Health Care Insurance in Maine (Bangor, Augusta: day care, month to, home)

[Submariner]

Originally Posted by angelo129

I think the best kind of welcome is the truth. Part of that truth is that Maine attracts many retired people, as well as retired military. For them, health insurance is usually not an issue and their eligibility isn't determined by where they live. ...

I stayed out of this thread.

I know that as a military retiree, I look at things differently, and in the case of health coverage I stand at a considerable advantage.

Health insurance aside, we moved to Maine due Maine's low cost of living, low taxes and the extent of rural forest land.

It does appear that private health insurance costs are extreme everywhere stateside. With no fix in sight.

I pay an enrollment fee, office visit co-pays, and drug co-pays. But I now get college educated doctors, whereas for decades I and my family were treated by 18-year-old OJT trained medics.

We like Maine.

We like living here.

We like being treated by health care professionals who are adults who also have college educations.

[angelo129]

It does appear that private health insurance costs are extreme everywhere stateside. With no fix in sight.

With most of my family working in the field of healthcare, and many of them in states other than Maine, I think it's misleading to minimize Maine's problem by suggesting that it can be lumped in with "extreme everywhere." This really isn't true, as a bit of research will show. No, other states do not have only a single provider, which is the beginning of the problem. No, not everyone in other states pays the enormous amount we do for insurance and co-pays and deductibles. A little research, again, will verify this.

Health insurance aside, we moved to Maine due Maine's low cost of living, low taxes and the extent of rural forest land.

But health insurance IS the topic here, and it is one that most people, not in your situation, must contend with and take into consideration when they consider the cost of living in Maine. For most of us, it is an inescapable part of the cost of living, so there is no point in considering Maine, "health insurance aside." That's a bit like saying "real estate aside, Manhattan is cheap."

We like being treated by health care professionals who are adults who also have college educations.

I'm not sure where you were before Maine, but I can't believe that being treated by non-adults, yet less non-adults without a degree, is common anywhere. Certainly it has not been my experience elsewhere, or that of anyone I know.

We like Maine.

Yes, as do many people, some of whom live here and some who cannot or don't wish to. The fact that you like Maine is really irrelevant to the question of how available and/or costly health insurance is in this state for those who are not covered as you are. Anyone considering Maine as a place to live would be foolhardy not to take the enormous cost of health insurance, the inadequate coverage, and the unlikelihood of getting a job that includes health insurance, into consideration.

[Submariner]

Originally Posted by angelo129

With most of my family working in the field of healthcare, and many of them in states other than Maine, I think it's misleading to minimize Maine's problem by suggesting that it can be lumped in with "extreme everywhere." This really isn't true, as a bit of research will show.

Each of us has formed our own opinions. Thank you for expressing yours.

I am still of the opinion that civilian health care stateside is very expensive, everywhere.

Personally I would consider it mis-leading to suggest that health care expenses were not extreme everywhere in the US.

... No, other states do not have only a single provider, which is the beginning of the problem. No, not everyone in other states pays the enormous amount we do for insurance and co-pays and deductibles. A little research, again, will verify this.

'single provider' hmm, I live in Maine and I use Martin's Point. I bet that is not the 'single provider' you are speaking of.

When you say 'single provider' it has the ring as if there were only one insurance company in Maine.

Consumer Guide To Individual Health Insurance : Brochures : Bureau of Insurance
"Individual health insurance is available in Maine from Anthem Blue Cross and Blue Shield, MEGA Life & Health Insurance Company, and several health maintenance organizations (HMOs). This brochure is intended to help you to understand your options and to compare premiums."

... But health insurance IS the topic here, and it is one that most people, not in your situation, must contend with and take into consideration when they consider the cost of living in Maine. For most of us, it is an inescapable part of the cost of living, so there is no point in considering Maine, "health insurance aside." That's a bit like saying "real estate aside, Manhattan is cheap."

A previous poster had said: "Part of that truth is that Maine attracts many retired people, as well as retired military. For them, health insurance is usually not an issue and their eligibility isn't determined by where they live."

So, lets make up our minds shall we?

Either health costs do effect everyone, or they do not effect everyone.

In my case, health costs really do not effect me much. I pay, but how much I pay is low.

... I'm not sure where you were before Maine, but I can't believe that being treated by non-adults, yet less non-adults without a degree, is common anywhere. Certainly it has not been my experience elsewhere, or that of anyone I know.

sigh.

Welcome to life on planet earth

From 1976 until I was forced to retire due to old age in 2001, my employer provided health care to me and my family. We lived on the West Coast, on the East Coast, in Scotland, and in Italia. My career field had us moving around a lot. My Dw, my children and I were usually treated by 18 to 22 year olds whose medical training was OJT.

... Yes, as do many people, some of whom live here and some who cannot or don't wish to. The fact that you like Maine is really irrelevant to the question of how available and/or costly health insurance is in this state for those who are not covered as you are. Anyone considering Maine as a place to live would be foolhardy not to take the enormous cost of health insurance, the inadequate coverage, and the unlikelihood of getting a job that includes health insurance, into consideration.

Sigh.

As that previous post said: "Part of that truth is that Maine attracts many retired people, as well as retired military. For them, health insurance is usually not an issue and their eligibility isn't determined by where they live."

Whoever that poster was, nailed it nicely I thought.

I am a retiree, I was attracted to Maine partly by it's low cost-of-living, the quality of rural life here, and partly by the health care options that would be available to us here.

Had we stayed where we were last, we would have been required to continue seeking health care from my former employer.

By moving here [far far away from my former employer] they under-write a health care plan with a local health care insurance provider for us. So for us, moving here did make this wonderful high quality of health care available to us.

[cebdark]

Originally Posted by angelo129

.
I'm not sure where you were before Maine, but I can't believe that being treated by non-adults, yet less non-adults without a degree, is common anywhere. Certainly it has not been my experience elsewhere, or that of anyone I know.

I just have one "clarification" if-you-will.

Forest is retired military. Have you had any experience with military medical facilities (not so much now, but within the timeframe of which Forest speaks)? Not trolling mind you, but I have (although a little later). I don't believe he said that they were non-adults, I believe he said they were non-college trained medical personnel. It is better now in the military, but for many years, it was OJT by very young and inexperienced medics and medic trainees. Military dentists - I won't even go there...

Maine's health insurance access is not the best by any means for folks who don't have the benefit of being retired. Personally, I think it goes hand-in-hand with the fact that we lack incentives to make it worth it for businesses who offer medical benefits to come up here. We have a great workforce, but it's obviously easier to heat a building in an area south of here, and Maine's business taxes and other expenses are very prohibitive.

[cebdark]

I'll go one step further by noting that a despite what many people think about Mainecare coverage for only welfare recipients, a vast number of working poor are qualified for and receive Mainecare benefits because their employer either can't or won't offer medical benefits.

That's just a statement of what becomes more and more apparent to me every day. We need to incent businesses to come up here, and we as a populace, need to support those businesses by purchasing local products.

[Acadianlion]

Originally Posted by angelo129

With most of my family working in the field of healthcare, and many of them in states other than Maine, I think it's misleading to minimize Maine's problem by suggesting that it can be lumped in with "extreme everywhere." This really isn't true, as a bit of research will show. No, other states do not have only a single provider, which is the beginning of the problem. .

It isn't so much that there is a single provider that is the problem. The problem is that the legislature seems to have a permanent vendetta against the insurance industry that surfaces from time to time, and is usually related to a need to force either some sort of social or fiscal agenda onto some business group. The legislature chronically seems to want to try to steal money from one group to give to another.

In the 1970's and 1980's it was the property and casualty insurance industry, and the weapon of choice was workers compensation insurance. At that time there was virtually no limit to the injury and disability that a worker could get by manipulation of the worker's comp policy at the hands of legal assistance since the worker's lawyer was guaranteed payment by the employer's insurance policy. The statistic at one point that an employee who alleged that he/she was injured on the job and who received care for more than thirty five days would never work again.

Employers were not required to provide loss control programs to make employees workplaces safer, and employees were not required to participate in workplace safety programs. I was on one city's insurance committee in an effort at reducing the surcharges applied to the manual rates (ONE HUNDRED SEVENTY FIVE PERCENT!!!), we tried to get a weight management program installed for all city workers. Heart attacks and other weight related injuries were the cause of the adverse rating. The city offered to make an additional contribution to the city employee's retirement program equal to the percentage that the cost of workers comp could be reduced. But the employee's union said that "workers comp was the city's 'problem'". Loss control programs were available but not mandatory.

In the end, the state began to mandate that substandard risks had to be underwritten in the standard market, and the insurance industry finally had enough and left the state. That resulted in a complete overhaul of the worker's comp laws, and the creation of an employer's mutual insurance "company". With more restrictive laws, the elimination of unlimited legal services to employees, and other changes that SHOULD have been made before, the cost of worker's compensation has stabilized.

With health insurance the situation is a bit different. The governor has wanted Maine to be THE provider of health insurance and the foolish Dirigo Health Plan was developed, funded in part by taxes on insurance policies. It has failed miserably, yet the state persists. The health insurance market has dried up in Maine, and only Anthem really is an available provider. The sticking point is UNDERWRITING. Any insurance company providing coverages MUST be able to pick and chose for whom it provides coverage at what rate. This is true for health insurance, homeowners insurance, auto insurance, business insurance or insuring rockets going to the moon. If the laws requrire guaranteed issue of coverage AND the rates are regulated in one manner or another, an insurance company will befored to provide coverage at a loss.

The only insurance company that can provide coverage at a loss is one that is directly owned and operated by either the state or federal government because any loss sustained by providing services can be made up by taxation.

Here in Maine health insurance and health care services for that matter, are hampered by the simple fact that there are so few people in the state. One Point Three million people is too shallow a risk pool to provide true spread of risk and if ALL people are rated the same way regardless of condition of health, then a health insurance plan of any sort is due to continually lose money. If auto insurance in Maine was suddenly required to be provided to everyone with any kind of driving record, driving every kind of vehicle, for every kind of reason at the same rate, the state would very suddenly be without auto insurance companies.

The solution to Maine's health insurance issues is for

• The state to provide a special health insurance program for the chronically ill
  • Allow individual risk underwriting for small groups, and individual family and individual polices for Maine residents.

These two changes would do wonders for restoring a competitive market for health insurance in Maine, and the direct savings to those who do not have the benefit of an employer's large group policy will immediately benefit.

Maine is a state of small businesses. The governor and the legislature simply needs to learn that most people in Maine do not work for a large employer and hence must bear the entire cost of health care themselves. There is a bill being worked on right now in Augusta that would require state employees to pay at least a portion of their own health insurance costs. If that passes, there will likely be other changes that may benefit the rest of the people of the state.

[Submariner]

Originally Posted by reloop

... It is better now in the military, but for many years, it was OJT by very young and inexperienced medics and medic trainees. Military dentists - I won't even go there...

I could go for hours telling stories of medical 'treatment' at the hands of the un-educated that I have been subjected to, that my Dw and children have been subjected to, here in the USA.

But I won't do that for now.

... Maine's health insurance access is not the best by any means for folks who don't have the benefit of being retired. Personally, I think it goes hand-in-hand with the fact that we lack incentives to make it worth it for businesses who offer medical benefits to come up here. We have a great workforce, but it's obviously easier to heat a building in an area south of here, and Maine's business taxes and other expenses are very prohibitive.

I agree.

[Submariner]

Originally Posted by Acadianlion

It isn't so much that there is a single provider that is the problem. The problem is that the legislature seems to have a permanent vendetta against the insurance industry that surfaces from time to time, and is usually related to a need to force either some sort of social or fiscal agenda onto some business group. The legislature chronically seems to want to try to steal money from one group to give to another.

When Susy home-maker gets into politics, and wins a seat in Augusta, she likely does not carry with him an agenda like this.

From your unique perspective, perhaps you can see, where does this agenda of the elected officials come from?

... Here in Maine health insurance and health care services for that matter, are hampered by the simple fact that there are so few people in the state. One Point Three million people is too shallow a risk pool to provide true spread of risk and if ALL people are rated the same way regardless of condition of health, then a health insurance plan of any sort is due to continually lose money. If auto insurance in Maine was suddenly required to be provided to everyone with any kind of driving record, driving every kind of vehicle, for every kind of reason at the same rate, the state would very suddenly be without auto insurance companies.

A neat perspective.

Thank you

... Maine is a state of small businesses. The governor and the legislature simply needs to learn that most people in Maine do not work for a large employer and hence must bear the entire cost of health care themselves. There is a bill being worked on right now in Augusta that would require state employees to pay at least a portion of their own health insurance costs. If that passes, there will likely be other changes that may benefit the rest of the people of the state.

Good.

[flycessna]

Don't forget Maine's freecare. If you are living here and are below a minimum income which is based on the number of people in your family, you would eligible for free care. I also see that there is limited or partial coverage for people who make more. And at first glance it all appears rather liberal....both my wife and I working do not make that much more than the limits. But thats all I know about it

Also, At least here in Lewiston and the affiliates of CMMC offer their own type of free care for people below a certain income.

As for the insurance "options" in Maine........very limited!! and it seems as though every year my Employer Covered Insurance gets worse. Everytime I need a referral from a particular doc to another. I see stress and concern when they here we have Antham

[msina]

There is also Penobscot Community Health Care in Bangor, it's a clinic and has a dental care division. They also have an affiliate in Old Town. Payment is based on a sliding scale based on income.