What Happens if You Miss a Payment on Your Health Insurance Policy?

Your health insurance company may cancel your coverage if you fall behind in paying your monthly premiums. This usually happens after a short period of time, usually 90 days after the monthly health insurance payment is due. If you haven't made your payment, you can do so during the grace period and avoid losing your health coverage. If, at the end of the 90-day grace period, the amount due for all outstanding premium payments is not paid in full, the insurer can cancel the coverage.

After you make your first payment, you'll have a grace period if you don't pay your bill on time. You'll need to pay everything you owe before the grace period ends. If you don't, you could risk losing your coverage. If you're behind in paying your insurance premium, the outstanding balance could be sent to collections.

That delinquent account is likely to show up on your credit report and lower your credit rating. It will remain on your credit report for seven years (however, some scoring models don't include paid collection accounts in your score). There are other possible consequences of not paying premiums. You're not the first person to be late paying your health insurance premium, and you won't be the last.

The rules are stricter for those who don't have subsidies, while those who get help paying for their health insurance have a longer grace period. If you are late in paying your monthly health insurance premium, the rules are a little less stringent than those for the down payment, because there is a grace period. If you don't fully update your premiums within the 90-day grace period, your health plan will cancel your coverage retroactively to the day you were 31 days late in paying your health insurance premium. This is what happens if you don't pay your insurance premium, along with ways to save on insurance costs.

The Kaiser Family Foundation, the independent source for research, surveys and news on health policy, is a non-profit organization based in San Francisco, California. Losing your health insurance because you didn't pay your premium doesn't qualify you for a special enrollment period for loss of coverage to choose a new plan. However, after the first 30 days of the grace period, the insurer may defer payment of any health care claim for care received during the grace period. For the first 30 days after the premium is due, your health plan will continue to pay health insurance claims for the health care services you receive.

If you receive a health insurance subsidy with a tax credit for premiums (which is paid directly to your health insurer to offset the monthly premium costs) and you are late in paying your health insurance, you have a 90-day grace period before your health plan will cancel your coverage. If you don't have health insurance through your employer or are looking for coverage that best fits your needs, you can purchase a plan yourself through your state's health insurance marketplace. The one-month grace period also generally applies to all plans purchased outside the health insurance exchanges, since premium subsidies are never available to offset the cost of those plans (however, the policies themselves meet the requirements of the ACA, as long as they are important individual medical plans, as opposed to excepted benefits). How the grace period works depends on whether you get help paying for health insurance or not.

Market-available health insurance plans have a 90-day grace period, although this may vary if you don't qualify for a premium tax credit. If you don't receive a health insurance subsidy with a tax credit for premiums, your health plan will generally cancel your coverage after your payment is delayed by 30 days.

Lucy Anderson
Lucy Anderson

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