When to pay your first premium

Important: You must pay your first premium for your coverage to start.

To make sure your coverage starts, you need to pay your first premium. Your first premium payment is known as a “binding payment.” That means your health insurance coverage will be canceled if you don’t make a payment by January 1st!

Once you enroll in a plan, you’ll pay your premiums directly to the insurance company — not to Maine’s Health Insurance Marketplace.

  • Anthem Blue Cross and Blue Shield (Maine) – Call 855-738-6674
  • Harvard Pilgrim (Maine) – Call 888-333-4742
  • Community Health Options (Maine) – Call 855-624-6463

Make sure you continue to pay your monthly premiums to your health insurance company on time. If you don’t, the insurance company could end your coverage.

Grace Periods

If you fail to pay your premiums and exhaust the grace period for plans offered in a health insurance marketplace, you will lose your insurance coverage.

The grace period is either one month or three months long, depending on whether or not you’re receiving subsidies and whether or not you’ve paid at least one premium so far during the year.

The three-month grace period applies to those who receive federal subsidy assistance in the form of an advanced premium tax credit and who have paid at least one full month’s premium within the benefit year.

For those without a subsidy the grace period is one month (the one-month grace period also applies to plans purchased outside the exchange, since none of those plans qualify for subsidies).

If you are not receiving a subsidy that lowers your monthly premium, or if payment is not made prior to the end of the one-month grace period, coverage will be retroactively terminated to the end of the month for which premium was last paid.

If you are receiving a subsidy (and you have paid at least one month’s premium), and your premium payments go past three months overdue, the coverage will be terminated retroactive to the end of the first month of the grace period. So if a subsidized enrollee pays the January premium but then doesn’t pay February, March or April, the coverage would then be terminated as of the end of February.

In order to keep coverage in place past the end of the grace period, you have to be fully paid-up by the end of the grace period.

In other words, the grace period does not allow people to be perpetually three months behind on their premium payments. If you get behind on your premiums (and you’re receiving subsidies), you’d need to fully pay premiums for all three months of the grace period in order to retain your coverage.

And if you lose coverage in the marketplace due to non-payment of premiums you will not be able to rejoin a marketplace health plan until there is a new open enrollment period. During the time that you’re uninsured, you’ll be responsible for paying any and all medical bills that you incur.

FAQ Frequently Asked Questions

Can I enroll again during open enrollment if my old plan terminated for non-payment of premiums?

Open enrollment allows people a chance to start over each year with new coverage, regardless of whether the prior year’s coverage was terminated during the year due to non-payment. But if your coverage is terminated for non-payment of premium and you then enroll in a plan offered by that same insurance company within 12 months of your prior plan being terminated, they can require you to pay your past-due premium before starting your new policy.

If your coverage was already terminated for non-payment of premiums, the most you would owe in past-due premiums is one month of premiums, as your plan termination date would have been the end of the first month of the grace period. If you weren’t getting a premium subsidy, you wouldn’t have any past-due premiums, because your plan would have been terminated to the last date that you had paid for the coverage (insurers cannot assess past-due premiums for months after the coverage termination date).

What if I’m in the grace period during open enrollment?

I you are in the grace period at the end of the year need to be aware that the grace period does not reset at year-end if the plan is auto-renewed.

So for example, if you didn’t pay November and December premiums, and then your plan is auto-renewed for January, you can’t just pay January’s premium to keep your coverage going for the coming year. You’d have to pay all three months (November, December, and January) by the end of the three-month grace period that began when you missed the November payment. The total amount has to be paid in full by the end of the grace period, or else your coverage will be terminated back to the end of November.

However, if you enroll in a different plan for the coming year (rather than letting your plan auto-renew), your old plan would terminate back to the end of November, and your new plan would start January 1, as long as you pay January’s premium.

I have a $0 premium. What do I do?

Although you have a $0 premium, we advise you reach out to your insurance company directly to see if there’s anything else needed to ensure your plan goes into effect. Some insurance companies require payment info before your insurance can go into effect in case something changes with your eligibility throughout the year.

I paid, but it says “payment pending” still. What does that mean?

It can take 5–10 business days for the insurance company to process a payment. and there can be a delay between the insurance company letting us know that information. You can call your insurance company to check and make sure the payment went through.

How do I set up recurring payments?

Reach out to your insurance company to set up recurring payments.