By Marc Gilman
Questions? Call (800) 927-9326 or email
Key Takeaways
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Maine offers stronger Medigap protections than most states — but it’s not unlimited “any plan, any time” guaranteed issue. The reality is a specific set of ongoing rights, not a blanket rule.
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Everyone gets the same federal baseline: a one-time 6-month window at 65+ enrollment in Part B, guaranteed issue for any plan.
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Maine’s added protection lets you switch to equal-or-lesser coverage without medical underwriting, as long as you haven’t had a coverage gap longer than 90 days since first enrolling in Medigap — but you generally can’t use this to upgrade to richer benefits.
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Every Maine Medigap insurer must offer Plan A on a guaranteed-issue basis at least one month per year — and two insurers offer it year-round.
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Maine extends the Medicare Advantage trial right to 36 months, versus the federal standard of 12 months, if you try MA and want to switch back to Original Medicare with Medigap.
The Federal Baseline Everyone Gets
No matter which state you live in, Medicare gives you a one-time 6-month Medigap Open Enrollment Period, starting the month you’re both 65 or older and enrolled in Part B. During this window, insurers must sell you any Medigap plan they offer, at their standard rate, regardless of your health history. This is the same in Maine, Massachusetts, New Hampshire, or anywhere else — it’s federal law, not state-specific.
The differences start after that window closes.
What Maine Actually Adds
1. Ongoing Right to Switch — With a Catch
Maine gives you an ongoing right to switch Medigap plans or carriers without medical underwriting, but only to a plan with equal or lesser benefits than what you currently have. The condition: you can’t have had a coverage gap longer than 90 days since you first enrolled in a Medigap plan.
This is the detail that trips people up. It sounds like “guaranteed issue, anytime” — and functionally, it is guaranteed issue — but it’s specifically a downgrade-or-lateral-move right, not a way to freely upgrade to richer coverage whenever you want.
2. A Guaranteed-Issue Window for Plan A, Every Year
Every Medigap insurer licensed in Maine must designate at least one 30-day window each year during which they’ll accept any applicant for Plan A — the most basic, least expensive standardized Medigap plan — regardless of health history. Two insurers currently active in Maine (Anthem Blue Cross Blue Shield and Colonial Penn) go further and offer Plan A on a guaranteed-issue basis year-round.
This matters most for people whose primary goal is simply having some Medigap coverage in place, even if it’s not the most comprehensive plan available.
3. A Longer Medicare Advantage “Trial Right”
If you enroll in a Medicare Advantage plan and later decide you want to switch back to Original Medicare with a Medigap policy, federal law generally gives you a 12-month trial period to do that with guaranteed issue rights. Maine extends this to 36 months — a meaningfully longer window to change your mind without facing medical underwriting.
What Maine Does Not Guarantee
To be equally clear about the limits:
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You can’t use Maine’s switching right to move to a richer plan than what you currently have — only equal or lesser benefits.
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The 90-day gap rule is a hard line — let your coverage lapse longer than that, and the ongoing switching right doesn’t apply.
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Outside of Plan A’s guaranteed window (or your original 6-month period, or a qualifying life event), insurers can still medically underwrite applications for other plan letters.
How Maine Compares to Massachusetts and New Hampshire
Since Gilman Agency serves all three states, this comparison matters:
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Massachusetts offers an annual guaranteed-issue window every February 1–March 31 for any plan, and most MA insurers voluntarily extend guaranteed issue year-round beyond that.
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New Hampshire has no additional state-level protection — the one-time federal 6-month window is genuinely the only guaranteed issue opportunity most NH residents get.
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Maine sits in between: real ongoing protections (equal-or-lesser switching, annual Plan A access, extended MA trial right), but more conditional than Massachusetts’s broader annual window.
Three states, three genuinely different sets of rules — worth knowing precisely which one applies to you rather than assuming they’re all the same.
What To Do Next
“Is Maine guaranteed issue?” doesn’t have a clean yes-or-no answer — it’s yes, with specific, real conditions that determine what you can actually do and when. Knowing exactly which protection applies to your situation (the initial window, the equal-or-lesser switching right, the annual Plan A window, or the extended MA trial right) is the difference between a confident decision and an expensive surprise.
If you’re in Maine and want to know exactly where you stand, reach out and we’ll walk through your specific situation together.
Questions? Call (800) 927-9326 or email
