Maine Billing Rights

Additional State-Law Protections for Patients with State-Regulated Health Plans

Under Maine’s “Act To Protect Maine Consumers from Unexpected Medical Bills,” an out-of-network provider may not bill an enrollee for health care services beyond the applicable coinsurance, copayment, deductible or other out-of-pocket cost expense that would be imposed if in-network for surprise bills, bills for covered emergency services, or for bills for COVID-19 screening and testing. A “surprise bill” is a bill for health care services received by an enrollee for covered services rendered by an out-of-network provider, when the services were rendered at a network provider, during a service or procedure performed by a network provider, or during a service or procedure previously approved or authorized by the carrier and the enrollee did not knowingly elect to obtain such services from that out-of-network provider.

Filing a Complaint

If you believe you’ve been wrongly billed, you may contact your insurance carrier by calling the number on your insurance card. You may also file a complaint with the Maine Bureau of Insurance at www.maine.gov/pfr/insurance/consumers/file-a-complaint-dispute.

State Agency Contact Information

Maine Bureau of Insurance

Phone: 207-624-8475, or 800-300-5000 (toll-free)
Website: www.maine.gov/pfr/insurance/about/contact

Additional Information

Visit www.cms.gov/nosurprises/consumers or call 800-985-3059 for more information about your rights under federal law.