I have a lot of unexpected bills because of a natural disaster in my area, and can’t afford to pay my Marketplace premiums for the rest of the year. What are the consequences of not paying?

Post enrollment issues | Individual Health Insurance |

If you decide you can’t afford to maintain your coverage this year, you should contact the Marketplace Call Center ( at 1-800-318-2596 (TTY: 1-855-889-4325) or your state health insurance Marketplace as soon as possible to terminate your coverage and, if applicable, stop receipt of any premium tax credits. You should also contact your health insurance company to ensure your health plan is terminated. Make sure to document the dates of your contacts with the marketplace and the insurer.

In general, if you are receiving advanced premium tax credits, and have paid at least one month’s premium, insurers must provide a 90-day grace period to pay all premiums that are owed (if you are not receiving premium tax credits, grace periods may vary by state, but the general practice is a 31-day grace period). Federal guidance allows insurers to extend the grace period for consumers who are receiving premium tax credits, if requested or directed to do so by state authorities. In light of the natural disaster in your area, some insurance companies may voluntarily provide additional time for policyholders to submit late premium payments, and some states may require them to do so. You should contact your insurance company to determine whether they have changed their policies with respect to premium payments due to the natural disaster.

Note that a federal rule prohibits insurers from denying enrollment in new coverage because an enrollee owes outstanding premiums for prior coverage from that insurer. If an insurer denies you coverage because you owe them unpaid premiums, please contact your state Department of Insurance.

(45 C.F.R. § 147.104(i); CMS, Emergency and Major Disaster Declarations by the Federal Emergency Management Agency (FEMA) – Special Enrollment Periods (SEPs), Termination of Coverage, and Payment Deadline Flexibilities, August 9, 2018; CMS, Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency, March 24, 2020).

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Post enrollment issues