

Bronze – 60%

Silver – 70%

Gold – 80%

Platinum – 90%

Bronze
Silver
Gold
Platinum

Note also that this year, the approved rate increases vary from 18% to 25.5% (on-exchange carriers). To give Maine insurance plan holders an idea on how much they can expect their premium averages to be, the United States Department of Health & Human Services provided the following projections:

  • Average lowest-cost, monthly premium within metal level: $498

  • Average net premium for lowest cost plan within metal tier: $150

  • Second-lowest silver before advance premium tax credit (for a 27-year old with a $25,000 household income): $317

  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $142

  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $1,146

  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $405

A quick look at your health insurance this 2017

Every state in the country has seen a hike in rates. Some have as high as more than 100% increases. Fortunately, this isn’t the case with ME. Of course, you still have to set realistic expectations when it comes to your own premiums, as who you are still dictates how high or low the increase your insurer will apply.

You have your state to thank for, as it has quite the low uninsured rate. This is one of the factors insurers use to determine state rate averages. According to a study that the U.S. Department of Health & Human Services conducted, the percentage of its residents without insurance during the 2015 was 8.4%. The five-year study found that 22,000 more individuals became insured, from its then estimated population of 1,329,328 (2015, latest data1).

Missed open enrolment? You can still obtain coverage

The Affordable Care Act isn’t your only choice for an affordably-priced health insurance plan. Just in case you missed the open enrolment, you still have the option to get coverage. You should take advantage of this, seeing as you don’t want to pay for medical costs entirely on your own. Look up private insurance providers in your city and state as soon as possible.

References:

https://www.healthinsurance.org/maine/

http://datacenter.commonwealthfund.org/scorecard/state/21/maine/

https://aspe.hhs.gov/sites/default/files/pdf/212721/2017MarketplaceLandscapeBrief.pdf

https://aspe.hhs.gov/compilation-state-data-affordable-care-act

1Latest data: The U.S. census is conducted every 10 years as per requirement of the United States Constitution. The 23rd edition and the latest data is the 2010 United States Census. Source: https://en.wikipedia.org/wiki/2010_United_States_Census
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