What Happens If I Miss a Health Insurance Premium Payment?

Jenifer Dorsey
2018-09-11 February 21st, 2017 |
Read time: 9 minutes

Uh oh. Life got crazy. Or, maybe money got tight. Something or other happened, and you didn’t pay your first Obamacare premium in 2017.

Now what?

You may not have health insurance.

What to do if you didn’t pay your premium … or aren’t sure if you paid it

Contact your health insurance company as soon as possible. Find out if you are enrolled in an Obamacare plan for 2017 and if you are up to date on your premium payment(s). While it is likely the company would have notified you about any unpaid premium amounts and resulting plan cancellation, it is not always safe to assume—addressing errors, technical glitches and mail delivery mistakes happen.

Not being able to recall paying your premium, not seeing payments withdrawn from your bank account, or not receiving communication from your health insurance company can all be red flags.

If you find out you are:

Current with your premium payment: Great. You should be covered for 2017 as long as you continue making timely payments. Consider finding out if your health insurance company offers an auto-pay option in which monthly payments are deducted from your bank account on a certain date each month—even then, check your bank statements or online account to be sure the payments are going through.

Not current with your premium payment? This could go one of two ways:

1. You may be within your health insurance company’s grace period for late payments—grace periods vary by insurer—and still covered by your plan. If this is the case, contact your health insurance company and make the past-due payment as soon as possible.

2. Your coverage may have been cancelled by the insurer, which means you are uninsured. As such, you don’t have benefits to help pay for healthcare and could also owe the shared responsibility payment (i.e., Obamacare tax penalty) for going without insurance.

Is there anything I can do if my Obamacare coverage got cancelled?

If your 2017 health insurance plan was cancelled because you failed to make your premium payment, you may find you have no health insurance and no recourse. Open enrollment for 2017 Obamacare plans ended on Jan. 31 and was not extended this year.

You will need to explore your ACA-compliant coverage options, which may include the following:

  • A special Obamacare enrollment period — you must experience a qualifying life event
  • Job-based health insurance — if you (or your spouse) start a job that provides access to major medical benefits
  • Medicaid – you must meet your state’s program enrollment criteria
  • Medicare – you must meet program enrollment criteria

For a list of what qualifies as minimum essential coverage, visit IRS.gov. Think you might be exempt from the shared responsibility provision and able to avoid a tax penalty? Visit IRS.gov to learn more about exemptions and how to apply for them.

If you didn’t pay your premium and lost your health insurance coverage due to cost, read our article “3 Options If You Lost Health Insurance Coverage Due to Affordability” and listen to our podcast on the topic.

What if you can’t get an ACA-compliant plan outside open enrollment?

If an Obamacare plan or other minimum essential coverage is not available to you, then you may want to consider short term health insurance in the meantime—even if you are exempt from the shared responsibility provision.

Short term health plans offer temporary benefits that can help you pay for a range of covered medical expenses. Plans come in several designs, including PPO options, and can be customized in terms of policy length, deductible amount and more. Keep in mind that short term health insurance is not ACA-compliant, which means it will not fulfill the shared responsibility provision and you could be denied coverage based on your health history.

Call the number at the top of your screen to speak with a certified advisor about short term health insurance options or other supplemental products to help you pay for healthcare while you are in between Obamacare plans.

Need a quick quote? Click here.


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Originally Published On February 21st, 2017