Grace Period and Review of Cancellation
Grace Period and Review of Cancellation
Gather documents, cancelled checks, warnings, late notice, emails, phone logs
Gather documents, cancelled checks, warnings, late notice, emails, phone logs
Anthony says:

Hi.

What are my options as far as not paying for the months I didn’t have coverage?

***Pretty much none.  If you don’t pay, you won’t be able to get coverage till January 1, 2017 as you haven’t mentioned anything that would qualify you for special enrollment.  Check out our page on temporary plans to tide you over till then.

I have a similar problem. Some how there is a miscommunication between Covered CA and Healthnet.

My payments [subsidy – APTC Advance Premium Tax Credit] changed this year because my income is less than last year.

According to Covered Ca my monthly payments are $207.50 this year. However, Healthnet believes my Jan. payment should have been $223.00.

***So much of all the problems I’m seeing the the “Ask a Question”  sections of my website are miscommunication and “he said she said.”  Trying to prove who said what when.  Learn more – How to prepare for Small Claims Court.

I’ve paid $208 for Jan., Feb., and March. When trying to make my April payment I learned my policy had been cancelled because I was unable to pay.  Healthnet officially cancelled my policy as of Jan. 31 due to non payment. I’ve been back and forth with Healthnet since I found out in April about being cancelled.

***Next time try the complementary agent support and have someone experienced like us help you with these problems and hopefully let you know in January.   We only get paid if you appoint us.   Did Covered CA or Health Net give you an explanation as detailed as this page, without waiting on hold?

I’ve been told by Covered CA I will probably be reinstated but I will have to back pay for the months I didn’t have coverage (Feb., March, April, May, and maybe June).

***As soon as you prove that your payment was $208, you did have coverage.   Can Health Net prove they sent you a cancellation Notice in January?

45 CFR 156.270  (d) Grace period for recipients of advance payments of the premium tax credit. A QHP issuer must provide a grace period of three consecutive months if an enrollee receiving advance payments of the premium tax credit has previously paid at least one full month’s premium during the benefit year.

See our page on – was the cancellation legal?

Healthnet refunded my Feb. and March payments.

What are my options as far as not paying for the months I didn’t have coverage?

***Pretty much none.  If you don’t pay, you won’t be able to get coverage till January 1, 2017 as you haven’t mentioned anything that would qualify you for special enrollment.  Check out our page on temporary plans to tide you over till then.

I understand I may have to pay a fee [Mandate Penalty 2.5% of Income] at the end of the year for not having health insurance for those months. I’m fine with paying the fee.

***Are you OK with paying bills out of future earnings or losing your home and assets and bankruptcy if you have a large unexpected medical problem?

Thank you!

 

If you want to file and appeal – mislead and get a new special enrollment period – click here for our appeals page.

7 comments on “Paying Back Premiums to get reinstated?

  1. I found a form online to request a hearing. The form is called “Request for a State Fair Hearing to Appeal a
    Covered California Eligibility Determination”.
    Here’s a link to the form:
    https://www.coveredca.com/PDFs/HearingRequestFormCC.pdf

    I called the number on the form. (1-855-795-0634) I was able to submit an appeal over the phone instead of having to send in the hearing request form.

    I will let you know how it all turns out.

  2. Are you sure it was Department of social services or do you mean Department of managed healthcare or department of insurance I don’t see that department of social services has anything to do with it

    I don’t know of any law or precedent to allow you to start July 1 if you have that please post it here because it will teach me something new would be helpful to other site visitors

    When you say take it to a judge do you mean go to small claims court superior court or in and made a straight of law judge in the appeal section of covered California or Department of insurance I’m using my iPhone now so I can’t put in all the links that I’d like to but if you search for appeals on this website you can find everything that I have but don’t forget you’ve got to show all the proofs and you’re going to have to show that you were never properly canceled and have proof I’m not an attorney so please doublecheck everything that’s not cited

    • I guess you’re right because Medi-Cal is part of the department of public social services

      also if you can show a material violation or error then that would get you new enrollment.

      So your policy would be not reinstated it would be a brand-new special moment.

      Any be able to pick any plan and then you can appoint a says your age and we can get it going for you and that way we get paid for helping you rather than just is a public service

      In the menu above put your mouse over special enrollment and then look for material violation

  3. Hi Steve,
    Thank for responding back to me. Today I called CA Department of Social Services and submitted an appeal for being wrongfully cancelled and asked that I be reinstated starting July 1st. Since I will be reinstated July 1st, i will not have to back pay for the months I did not have coverage. The back pay is more than the federal fee for not having health insurance. I will gladly pay the federal fee.

    If for some reason, Covered CA and Healthnet can not resolve this issue I will have to present my case to a judge and he will decide.

    Thanks again for your time and all the great resources you have provided me.

    Anthony

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