It’s important to pay your monthly health insurance premium payment in full each month by the due date.
If you miss a monthly premium payment
Your health insurance company could end your coverage if you fall behind in paying your monthly health insurance premium.
But before your insurance company can end your coverage, you have a short period of time to pay called a “grace period.”
The health insurance grace period is usually 90 days — if both of the following are true:
- You have a Marketplace plan and qualify for advance payments of the premium tax credits (APTC) to lower your monthly premium
- You already paid at least one full month's premium during the benefit year
Note: If you don’t qualify for APTC, your health insurance grace period may be different. Contact your State Department of Insurance (DOI) for more information on grace periods in your state.
If you reach the end of your grace period
It’s important to pay all outstanding insurance premiums during a grace period so that your health insurance company doesn’t end terminate your coverage.
The 90-day health insurance grace period starts the first month you fail to pay, even if you make payments for later months afterward. For example:
- You don’t make your premium payment for May
- You submit premium payments on time for June and July, but still haven’t paid for May
- Your grace period ends July 31 (90 days from May 1).
- If you haven’t paid your May premium by then you lose coverage retroactive to the last day of May.
If your health coverage is terminated due to non-payment
If your health insurance company ends your coverage because you didn’t pay all outstanding health insurance premium payments in full by the end of your grace period:
- You have the right to appeal your health insurance company’s decision if you believe your coverage was wrongly terminated.
- You don’t qualify for a Special Enrollment Period (SEP) because you’ve lost qualifying health coverage. But you may qualify for an SEP for other reasons.
- If your coverage ends before the end of the benefit year and you aren’t enrolled in Marketplace coverage in mid-December of that year, you aren’t eligible to be automatically re-enrolled for the following year.
- If you don’t qualify for an SEP, you can apply for coverage during the next Open Enrollment Period.
- If you’re determined eligible to enroll in a Marketplace plan and want to enroll in the same plan, you may be able to if it’s still available. The health insurance company can’t refuse you based on failure to pay for any previously owed and unpaid premium. It also can’t apply any payment for the new enrollment toward the outstanding debt from the prior, terminated enrollment.
- Whether you choose a new plan or the same plan you were terminated from, you must pay your first premium directly to the insurance company — not to the Health Insurance Marketplace — to complete your enrollment.