Understanding Grace Periods

Do you know a consumer who has missed some premium payments? While many navigators know that coverage does not fully begin for a consumer until they make their first premium payment, you may not know that a carrier cannot immediately cancel a plan if a consumer misses one or more premium payments. In this week’s assister newsletter, the Centers for Medicare & Medicaid Services (CMS) further clarified these grace periods. If a consumer is receiving the Advanced Premium Tax Credit (APTC) the carrier is required to give the consumer a three month grace period. If the consumer is not receiving the APTC, then the carrier is required to provide a grace period in accordance with state law. CMS has indicated that they will be releasing a fact sheet on grace periods and when they do, we will post it on our Resources & Links page.