Marketplace Health Plans and Premiums

I’m behind on my premium payments and trying to catch up, but meanwhile I got sick and needed health care. Does my health plan have to pay these claims?

If you are receiving advanced premium tax credits, the insurer is required to pay your claims during the first 30 days of the grace period.  After that, during the second and third month of the grace period, the insurer is allowed to hold your claims and only pay them if and when you get caught up in your premium payments.

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.