What Happens if I Don't Pay December Premium Prior to Switch?

Cskill

New Member
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Please forgive if this is not the right forum to post. I scanned the forum index and am not sure and this one seemed closest. I am in Texas with United Healthcare under the ACA. I have not yet, but I am going to find another provider by Dec 15th under the ACA. What happens if I don't pay the final December premium to UHC? Since it won't really be a lapse situation with UHC since my coverage with them is ending anyway, will it have any consequences with the new provider I choose or my standing in the healthcare exchange? Also, I have a doctors appointment on December 6th... if I don't pay the Dec premium but the policy hasn't been seen as lapsed until the end of the month, would the appointment be seen as covered by the system and my doctor paid anyway, or will I end up getting a letter at some point in the future saying it wasn't covered and end up paying the full bill?
 
Please forgive if this is not the right forum to post. I scanned the forum index and am not sure and this one seemed closest. I am in Texas with United Healthcare under the ACA. I have not yet, but I am going to find another provider by Dec 15th under the ACA. What happens if I don't pay the final December premium to UHC? Since it won't really be a lapse situation with UHC since my coverage with them is ending anyway, will it have any consequences with the new provider I choose or my standing in the healthcare exchange? Also, I have a doctors appointment on December 6th... if I don't pay the Dec premium but the policy hasn't been seen as lapsed until the end of the month, would the appointment be seen as covered by the system and my doctor paid anyway, or will I end up getting a letter at some point in the future saying it wasn't covered and end up paying the full bill?

If you were getting a subsidy you will have a 90 day grace period to pay the premium, if not 30 days. And since in that time frame either way based on your question, yes, it would most likely be covered by UHC.... Could you get a letter? Yes. Will you? Unkown.

Not paying it has no affect on getting a new plan for 01/01/17 eff date
 
If you were getting a subsidy you will have a 90 day grace period to pay the premium, if not 30 days. And since in that time frame either way based on your question, yes, it would most likely be covered by UHC.... Could you get a letter? Yes. Will you? Unkown.

Not paying it has no affect on getting a new plan for 01/01/17 eff date

wrong answer mr west... i suggest paying the premium and mr kenny should stick to programing....
 
Please forgive if this is not the right forum to post. I scanned the forum index and am not sure and this one seemed closest. I am in Texas with United Healthcare under the ACA. I have not yet, but I am going to find another provider by Dec 15th under the ACA. What happens if I don't pay the final December premium to UHC? Since it won't really be a lapse situation with UHC since my coverage with them is ending anyway, will it have any consequences with the new provider I choose or my standing in the healthcare exchange? Also, I have a doctors appointment on December 6th... if I don't pay the Dec premium but the policy hasn't been seen as lapsed until the end of the month, would the appointment be seen as covered by the system and my doctor paid anyway, or will I end up getting a letter at some point in the future saying it wasn't covered and end up paying the full bill?

Three questions

1 - Will your new insurance company or healthcare.gov come after you for not paying the December 2016 premium for your current policy. Answer: No.

2 - Can you screw your doctors office out of the bill that you legitimately owe to him by scamming the system? Answer: Maybe. If you receive a subsidy, then the government program is set up to pay the doctor for the services he rendered legitimately to you even though you skated out of your responsibility, so long as it is within the first 30 days of a 90 day grace period for those who receive a subsidy. If you do not receive a subsidy, then you don't get those convoluted rules and the answer is "No."

3 - You asked if you will get "a letter at some point in the future saying it wasn't covered and end up paying the full bill?" Answer: I sure hope so. If that happens, it will indeed be the FULL bill, not the insurance company's discounted amount, and the FULL bill might include collections charges and interest.

This is scum. Not paying your insurance premium is your right --- you simply don't get coverage if you don't pay the premium. But taking a medical service from your doctor and not paying for it with cash or with insurance is simply theft. Man up. Pay your bill.
 
I've had clients not pay the last premium. Claim will be reversed and you'll be billed as out of network/ self-pay.

Figure out what plan you'll enroll in and either pay Dec premium or move appt to Nov or Jan depending on how claim would be paid under new plan. Pay premium if health conditions are severe enough that you need the current appointment.
 
Carriers can now chase you if you return to them, or some will chase you regardless

Perhaps but then you'll be where you were had you paid the premium when it was due. You have to deal with what is. What is is that policies lapse for nonpayment and there is a 30 day grace period.

Carriers know how to take care of themselves. I don't feel bad about advising someone who loses coverage to enroll in ACA during the SEP simply because I know that the person will have a large claim.

I don't like how providers charge up to 5x higher prices when out of network. I ran into this with lab work processed by Quest.
 
Carriers can now chase you if you return to them, or some will chase you regardless
It's really up to you. But is it really fair to use a system, get what you need and walk away and not pay your fair share. And yes you will have a grace period. The purpose of the grace period is to give you extra time to catch up on your premiums with out getting canceled. It is not to give you 30 days of free coverage. If you do not pay your premium by the end of the grace period you will be canceled retro actively to November 30th if you are not a subsidized person on top of that they can bill you full price for any care you received during the uncovered period.

If you are subsidized you will owe back at least one month of the subsidy that you received. Ouch if you are getting a big one. If you are an adult I think you know what to do.

What happens if I don’t make my premium payment by the end of the grace period?

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Unfair is not buying coverage and having access to healthcare that those with insurance pay for. Unfair is having laws where only the sickies enroll. My personal ACA premium for the lowest cost plan is ~ $10,800. My 2017 claims have been $0.

If I can shave premium I will. Electing COBRA and riding the grace period is SOP and has been for years. Our job is to know and advise on the loopholes. What do you think HW groups with lesser underwriting than individual plans was?
 
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