Marketplace health insurance is available to people and families who are not offered affordable coverage through work or who don’t qualify for public programs such as MaineCare or Medicare.
Open Enrollment to buy Marketplace health insurance begins November 1st and ends December 15, 2020 for coverage that will start on January 1, 2021. If you did not enroll in a Marketplace plan during Open Enrollment, you may not be able to buy health coverage for 2020 after December 15, 2019 unless you qualify for a Special Enrollment Period.
You can apply for Marketplace health coverage at www.healthcare.gov or by calling 1.800.318.2596 (TTY 1.855.889.4325).
People with income below 400% of the Federal Poverty Level (FPL) are eligible for help paying their monthly premiums. Many Mainers are eligible for Advanced Premium Tax Credits (APTC) that reduce what you pay each month for Marketplace coverage. See the Chart below to see if you may get help paying for your coverage.
People with income between 138% – 250% of the Federal Poverty Level (FPL) are eligible for both APTCs and Cost Sharing Reductions (CSRs).
To determine your eligibility to receive APTCs and CSRs, you need to look at the number of individuals in your household and the income of the household members. The chart below are the 2020 FPL guidelines, which are used to determine eligibility for 2021 coverage.
Income levels for free/low-cost MaineCare and Marketplace assistance
|MaineCare (Adult 21-64)*||Help with Marketplace monthly payments and cost sharing||Help with monthly Marketplace payments|
|Household Size||up to 138% FPL||up to 250% FPL||up to 400% FPL|
Need Help? You can call Maine’s Consumer Assistance HelpLine at Consumers for Affordable Health Care. 1.800.965.7476 or find local, in person help by visiting our How to Get Help page.
Below you can also find more information on:
- Types of plans, and How to Choose the Right Plan for You,
- Cost and Cost Sharing Options for Paying for Your Insurance,
- Tips for Buying and Paying for Your Insurance, and
- General Marketplace FAQs.
Medicare plans and plans offered through employers may have different open enrollment periods.
Not eligible for Marketplace coverage? You or your family members may qualify for MaineCare.