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- After you apply and enroll in a plan through the marketplace, you should pay your premium directly to your insurance company
- You typically have to apply for a marketplace plan during open enrollment between November and January
- In some cases, you might be eligible for a special enrollment period and will typically have 60 days to apply for a plan
- If you a miss your monthly premium payment, you are usually entitled to a 90 day grace period to get up to date
- If you still do not pay by the end of this grace period, you can be terminated from your health insurance plan
How do I pay my first premium for a Marketplace plan?
You pay your first monthly premium to your insurance company, not to the Marketplace. Keep in mind that you will not have any coverage until after you pay.
If you are unsure if your coverage has started, you can check it online on your Healthcare Marketplace website. When you log in to your account, you should click on “start a new application or update an existing one”.
After that, click on the link that says “My Applications and Coverage” and you should see a list of your coverage benefits and information. If you do not see this list, you may not be enrolled. You should call your insurance company and confirm your enrollment. You can pay over the phone if you have not already done so.
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When is the open enrollment period?
In most cases, you will have to apply for a marketplace insurance plan during the open enrollment period. You will typically enroll and pay your first monthly premium during this time as well.
The open enrollment period for each year is between November and late December or early January or February.
During this time, you can enroll in and switch plans, as well as apply for premium tax credits.
What is a special enrollment period?
There are certain circumstances that happen in life that might make you eligible for a special enrollment period. After certain life events, such as marriage, giving birth, moving, or losing your old health insurance, you may be able to get coverage outside of the open enrollment period.
You usually have a 60 day period to enroll and pay your premium for a new plan. In most cases, your coverage will start immediately. If you recently had a child, your coverage will begin the first day the baby was born even if you did not enroll until 60 days later.
Employer special enrollment periods are a little different, but you typically have at least 30 days to enroll in your job-based plan.
What are premium tax credits?
Premium tax credits help you pay for your health insurance. If your income is between 100 and 400 percent of the federal poverty level, you may be able to get cost sharing assistance such as tax credits to assist you in paying for your monthly premium.
You can use all of your tax credits in advance to offset the cost of your monthly premium or you can only apply some or none and receive the rest of the money as a refund when you file your federal tax return.
The amount of tax credit you qualify for depends on the income you report on your marketplace application. If you use more tax credits than you qualify for, you will have to pay them back when you file your tax returns.
If you use fewer credits than you qualify for, you should get that amount back as a refund.
What happens if I do not pay my health insurance premium on a Marketplace plan?
If you do not pay your monthly premium, you may qualify for a 90 day grace period before you lose your coverage. You are eligible for the grace period if you have a marketplace plan, are eligible for premium tax credits, and you paid your first month’s premium already. Those who do not qualify for tax credits may have a different grace period.
If you do not pay your premium amount by the end of your grace period, your insurance company can terminate your coverage. If you lose your coverage, you can appeal the decision if you believe it was incorrect.
You will not get a special enrollment period if your coverage ends because you did not pay. However, you can reapply during open enrollment period. An insurance company cannot refuse to provide you with coverage again because you were previously dropped for non-payment.
When is your payment due for Obamacare?
Your payment for a marketplace plan is due when you enroll. You pay your premium directly to the insurance company and your coverage will not begin until you pay. You must enroll during the open enrollment period unless you are applying for a special enrollment period.
If you are eligible, you can use premium tax credits to help with the cost of your monthly premium.
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