For those individuals that purchase a subsidized health insurance plan through the Exchange, and have previously paid at least one full month’s premium during the benefit year, the insurance plan must provide for a 90-day grace period for premium payment before canceling for non-payment. Within this 90-day period, claims for the first 30 days must be paid. Claims that occur within the last 60 days of the grace period do not have to be paid if the coverage is terminated. These claims are permitted to be placed in a pending status. The rule requires that the insurance plan notify the healthcare providers when the patient is within the last 60 days of the grace period, though it is not clear how this will be accomplished.
If you have any questions or if you would like more information on the Exchange, please Contact Us.
