Frequently Asked Questions

General FAQs

What is CoverME.gov?

CoverME.gov is Maine’s official health insurance marketplace where you can shop for and buy health insurance coverage. This is the only place where Mainers can apply for financial help that can lower your monthly premium and out-of-pocket costs.

Why is it important to get covered?

No one plans to get sick or hurt, but it happens. Health insurance through CoverME.gov protects you and your family members from the unexpected. All plans on CoverME.gov cover many preventive services with no co-pay. All plans at CoverME.gov also cover guaranteed essential benefits such as prescription drugs, maternity care, doctor visits, and more.

I received a letter from my insurance company with an estimate of my costs for 2026. Why is it more than I paid in 2025?

The letter you received from your health insurance company may include both an estimated monthly payment amount and an estimated monthly premium amount. The monthly premium amount may be more than you expected because it reflects the cost of your plan without any financial assistance for which you may qualify. The estimated monthly payment amount is that premium amount reduced by the amount the financial assistance you qualified for in 2025. This is the amount that your insurance company estimates you'll pay, but it may not be equal to what you will actually pay in 2026.

How much is my monthly payment in 2026?

If you are currently a CoverME.gov member, log in to your CoverME.gov account to see your monthly premium. If you don't have coverage through CoverME.gov, you can get an estimate of 2026 costs and review plan options with our Plan Comparison Tool. For assistance reviewing alternate options, find a free, local expert on our Broker or Maine Enrollment Assister list or contact Consumers for Affordable Health Care at 1-800-965-7476.

How do I get financial savings?

Financial savings on CoverME.gov are primarily based on household size and yearly income.

If you are a new consumer, you must include your estimated 2026 income on your application to see what you may receive in financial savings (also known as Advance Premium Tax Credit or APTC).

If you are a current CoverME.gov member and your information has not changed since last year, then you do not need to do anything. If your information has changed, you should review your most recent determined application so we can accurately determine your eligibility for savings in 2026. You must file your federal taxes and complete Form 8962 to reconcile APTCs received in 2025 because those credits were based on estimated 2025 income. CoverME.gov will send you Form 1095-A containing information on financial assistance received last year, which you will use to complete Form 8962. Failure to reconcile last year's APTCs will make you ineligible for future tax credits. Some of the most common reasons why APTC is not automatically renewing are:

You filled in an end date for your 2025 income on your application, so we don't have information about your 2026 income
You did not file your federal taxes with Form 8962 to reconcile advance premium tax credits received last year
You have been determined eligible or potentially eligible for MaineCare
Your consent for CoverME.gov to verify your information with the IRS has expired
You have missing or incomplete information on your last determined application

We also encourage you to make sure that both your application and My Household have the same people marked as requesting coverage. Sign in to your account to review your information.

When can I enroll in coverage?

Open Enrollment 2026 runs from November 1st, 2025 to January 15th, 2026. Enroll in coverage by December 15th for January 1st coverage, and by January 15th for February 1st coverage. You may still be eligible to enroll in coverage or change your current coverage outside of the annual Open Enrollment period if you experience a Qualifying Life Event - like losing insurance you get through your job, getting married or divorced, or having a baby. These events qualify you for a Special Enrollment Period, which means you may be eligible to enroll in a plan outside of the annual Open Enrollment period.

Can I add or change plans outside of Open Enrollment? What is Special Enrollment?

If you’ve recently experienced certain life changes, you may be eligible for a Special Enrollment Period which will allow you to enroll in coverage outside of the Open Enrollment Period. These changes can include losing insurance you get through a job, marriage, divorce, pregnancy, or having a baby.

Who can use CoverME.gov?

CoverME.gov is available to anyone seeking more information about health insurance options throughout the state. Individuals who may want to consider health coverage through CoverME.gov include:

People who are uninsured and do not have access to affordable health insurance through their job
People who buy their own health insurance such as self-employed, seasonal, or gig workers
People who work part-time and do not qualify for their employer’s benefits

What types of plans are offered through CoverME.gov?

CoverME.gov offers individual Marketplace plans, which are comprehensive health insurance plans that protect you from financial risk if you get sick or need care. These plans cover a core set of Essential Health Benefits, including many preventive services at no out of pocket cost to you. Marketplace plans on CoverME.gov cannot turn you away or charge you more for having a pre-existing health condition.

How do I know if I qualify for financial assistance?

There is financial help available to most people who shop for Marketplace plans on CoverME.gov. Depending on your income and family size, you may be eligible for financial assistance to help you afford your monthly premium and out-of-pocket costs.

CoverME.gov can also help you determine if you may be eligible for low-cost or no-cost coverage through MaineCare.

To see an estimate of the financial assistance you may qualify for, answer a few simple questions in our Plan Comparison Tool.

Open Enrollment runs November 1st through January 15th. Outside of Open Enrollment you can apply at CoverME.gov to receive a determination of your eligibility, but will only be able to enroll in a plan if you qualify for a Special Enrollment Period (SEP) or if you are eligible for MaineCare.

What information do I need to enroll through CoverME.gov?

You will need this information for yourself and anyone in your household applying for coverage:

Home and/or mailing addresses
Birth dates
Social Security numbers
Document information for legal immigrants, if applicable
Employer and income information for every member of your household (for example, pay stubs or W-2 forms)
Your best estimate of what your household income will be for the year
Policy numbers for any current health plans covering members of your household

Who do I have to include on my application?

 You need to include everyone in your tax household, even if they do not file taxes or are not looking for health care coverage. This includes your spouse, if you have one, and anyone you plan to claim as a dependent in the year you’re applying for coverage. Everyone does not have to live at the same address to apply on the same application. Your income and family size help us decide which programs you qualify for.

Follow these basic rules when including members of your household:

Learn more about who to include in your household here.

Include your spouse if you’re legally married
If you plan to claim someone as a tax dependent for the year you want coverage, do include them on your application
If you won’t claim them as a tax dependent, don’t include them
Include your spouse and tax dependents even if they don’t need coverage

Why do I have to submit documents for verification after submitting my application?

If you receive a list of items that require verification after submitting your application, it means that information you entered may not match information we have in our records. If it looks like you are eligible for enrollment in a private health plan through CoverME.gov (with or without financial assistance), then you will be conditionally eligible for 90 days. During this time, you can sign up for a plan and begin receiving financial assistance. It is important that you submit documents within this time frame. Otherwise, your eligibility will be redetermined based on our data sources and you may lose coverage or have your financial assistance reduced. The notice you receive from CoverME.gov will contain detailed instructions for submitting documentation.

Does CoverME.gov use text messaging?

Yes. Starting in 2025, CoverME.gov will use text messaging if you have opted in to text messaging preferences. There are four phone numbers that could text you. We will text the primary account holder for two reasons.

We will text you if you request a password reset. The message is "Your one-time passcode is [your one-time passcode]. You have 5 minutes to use this passcode to reset your password."
We will text you when a message is posted to the household's message inbox in your CoverME.gov account. The message is "[Primary Account Holder’s Name] You have a new message that may require action. Log in to your account to read it. Reply STOP to opt-out."

Mobile text messages from CoverME.gov will never include hyperlinks. Do not click on any links from a text you receive claiming to be from CoverME.gov. The phone numbers that text you are not monitored. If you text back, no one will see your message. At present, texts are only in English. If you have questions or are worried a text isn’t really from us, contact the CoverME.gov Consumer Assistance Center. Our phone number is 1-866-636-0355 TTY: 711.

What should I do if my income or household size changes after I enroll?

If your income or household size has changed, update your application as soon as possible. These changes may affect the coverage or financial support you receive. For example:

If your income goes down or you gain a household member, you could qualify for more savings than you're currently getting to lower your monthly premiums. Or you could qualify for free or low-cost coverage through MaineCare.
If your income goes up or you lose a household member, you may qualify for less savings than you're getting now. If you don't report the change, you may have to pay back money when you file your federal tax return next year.
When you file your federal taxes, you will need to include Form 8962 with your filing to reconcile the estimated income on your application with your actual income. CoverME.gov will send you Form 1095-A containing information on financial assistance received last year, which you will use to complete Form 8962. If your estimated income and actual income are different, the amount you receive in your tax return will reflect the amount of tax credits you would have received based on your real income, or you may owe money to the IRS if actual income was greater than the estimated income on your application.

How do I update my address on CoverME.gov?

To change your address, you need to update your application. Here's how:

Log in to your CoverME.gov account.
Go to the 'Applications' section.
Choose the year you want to update.
Click the 'Actions' drop-down next to that year.
Select 'Update Application'. Want to update information for just one person? Click their name directly.
Make your changes and resubmit your application.

Use this guide (PDF) for step-by-step instructions with images.

Is the Easy Enrollment Tax Referral Program still available?

No, the Easy Enrollment Tax Referral Program ended on 12/31/2025. The program and the associated Special Enrollment Period were repealed by the Maine State Legislature.

What should Taro customers know about the "Mending" name change?

One of the health insurance carriers on CoverME.gov - Taro - has changed their name and is now known as Mending. If you are a customer, here's what you need to know:

No disruption of service - Your health insurance plan remains fully intact, with the same coverage, benefits, and provider access.
No new ID cards until 2026 - You will continue using your current ID cards through 2025. New ID cards with the new company name, Mending, will be sent to customers in January 2026.
Same people, same support - Your contacts, billing, and member portal access will remain unchanged.

If you have questions about the name change, contact Mending's member support team at support@mending.com or (877) 522-5151

Broker & Assister FAQs

Who can help me fill out an application on CoverME.gov?

Both Maine Enrollment Assisters (MEAs) and Agents/Brokers can help you enroll in health insurance, at no cost to you.

You can also call the Consumer Assistance Center at (866) 636-0355 for live, free assistance with your application. TTY users should call 711. Assistance is available in many languages.

What is the difference between an Agent/Broker and a Maine Enrollment Assister?

Maine Enrollment Assisters provide unbiased information and help you apply for either MaineCare or a Marketplace plan, but they won’t endorse a specific plan choice for you. Agents/Brokers can help you find a plan that fits your needs, and most can provide a referral if you need help applying for MaineCare. Brokers may be paid directly by insurance companies.

There is no cost to you for using a Broker or Assister. Using one instead of the other will NOT impact the cost of your health plan.

How can I search for a Broker or a Maine Enrollment Assister?

Search for a Broker or Maine Enrollment Assister by using our Find Local Help Tool. You can search for assistance based on your location and the type of help you’re looking for.

CoverME.gov Plan FAQs

What is the Affordable Care Act?

The Affordable Care Act (ACA) is a federal law passed in the United States in 2010. The ACA made consumer protections the law. It allowed more people to qualify for Medicaid programs, like MaineCare. It also created health insurance Marketplaces (like CoverME.gov) and required several consumer protections for private health insurance plans.

The ACA exists to make insurance more affordable. To do this, the ACA created subsidies - a type of financial assistance - for health coverage. The best-known subsidy on CoverME.gov is the “Premium Tax Credit.” ACA financial assistance is income-based. It lowers monthly costs for qualifying households. Currently, qualifying households have incomes between 100%-400% of the Federal Poverty Level. If your household earns income between 100%-400% of the Federal Poverty Level, you may be eligible for savings.

The ACA also created many important consumer protections. It protects people with pre-existing health conditions. Health insurance companies cannot charge people with pre-existing conditions more money. They also cannot deny coverage to someone with a pre-existing condition. People with Marketplace plans are also guaranteed certain benefits. All health plans sold on Marketplaces like CoverME.gov must cover the ACA’s ten Essential Health Benefits. They also must cover recommended preventive services with no additional out-of-pocket costs.

What’s the difference between CoverME.gov and other available health insurance coverage options?

CoverME.gov is not an insurance company. We’re a “one-stop shop” website. We give Mainers a way to compare health insurance plans from private insurance companies. We’re also the only place where Mainers can get financial assistance to lower out-of-pocket costs. Financial assistance on CoverME.gov is based on household income. People who buy coverage outside of CoverME.gov cannot access this financial assistance.

All private health plans must cover pre-existing health conditions and free preventive services. This is true for plans sold on CoverME.gov and plans sold directly by insurers. All plans must also cover the ACA’s ten Essential Health Benefits. This allows people to access a full range of medical care like emergency services, mental health care, and more.

What are Essential Health Benefits?

Since 2014, the federal Affordable Care Act (ACA) has required health plans to cover certain benefits. Ten benefits, called the “Essential Health Benefits,” must always be covered. All CoverME.gov plans cover the Essential Health Benefits. Almost all private health insurance plans cover them too, as required by the ACA. How much they cost depends on which plan you choose. Some plans cover Essential Health Benefits with no out-of-pocket cost to you. Some plans include a co-pay or co-insurance charge. The benefits are: 

Ambulatory patient services (e.g. urgent care)
Emergency services
Hospitalization (like surgery and overnight stays)
Pregnancy, maternity, and newborn care (both before and after birth)   
Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
Prescription drugs 
Rehabilitative and habilitative services and devices (i.e. services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
Laboratory services 
Preventive and wellness services and chronic disease management
Pediatric services, including vision care

What Financial Assistance is Available through CoverME.gov?

When you apply for coverage through CoverME.gov, you may qualify for financial assistance. Financial assistance is based on household size and estimated income. Assistance includes Advance Premium Tax Credits (APTC) and Cost-Sharing Reductions (CSR).

What are Advance Premium Tax Credits (APTCs)?

Advance Premium Tax Credits (APTCs) are federal tax credits. They are a type of financial assistance. They lower your monthly health insurance payment, called your “premium.” They are called “Advance” credits because you can take them throughout the year as you pay your monthly premiums, instead of just at tax time.

Most people who qualify for Advance Premium Tax Credits take them monthly. Let’s say you pick a health plan with a $500 monthly premium. If you qualify for $400 in Advance Premium Tax Credits, you will only be charged $100 per month for your plan. Your Advance Premium Tax Credits (in this example, the $400) will be sent directly to your insurance company.

So who can get Advance Premium Tax Credits? And how much do you get? It depends on your household size and expected annual income. Households earning between 100-400% of the Federal Poverty Level can get APTCs. The dollar amount of APTCs you get depends on how low or high your income is. There are some other rules: APTCs are only available to U.S. citizens or people with eligible immigration or citizenship statuses. You generally can’t get APTCs if you are offered another source of affordable health coverage. This includes health coverage offered through your employer, Medicare, or Medicaid. 

The amount of APTCs you can get depends on your estimated household income. It's important to give us your best estimate. If your estimate changes, update your CoverME.gov application throughout the year. If you tell us you expect to make $40,000 a year and you actually make $140,000, you'll have a big bill from the IRS at tax time. If you get more APTCs through the year than you're actually eligible for, you will have to pay money back. You will need to make repayments to the IRS at tax time.

You apply for APTCs as part of your CoverME.gov enrollment.

What are CSRs?

Cost-Sharing Reductions (CSRs) are often referred to as “extra savings.”   Cost-Sharing Reductions lower the amount of money you will pay out-of-pocket for healthcare. If you choose a plan with Cost-Sharing Reductions, your deductible will be lower. Your copayments, coinsurance, and out-of-pocket maximums will also be lower. You will pay less money to access high-quality healthcare.

Do you qualify for Cost-Sharing Reductions? It depends on your annual household income and household size. If your household income is between 100%-250% of the Federal Poverty Level, you’ll likely qualify for CSRs. When you apply for financial assistance on CoverME.gov, your results will say if you qualify for CSRs or not. If you qualify for CSRs, you must enroll in a Silver plan to get these extra savings.

There are similarities and differences between Cost-Sharing Reductions and Advance Premium Tax Credits. Both Advance Premium Tax Credits and CSRs bring your health insurance costs down. They are both income-based. Some people who get Advance Premium Tax Credits will also qualify for CSRs. However, there are some important differences. Advance Premium Tax Credits are a dollar amount of savings that you can get each month. They bring down your monthly payment, or “premium,” to your health insurance company. Cost-Sharing Reductions are built into plans for people who qualify and lower the plan deductible, co-pays, co-insurance, and out-of-pocket maximum. You can use Advance Premium Tax Credits at any metal level, but if you qualify for a Cost-Sharing Reductions, you’ll only get those savings if you enroll in a Silver plan.

To qualify for Advance Premium Tax Credits, your annual household income must be between 100%-400% of the Federal Poverty Level. To qualify to buy a Cost-Sharing Reduction plan, your annual household income must be between 100%-250% of the Federal Poverty Level. People with annual household income between 100%-250% of the Federal Poverty Level typically qualify for both Cost-Sharing Reductions and Advance Premium Tax Credits.

What are Association Health Plans?

Association Health Plans (AHPs) are group health insurance plans. They are offered to the members of professional associations or organizations. With these plans, multiple employers in the same industry can offer employees group health coverage. AHPs can be inexpensive. This low cost can be appealing. However, there are drawbacks.

If you choose an AHP, they can limit which health services they cover. You might face waiting periods from the AHP for getting healthcare services. The AHP might limit certain benefits and services. These plans often charge varying premiums based on your health status.

Some examples of Association Health Plans are Farm Bureau Plans and Health Sharing Ministries.

If concerns about costs have you considering a Farm Bureau Plan or another AHP, please exercise caution. Review the plan carefully to see if there are limitations on coverage. If you have an existing health condition or if you are diagnosed with a serious health condition, you might be denied care. You might pay money for your AHP, and not be able to access the care you need.

CoverME.gov will never limit coverage based on health conditions. Many Mainers can also get financial assistance on CoverME.gov. These savings can lower monthly premiums and your out-of-pocket costs. The comprehensive plans offered through CoverME.gov may be more affordable than you expect!

How do I know if I am working with a reputable agent or buying a comprehensive health insurance plan?

Scams are on the rise. Health insurance scams have been reported in Maine. By staying alert, you can protect yourself from high costs.

CoverME.gov is Maine’s only official health insurance Marketplace. If you do not see the ".gov" ending, you are on the wrong website. Avoid sites like CoverME.com and CoverME.org. They are not the real Marketplace and exist to trick consumers. Scam sites sell insurance plans that may not meet the Affordable Care Act standards. Consumers who buy these plans lose out on consumer protections and don't get comprehensive insurance.

Maine’s Bureau of Insurance (BOI) warns consumers about plans that are not what they appear to be. These may appear to be comprehensive insurance plans, but they are not. Health care sharing ministries (HCSMs) are one example. They may present themselves as insurance, but there is no guarantee of coverage. Unlike Marketplace plans, HCSM plans can refuse to pay for your medical expenses. They are not required to cover pre-existing health conditions. They can have waiting periods or significant limits on coverage. Exercise extreme caution. If you purchase a plan like this and end up not having the coverage you expected, you have limited options for next steps.

Maine’s BOI is here to protect Mainers. Unsure about a company or person offering you insurance coverage? Call the BOI before sharing any personal information or making payments. The BOI’s phone number is 800-300-5000 TTY 771.

If you are unsure about a company or agent, write down what you know about them. Write down information like website, name, and any other details. Scammers may present themselves as agents to steal your personal and financial information. If you’re talking to an agent, ask them for their National Producer Number (NPN). If they refuse to share an NPN, they are probably not a real and/or licensed agent. There may be other clues that you are talking to a scammer. Scammers often try to rush you into a purchase. They might charge you an extra fee to purchase a plan. They might require you to join an association to purchase a plan. Stay vigilant to protect yourself. Call Maine’s BOI at 800-300-5000 TTY: 771 to report any suspicious behavior.

All plans purchased through CoverME.gov are legitimate plans. All plans on CoverME.gov are compliant with the Affordable Care Act standards. CoverME.gov offers comprehensive coverage, plus free broker and assister support. Call CoverME.gov directly at 866-636-0355 TTY: 711 to find a reputable and licensed agent.