Written by a parent, not a doctor. Nothing here is medical advice.

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Maine program

CoverME.gov: buying a plan, or updating the one you have

Maine’s Marketplace sells individual and family health plans, with premium help for people who qualify.

What it is

Maine’s Marketplace sells individual and family health plans, with premium help for people who qualify.

CoverME offers enrollment during its annual window or an applicable special-enrollment period. Losing qualifying work insurance or MaineCare can open a special window. The counselor checks each person’s coverage needs, premium assistance and cancer-care network.

Eligibility rules
  • Maine residents can review CoverME coverage during open enrollment or an applicable special-enrollment period, subject to the program’s other rules.
  • Premium help runs from 100% to 400% of poverty on the year’s expected income. Tell CoverME promptly if income changes or MaineCare is approved, because help taken in advance can have to be repaid at tax time.
What you get
  • A new health plan after a qualifying coverage loss.
  • Help with monthly premiums for eligible households.
What the help includes
  • You pay the plan’s premium after any credit, plus its applicable treatment cost sharing.
If you decide to apply
  1. Speak with the CoverME.gov assistance center to arrange special enrollment.
  2. Have the coverage end date and income estimate ready. Compare the cancer team, hospital and medicines before choosing a plan.

CoverME.gov assistance center: 1-866-636-0355 · Official page ↗

After you ask
  • The coverage-loss window runs from 60 days before the loss through 60 days after it.
  • If MaineCare or CHIP ends, ask whether you have 90 days rather than 60. Coverage usually starts the first of the month after you choose a plan.
Good to know

Since March 2026, special enrollment requires help from the assistance center. You cannot complete that process online by yourself.

Other details
  • A plan’s network listing and treatment rules need checking against the exact oncology practice and hospital.

Federal background: Marketplace special enrollment.

Official sources
Ask your social worker

“If our coverage ends, which CoverME plans cover the cancer team, and what would we pay? Would you recommend one, and help us enroll if it is the best fit?”

Why I’m asking: I want to compare the full cost of replacement insurance while keeping treatment covered.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ring as soon as you know coverage is ending, and check the oncology network before choosing.

Your social worker

The Marketplace assistance centre sets up the special enrolment for you.

The care team

Records and letters when the application asks for them.

Who decides
Maine's Office of the Health Insurance Marketplace.
Ask the agency
“We are losing coverage on this date. Can you open the special enrolment and tell me which plans the oncology team takes?”

How to apply

First step: Call 1-866-636-0355 as soon as you know the date coverage ends.

  1. Call CoverME.gov as soon as you know coverage is ending, not after.
  2. Check that the oncology team is in the plan before you choose it.

Official application / program page ↗

Where it starts: Call 1-866-636-0355. Since March 2026 the special enrolment is not self-service online.

What to gather

  • The date the old coverage ends
  • Expected household income for the year
  • The names of the treating doctors and the hospital

How long: The window is 60 days either side of the loss.

Clock: Report a loss of coverage to CoverME.gov from 60 days before it happens to 60 days after.

What a yes looks like

A plan with a premium credit and a start date that closes the gap.

What a no looks like, and the next move

If the window has closed, ask about MaineCare instead, which has no enrolment season.

Watch out

  • Since March 2026 you cannot set the special enrolment up online yourself. Ring 1-866-636-0355.
  • Check the oncology team is in the plan before you pick it.

Dates that change this

2026-03-01: From March 2026 CoverME.gov stopped offering online self-service for special enrolment periods. Call 1-866-636-0355 instead.

2024-01-01: Federal rules let a Marketplace give 90 days after a Medicaid loss instead of 60. That is an option each Marketplace chooses, and no Maine adoption was found, so act inside 60 days. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

A Marketplace plan with help paying for it, inside a window running 60 days before to 60 days after coverage ends.

  • $60 — Days before and after losing coverage to report it

Covers: Individual and family health plans with premium help

Legal protection: A special enrolment window when other coverage ends

What it costs the family: A monthly premium after the credit.

The eligibility facts, as published

Residency
Maine
Trigger
Open enrollment or an applicable special-enrollment event, including qualifying loss of job coverage or MaineCare.
Income
For 2026 the ordinary premium-tax-credit range is 100%–400% of poverty using annual tax-household income, subject to other coverage/tax rules and applicable exceptions. Excess advance-credit repayment caps no longer apply after 2025.

Decisions this site cannot make: Marketplace eligibility determination

Expect friction on: Since March 2026 the special enrolment cannot be done online by yourself

The trap: From March 2026 CoverME.gov no longer lets you set up a special enrolment online by yourself. Ring 1-866-636-0355. The window runs from 60 days before you lose coverage to 60 days after.

Where I read this

← Back to your options