Julie’s Got You Covered

Missed a Payment? What You Need to Know About Health Insurance

• Julie Sears • Episode 11

Share episode

What Happens If I Miss A Premium Payment?

Have you ever worried about what happens when you miss a health insurance premium payment? This episode addresses those concerns head-on, empowering listeners with the knowledge they need to navigate the complexities of coverage gaps and grace periods. Join Julie Sears, founder of Integrity Health Insurance Advisors, as she delves into essential information every policyholder needs to know about premiums and your health insurance rights.

From understanding the crucial 30-day grace period that may prevent you from losing coverage to discussing the steps to take if you've missed a payment, we make sure you’re well-informed. Not only that, but we also touch on scenarios diving into the world of emergency coverage options—what to do if you find yourself uninsured right when you need care the most. Our engaging conversation breaks down what qualifies for enrollment and reinstatement, showcasing why if you miss a payment, you need to act fast.

This episode is packed with valuable insights, tips, stories, and expert advice designed to help you stay covered and prepared for whatever life throws your way. Don't forget to book your free consultation with Julie and gain peace of mind knowing you’re prepared for the future! Subscribe, share, and leave us a review to let us know how we can continue to support you on your health insurance journey!

To learn more about Integrity Health Insurance Advisors visit:
https://www.IntegrityHealthInsuranceAdvisors.com/
Integrity Health Insurance Advisors
469-348-4066

Speaker 1:

Welcome to Julie's Got you Covered, the podcast where Julie Sears, founder of Integrity Health Insurance Advisors, takes the fear out of finding the right health insurance. With seven plus years of experience, she's here to make finding the perfect coverage a breeze. Stay tuned for details on how you can snag a free 30-minute consultation. Tuned for details on how you can snag a free 30-minute consultation.

Speaker 2:

Life gets busy and sometimes a bill slips through the cracks, but when it's your health insurance premium, what's at stake? Julie Sears of Integrity Health Insurance explains what happens if you miss a payment, how much grace you really have and what to do if you find yourself in a lapse of coverage. Welcome back everyone. I'm Sophia Yvette, co-host slash producer. Back in the studio with Julie Sears. Julie, how's it going? Good, how are you? I'm good. So, Julie, what happens if I miss a premium payment?

Speaker 3:

You have a 30-day grace period to get that payment in and they will keep that policy in force. If you go beyond that 30 days, some companies may give you a few days grace if there was a holiday or something in there, but typically they do not have to continue your coverage. Unfortunately, it does not give you a qualifying reason to enroll in new coverage. Some people assume that they lose coverage, but losing coverage to your non-payment is not a qualifying reason. So if you are ever found in that situation, we can either look at private options at that point or we might have to look at some type of limited benefit plan, depending on the situation, or short term.

Speaker 3:

Short term legislation is back in the news again, but as of right now, you can only keep a short term plan for four months months. So it's best to make sure that those are on auto draft and that those aren't going to be missed, because it is like you said life gets busy. Just happens to the best of us that something can slip through the cracks. Just don't want to find out in the worst possible time, while you're at the emergency room or trying to schedule an appointment for a follow-up, and find out then, whoops, you forgot to make that payment.

Speaker 2:

So, julie, in those emergency situations let's say you find out that you're pregnant what would my options be in emergency health coverage? Let's call it.

Speaker 3:

So while pregnancy is a beautiful thing, it is the worst when you are unprepared. Private options do not cover maternity coverage because of course insurance is looking at the risk assessment. So worst case scenario, you know they're looking at it from the standpoint of if it turns into a high risk or really crazy delivery with a surgical delivery and heaven forbid, a NICU for the baby. That is a very high, expensive cost and so they just do not cover it. So short term limited benefits even the share plans will not cover if it was not active prior to that pregnancy being confirmed.

Speaker 3:

So at that point it is just kind of trying to mitigate the loss and get you some type of emergency coverage. But it will not actually cover any of the labor and delivery or those prenatal care. It's just for maybe some negotiated rates. But luckily we live in an area where we have some really good cash rates for delivery. I've had several clients where they weren't properly planned and they've still been minimally impacted by the cash rates. Thankfully they were uneventful deliveries, just got to go with the sweet baby at the end of the day.

Speaker 3:

Well that's good to hear, right? Yeah, those were best case scenarios. I have had those calls, though, where someone is high risk. It really hurt my soul a little bit that the offerings are so limited, which is why we do have to try to plan ahead. I know it takes the romance out of it a little bit, but try to plan ahead and have the right protection in place prior to any of those life events happening.

Speaker 2:

So, julie, is there a grace period, or do I need to start selling homemade cookies immediately to cover the bill?

Speaker 3:

For missing a premium. You have a 30-day grace period For pregnancy. I would definitely start selling cookies before you get really tired and try to push those as much as possible, because out-of-pocket is probably anywhere from $7,000 to $10,000 cash for a normal labor and delivery. It's a lot of cookies.

Speaker 2:

A ton of cookies, Julie. What steps should someone take immediately if they realize they missed a payment?

Speaker 3:

if they realize they missed a payment, figure out when that payment was due and either call their insurance company ASAP or get online to the portal and make sure that you've got that payment made and probably set that up on an ACH auto draft so that you don't have to worry about it ever again. If it is beyond that 30-day grace period, give me a call and I will do everything I can to try to find an alternative plan to get in place and hopefully still match that same comprehensive coverage that you had. The ACA does not have a lot of forgiveness and unfortunately, if you are receiving any type of subsidy and those tax credits, those will all be lost. So that is when it is most important to make sure you stay on top of it, because if you are getting any reduced rates on the ACA, you won't get them anywhere else.

Speaker 2:

If a policy lapses due to nonpayment, what options are available for reinstatement or obtaining new coverage?

Speaker 3:

Reinstatement won't be possible until open enrollment. So, depending on the time of year, that could leave you very exposed in the event of something happening. For alternative coverage, we've got private options. There are some short-term plans and then, of course, limited benefit plans are kind of a dime a dozen. Some are better than others. I always take the approach any coverage is better than none. I've had several people reach out this week that they can't get an appointment with a specialist due to the fact that they are uninsured currently. So they are trying to remedy that situation. But once you have a pre-existing, the options do become more limited. So always try to be proactive and get those policies in place prior to anything happening. Love it, Julie. We'll catch you in the next episode. Have a fantastic rest of your day and get those policies in place prior to anything happening.

Speaker 2:

Love it, Julie. We'll catch you in the next episode. Have a fantastic rest of your day.

Speaker 1:

You too. Thanks for tuning in to Julie's Got you Covered. Ready to say goodbye to insurance stress Head to IntegrityHealthInsuranceAdvisorscom or call 469-348-4066. That's 469-348-4066. To book your free 30-minute consultation With Julie. Health insurance doesn't have to be scary, she's got you covered.