LD 1496
pg. 17
Page 16 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 18 of 41
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LR 541
Item 1

 
risk by at least one member insurer within 6 months of the date of
the certificate, or if the resident meets other eligibility
requirements adopted by rule by the superintendent that are not
inconsistent with this chapter and that evidence that a person is
unable to obtain coverage substantially similar to that which may
be obtained by a person who is considered a standard risk.__Rules
adopted pursuant to this subsection are routine technical rules as
defined in Title 5, chapter 375, subchapter 2-A.

 
2.__Change of domicile.__The board shall develop standards for
eligibility for coverage by the association for a natural person
who changes domicile to this State and who at the time domicile
is established in this State is insured by an organization
similar to the association.__The eligible maximum lifetime
benefits for that covered person may not exceed the lifetime
benefits available through the association less any benefits
received from a similar organization in the former domiciliary
state.

 
3.__Eligibility without application.__The board shall develop
a list of medical or health conditions for which a person is
eligible for plan coverage without applying for health insurance
under subsection 1.__A person who can demonstrate the existence
or history of any medical or health conditions on the list
developed by the board may not be required to provide the
evidence specified in subsection 1. The board may amend the list
from time to time as appropriate.

 
4.__Exclusions from eligibility.__A person is not eligible for
coverage under the plan if:

 
A.__The person has or obtains health insurance coverage
substantially similar to or more comprehensive than a plan
policy or would be eligible to have coverage if the person
elected to obtain it, except that:

 
(1)__A covered person may maintain other coverage for
the period of time the person is satisfying a
preexisting condition waiting period under a plan
policy; and

 
(2)__A covered person may maintain plan coverage for
the period of time the person is satisfying a
preexisting condition waiting period under another
health insurance policy intended to replace the plan
policy;

 
B.__The person is determined eligible for health care
benefits under the MaineCare program pursuant to Title 22;


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