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Population: 1,321,574 (Source: U.S. Census Bureau)
Uninsured: 124,000 (Source: U.S. Census Bureau)
Health Benefits Direct is a licensed insurance broker for Maine health insurance policies. Click here to view our registration with the Maine Office of Insurance (We're listed as HBDC). |
 Maine has the 42nd highest number of uninsured in the U.S. |
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Buying Individual Insurance Policies in Maine
State regulation of individual health insurance differs greatly from state to state. For you, this means certain conditions or providers covered in one state may not be covered in another.
Each state has its own health insurance mandates. Those mandates require that insurance companies and health plans cover, or offer coverage for, certain conditions, benefits, providers and patient populations.
Here is a list of mandated and non-mandated conditions, covered persons and providers in Maine:
(Source: Health Insurance Mandates in the States 2008¹, Council for Affordable Health Insurance. Last updated Jan 2008.)
| Mandated (Covered) Conditions |
Non-Mandated Conditions |

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Alcoholism
Breast Reconstruction
Cervical cancer/HPV Screening
Clinical Trials
Contraceptives
Dental Anesthesia
Diabetic Supplies
Drug Abuse Treatment
Emergency Services
Hearing Aid
HPV Vaccine
Home Health Care
Hospice Care
Lyme Disease
Mammogram
Mastectomy
Mastectomy Stay
Maternity
Maternity Stay
Mental Health General
Mental Health Parity
Off-Label Drug Use
Orthotics/Prosthetics
PKU/Formula
Prescription Drugs
Prostate Cancer Screening
Rehabilitation Services
Smoking Cessation
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Alzheimer's
Ambulatory Surgery
Ambulance Services
Anti-Psychotic Drugs
Autism
Birthing Centers/Midwives
Blood Lead Poisoning
Blood Products
Bone Marrow Transplants
Bone Mass Measurements
Cancer Medications
Chemotherapy
Chlamydia
Cleft Palate
Colorectal Cancer Screening
Congenital Bleeding Disorders
Diabetes Self Management
Early Intervention Services
Habilitative Services
Hair Prostheses
In Vitro Fertilization
Kidney Disease
Long Term Care
Minimum Hysterectomy Stay
Minimum Testicular Cancer Stays
Morbid Obesity Treatment
Neurodevelopment Therapy
Newborn Hearing Screening
Newborn Sickle-Cell Testing
Ostomy Related Supplies
Other Infertility Services
Ovarian Cancer Screening
Port-wine Stain Elimination
Psychotic Drugs
Second Surgical Opinion
TMJ Disorders
Well-Child Care
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| Mandated Covered Persons |
Non-Mandated Covered Persons |

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Continuation/Dependents
Continuation/Employees
Conversion to Non-Group
Dependent Students
Newborns
Non-Custodial Children
Domestic Partners
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Adopted Children
Grandchildren
Handicapped Dependents
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| Mandated (Included) Providers |
Non-Mandated Providers |

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Acupuncturists
Chiropractors
Dentists
First Nurse Assistant
Lay Midwives
Marriage Therapists
Nurse Anesthetists
Nurse Midwives
Nurse Practitioners
Optometrists
Pastoral Counselor
Psychiatric Nurse
Psychologists
Public or Other Facilities
Social Workers
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Chiropodist
Denturists
Dieticians
Licensed Health Professional
Massage Therapists
Naturopaths
Nurses
Occupational Therapists
Opticians
Oral Surgeons
Osteopaths
Pain Management Specialist
Pharmacists
Physical Therapists
Physician Assistants
Podiatrists
Professional Counselors
Speech or Hearing Therapists
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Although health insurance coverage for a particular condition or provider may not be mandated in your state, insurance carriers may still provide coverage for the condition or provider. Please keep in mind that major medical health insurance plans are subject to health underwriting and that mandates do not necessarily guarantee coverage. If you're not sure whether you could receive coverage, one call to Health Benefits Direct can help you determine if you're eligible to buy an individual health insurance policy in Maine.
Health Benefits Direct provides free health insurance quotes on affordable health insurance plans for Maine residents. We work with highly rated insurance carriers to deliver quality health insurance plans to families and individuals across Maine.
¹Authors: Victoria Craig Bunce & JP Wieske
Please note that information contained on this page can change at any time. Consequently, while we seek to present as up-to-date information as possible, Health Benefits Direct in no way warrants the accuracy of the information.
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