Renewing Marketplace Coverage

I tried to renew my same plan for next year, but the insurance company says I missed a payment and won’t let me continue coverage next year until I pay the back premium I owe. Can they do that?

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No. Insurers are no longer allowed to require people who owe back-due premiums from the past 12 months to repay the premium debt before they will renew coverage for another year.  You must be allowed to renew; your payment for January 1 cannot be applied to the back premium you owe.

Going forward, keep in mind that insurers are allowed to cancel your coverage if you don’t pay premiums. In most cases, if you fall behind, the insurance company is required to notify you within 10 business days of discovering the payment delinquency and offer you a 3-month grace period to catch up on back-due premiums. The insurer must continue to pay your claims during the first month of that grace period. If you haven’t caught up on premium payments by the end of the grace period, the insurer can cancel your coverage retroactive to the first day of the second month of the grace period and deny any claims that you submitted during months 2 and 3 of the grace period.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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