Should I keep my existing MaineCare or VA/CHAMPVA/TRICARE plan?

Deciding whether to keep your existing MaineCare (Medicaid) plan when transitioning to Medicare depends on your circumstances. Here are some factors to consider when making this decision:

  1. Coverage and Benefits: Compare the coverage and benefits provided by your MaineCare plan with what Medicare offers. While MaineCare can provide comprehensive coverage, Medicare covers many medical services. Evaluate whether Medicare’s offerings better meet your healthcare needs.

  2. Costs: MaineCare might have lower or no premiums and cost-sharing compared to specific Medicare plans. However, eligibility for MaineCare is based on income, so as your income changes, you might no longer qualify for MaineCare.

  3. Provider Network: Check if your preferred healthcare providers accept Medicare. Some providers who accept MaineCare might also accept Medicare, but ensuring that your doctors and specialists are in the Medicare network is essential.

  4. Transition Period: If you’re eligible for both Medicare and MaineCare, you might consider enrolling in both temporarily. Medicare can become your primary insurance, and MaineCare can act as secondary coverage to help cover additional costs.

  5. Prescription Drug Coverage: Depending on your coverage under MaineCare, you might want to assess how it compares to Medicare Part D for prescription drugs. Could you make sure the medications you need are covered under both plans?

  6. Medicare Savings Programs (MSPs): Some states offer Medicare Savings Programs that help cover Medicare premiums and, in some cases, other out-of-pocket costs. You might qualify for an MSP alongside Medicare, depending on your income and assets.

  7. Medigap or Medicare Advantage: If you opt for Original Medicare (Parts A and B), you might also consider enrolling in a Medigap (Medicare Supplement) plan to help cover out-of-pocket costs. Alternatively, you could explore Medicare Advantage plans (Part C) that might offer additional benefits beyond Original Medicare.

It’s crucial to assess your unique healthcare needs, financial situation, and preferences when deciding whether to keep your MaineCare plan alongside Medicare. You may want to consult with healthcare insurance experts or counselors who can provide guidance tailored to your circumstances. Keep in mind that you have the option to make changes during specific Medicare enrollment periods, so you can adjust your coverage as needed over time.

We do not offer every plan available in your area. Currently we represent 6 organizations that offer 46 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.