Benefits of Automatic Premium Payments

What if you’re in a coma in the hospital when the premium is due?

Long Story –

Bill Duncan* called in and asked if we could get medical insurance for his Mother who has an adrenal problem and possibly has Addison’s Disease and is on Paxil for Major Depression.

Her prior coverage had lapsed for non-payment of premium as she states that she has memory loss due to her medical conditions.   The Insurance Company** so far has told them that they won’t reinstate and said that they would send a grievance form for them to fill out.   I found a standard grievance form and emailed it to my friend.

I don’t know how this will come out, but I looked all over the California Case Law section on  FindLaw.com and so far have found nothing in the sister’s  favor.  The closest cases were on Life and Disability Policies that had a special provision at additional cost that will pay your premiums, if you are disabled for say 6 months or more.  Under HIPAA, COBRA and other Insurance Laws, Anti-Discrimination, etc. they all allow cancellation for non-payment of premium.

Here’s a letter from an Attorney on a similar issue.

The only medical plan I can find for her at this point is MR. MIP, which is really great as it covers virtually anyone who for medical reasons can’t get Individual coverage, the down side was that they have a  waiting list to get in.

So, the moral of the story is, make sure that you have a method to pay your medical premiums so that the Insurance Company can’t cancel you, when you need it the most!

Unfortunately, if you can’t remember to pay your premiums, you will probably have trouble working too.  Check out Disability Coverage ,  if you have a Retirement Plan or Cash Values in Life Insurance you might be able to access that money.  If all else fails the Government has various plans available.  Healthy Families to cover your children, Medi-Cal if you’ve become poor,  Social Security Disability – SSI which will qualify you for Medicare – after 2 years of disability and the Free Clinic.

*Name changed for privacy

**Insurance Company named not mentioned as we may be filing a grievance and as near as I can tell, all companies and HMO’s would cancel for non-pay, regardless of the reason.

Blue Cross form  Ways to pay your premium or Email us for the form to have your premiums automatically withdrawn from your checking account or credit card

Blue Shield
No more reinstatements on late payments 1/1/2010

FAQ

I knew that I hadn’t made my health payments through Blue Shield of Ca via Covered ca for a few months, but I failed to realize i had gone too long.

***Right.  It’s 90 days if one is getting subsidies.

Previously I made payments easily with Health Net ,since I changed over to Blue Shield I  have had issue logging in and being able to call in during business hours.

***Do you have a member portal?

Premium Due Date vs Automatic Bank Withdrawal

 

I have a question regarding on paying auto pay. It says my payments will be taken out every 23 of the month. When is my payments due? If I remember correctly you said it is due every 1st of the month?

Answer

The payment is due on the 1st of the month.  Your coverage then goes into the grace period if not paid on the first.

I will check what options Molina has for the withdrawal date.  Here’s a link to the various ways to pay your premium with Molina.   Here’s the Molina Member Portal.   Create an account and see if you can change the auto withdrawal date.   It might be that the 23rd came up as you are doing the first payment on the 17th…

Reply from Molina

The Autopay is not set-up to allow member to select a payment due that they wish, the 23rd is in place to ensure payment is received and applied for coverage for the following month-it is clearly stated in the Terms and Conditions when enrolling. (see below)
Here’s definitions  from a specimen policy on when the premium is due.

All Monthly Premium Payments and administrative fees are payable in advance and due on the Monthly Premium Due Date. The Monthly Premium Due Date is the first day of the Plan period for which we receive Premium Payment. For example, if the Plan Period is March 1 to March 31, the Monthly Premium Due Date is March 1. The Plan Period is not affected by and does not affect the use of other periods of time to measure or determine Your rights and benefits, for example, the use of the calendar Year as applied to Deductible, or the use of the calendar Year to determine maximum Copayments/Coinsurance  – Page 32

For Your convenience, You may authorize us to automatically deduct Your Premium Payment from Your financial institution account every month. To learn more about this option, contact customer service.  Page 33

The grace period for payment of future premiums is thirty (30) days from the Monthly Premium Due Date. If You fail to pay premiums as they become due, xxx may terminate this Agreement as described below as of the last day of the grace period.  Page 39

 

 

 

Auto Withdrawal Premium Payment Confirmation
Auto Withdrawal Premium Payment Confirmation

 

Auto Pay Defaults to the 23d
Auto Pay Defaults to the 23d

Proof of an Automatic Payment?

Question

1. My credit card was on file with Anthem Blue Cross Platinum PPO for monthly payments of my premium. I do this with all of my insurance plans: house, health, and car. I have never had a problem.

2. After my daughter got sick and I was told her prescription wasn’t covered, that pharmacy wasn’t available, I did some investigation by phone and was told that my insurance was canceled and it cannot be reinstated. I am floored and sick to my stomach. I did nothing wrong.

3. I cannot even find the page for payment where my Visa CC was stored on the website.

 

Reply

1. I guess the big issue here is proof, evidence and establishing that Blue Cross had you set up on Auto Pay. Please email us everything you have to show that you were. Please also send us your user name & password to your BC online account and Covered CA if you have that

What about the late notices and cancellations they are mandated to send you?

What payment were withdrawn from your credit card?

3. Send us the user name & password of your BC online account. Also, we can contact BC on your behalf if you authorize us as your agent and we will look for what we can in your favor.

If all else fails, there are temporary plans, but most do not meet minimum essential requirements, thus you pay the fine and do not cover pre-existing conditionsMr. Mip will though.

Steve Shorr
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One comment on “Automatic Premium Payments – Benefits and Advantages

  1. Jeremy C says:
    April 14, 2017 at 2:04 PM
    Hello,

    I got a cancellation notice from anthem today because they have not received the current payment.

    I thought they were debiting my checking account, as that as how it has worked for the past five years, but apparently not this year.

    Anyway, wondering what might be done to get some kind of insurance policy in place or reinstate this one.

    We don’t have anything particular going on health wise, but you have to have it.

    Two parents, 62 and 51, daughter 21, daughter 20, son 18, daughter 15.

    Any suggestions. Hard to believe that they will cancel with no warning, just like that…

    Jeremy C 434 xxx

    Reply
    Steve Shorr says:
    April 14, 2017 at 2:22 PM

    Since you were on Auto Pay – I think we would have a good chance to appeal the cancellation. Do you have all the proofs? See our pages on appeals & grievances. Do you have anything that might qualify as a special enrollment period, as cancellation for non-payment of premium doesn’t count. Be careful as next year under new CFR 9929 F Insurance Companies can make you pay past due premiums before writing you at Open Enrollment.

    Check our temporary insurance pages for quotes. You can also get California Quotes here and Nationwide here. The downside to temporary plans is that they don’t meet minium essential coverage or benefits for the mandate nor do they cover pre-existing conditions.

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