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Maine Bureau of Insurance
Consumer Health Care Division

  • Do you need answers to your insurance questions?
  • Are you having a problem with your insurance company?

WE CAN HELP!

We help Mainers for FREE, in person, by phone, via email and through the mail.

Last year, the Bureau’s health, life & disability staff responded to over 5,000 questions from the public, helped over 500 consumers with written complaints and obtained over $1 million in either claims paid or money returned to consumers.

CONTACT US:

Maine Bureau of Insurance
34 State House Station
Augusta, Maine 04333
Toll Free: 1-800-300-5000 (In Maine)
Long Distance: (207)-624-8475
TTY: 1-888-577-6690
Fax: (207) 624-8599
www.maine.gov/pfr/insurance

HEALTH INSURANCE

The Bureau regulates fully-insured individual or group plans which must follow Maine laws. (Other group plans, called self-insured plans, follow federal laws; if you're not sure which kind of plan you have, check with your Human Resource Office.) We can answer questions about any kind of health insurance.

Things to know about health insurance:

  • In Maine, you cannot be denied insurance, or charged more, because of a health condition.
  • If you don’t have a break in coverage for so many days (specified in law), your new insurance must cover any pre-existing condition to the same extent as the old policy did. (Call us for details on the number of days.)
  • You have the right: to see the reason for a denied claim in writing; to know who is making decisions about your claim; to ask questions; and to appeal decisions made by your health insurance company.

 

MEDICARE SUPPLEMENT INSURANCE
(MEDIGAP)

Medicare Supplement insurance covers some of the expenses not paid by Medicare.

Things to know about Medicare supplement insurance:

  • Medicare supplement insurance products come in 10 standard plans, plus one high deductible plan. Any insurance plan (A-L) under a particular letter will have the same benefits regardless of which company sells it.
  • Plan "A" is the one plan that must be offered by all insurers. Insurers may sell any of the other plans.
  • If, for any reason, you are not happy with your policy, you can return it within 30 days and all your money will be returned.

 

LONG TERM CARE INSURANCE

If you develop a chronic physical or cognitive impairment, you may need long term care in a nursing or assisted living facility, or at home. Long term care insurance helps pay for such care. Whether you should buy a long term care insurance policy will depend upon your age, health status, income, and assets.

Things to know about long term care insurance:

  • Medicare, Medicare supplement insurance and health insurance policies will not pay for long term care.
  • The services covered and benefit amounts will vary from policy to policy.
  • Beware of long term care insurance advertising that appears to be from an official government source. Only private insurance companies sell long term care insurance.

LIFE INSURANCE

Life insurance provides income replacement to beneficiaries in the event of a death.

Things to know about life insurance:

  • Life insurance comes in two basic types: term and cash-value. Term insurance generally has lower premiums in the early years, but does not build up cash values that you can use in the future. Cash-value insurance includes: whole life, universal life, and variable life.
  • Base your choice on your needs now and in the future and on what you can afford.
  • We can help you locate a lost life insurance policy, or your insurance company.

 

DISABILITY INSURANCE

Disability policies can replace part of your income should you become unable to work.

Things to know about disability insurance:

  • There are two main types: short term and long term.
  • Most insurance companies reduce the disability benefit by the amount of other income you may receive (such as Social Security).

 

ANNUITIES

An annuity is a contract in which an insurance company gives you a series of payments in return for premiums you’ve paid.

Things to know about annuities:

  • Annuities come in two basic types: fixed and variable. With a fixed annuity, the insurance company guarantees the rate of return and the payout. With a variable annuity, the rate of return varies with the stocks, bonds, etc. that you choose.
  • Avoid being fooled by deceptive sales practices of some agents; watch out for high pressure sales pitches. Remember, if it seems too good to be true, it probably is.
  • If you suspect you’ve been a victim of deceptive sales practices, contact us immediately.

 

HOW DO I FILE A COMPLAINT AGAINST MY INSURANCE COMPANY?

  • You can file a complaint at any time with the Bureau of Insurance.
  • Complaints can be filed by mail, faxed (we will send you a form to fill out), or by logging on to our website.

 

FOR MORE INFORMATION:

We have brochures on our website (or that we can mail to you) about the topics mentioned in this brochure, plus information on:

  • Individual and small employer insurance
  • Health insurance company finances
  • Insurance company complaint ratios
  • Independent external reviews
  • Viatical & life settlements

telephoneMaine Bureau of Insurance
34 State House Station
Augusta, Maine 04333
Toll Free: 1-800-300-5000 (In Maine)
Long Distance: (207)-624-8475
TTY: 1-888-577-6690
Fax: (207) 624-8599
www.maine.gov/pfr/insurance

 


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Last Updated: August 12, 2013