Reminder: Exchange patients, eligibility and the 90-day grace period Practices are reminded that under the Affordable Care Act, exchange enrollees who receive federal premium subsidies (approximately 90 percent of enrollees) to help pay their premiums are entitled to keep their insurance for three months after they have stopped paying their premiums. In the first month of the grace period, federal law and California regulations require plans to pay for services incurred even if the patient fails to pay the premiums due by day 90 (CCR §1300.65.2(b)(1)(A)). But in months two and three of the grace period, plans can ... February 3, 2016 General, Managed Care Affordable Care Act, Grace Period, ACA 0 0 Comment Read More »
Ask the expert: If an exchange patient is in the 90-day grace period and fails to pay the premium, is the plan required to pay for services provided? Maybe. Under the Affordable Care Act, exchange enrollees who receive federal premium subsidies to help pay their premiums are entitled to keep their insurance for three months after they have stopped paying their premiums. Insurance ID cards for exchange enrollees do not indicate whether the enrollee is subsidized, but Covered California recently reported that 90 percent of California exchange patients are receiving subsidies, so the likelihood of encountering a patient receiving subsidies is very high. In the first month of the grace period, federal law and California regulations require ... November 10, 2015 Managed Care Grace Period, Exchange plans, Health Insurance Exchange 0 0 Comment Read More »
CMA releases fact sheets regarding Covered California grace period, updates toolkit Recognizing the Affordable Care Act’s “grace period” provision to be one of the most confounding provisions of the law, the California Medical Association (CMA) has published an FAQ sheet dedicated entirely to helping physicians make sense of the issue. The fact sheet, “Covered California: Understanding the Grace Period for Subsidized Exchange Enrollees," is available through CMA’s exchange resource center. Federal law allows Covered California enrollees who receive financial subsidies to keep their health insurance for three months, even if they have stopped paying their premiums. This is known as the “grace ... February 7, 2014 General Grace Period, Health Care Reform, Health Insurance Exchange, Covered California 0 0 Comment Read More »
