Breaking News
December 15, 2018 - When should dementia patients stop driving? A new guidance for clinicians
December 15, 2018 - Researchers use INTEGRA’s VIAFLO 96/384 to streamline the experimental workflow
December 15, 2018 - Researchers discover protein involved in nematode stress response
December 15, 2018 - Cancer patients have greater risk of developing shingles, study shows
December 14, 2018 - UAlberta scientists identify biomarkers for detecting Alzheimer’s disease in saliva samples
December 14, 2018 - Study uncovers link between tube travel and spread of flu-like illnesses
December 14, 2018 - Caffeine plus another compound in coffee may fight Parkinson’s disease
December 14, 2018 - GW researchers review studies on treatments for prurigo nodularis
December 14, 2018 - Lack of peds preventive care ups unplanned hospital admissions
December 14, 2018 - Miscarriage: When Language Deepens Pain
December 14, 2018 - New method helps better understand pathological development of ALS
December 14, 2018 - Intellectually active lifestyle confers protection against neurodegeneration in Huntington’s patients
December 14, 2018 - Mammalian collagen nanofibrils become stronger and tougher with exercise
December 14, 2018 - Considerable Morbidity, Mortality Due to Animal Encounters
December 14, 2018 - Researchers find inhibiting one protein destroys toxic clumps seen in Parkinson’s disease
December 14, 2018 - How early physical therapy can lessen the long-term need for opioids
December 14, 2018 - Depression, suicide rates highest in Mountain West states
December 14, 2018 - New model could cure the potential to underestimate how quickly diseases spread
December 14, 2018 - Exercise-induced hormone activates cells critical for bone remodeling in mice
December 14, 2018 - Researchers discover new mechanism behind spread of malignant pleural mesothelioma
December 14, 2018 - Health Tip: Celebrate a Healthier Holiday
December 14, 2018 - Scalpel-free surgery enhances quality of life for Parkinson’s patients, study finds
December 14, 2018 - Early physical therapy can reduce risk, amount of long-term opioid use | News Center
December 14, 2018 - Genetic marker, predictor of early relapse in common childhood cancer discovered
December 14, 2018 - Study could lead to a potential new way of treating sepsis
December 14, 2018 - New protein complex helps embryonic stem cells to maintain their indefinite potential
December 14, 2018 - Salk professor receives $1.8 million from NOMIS Foundation for research on mechanisms to promote health
December 14, 2018 - New discovery will improve the safety and predictability of CRISPR
December 14, 2018 - Geneticists discover how sex-linked disorders arise
December 14, 2018 - New method to visualize small-molecule interactions inside cells
December 14, 2018 - Study describes mechanism that makes people more vulnerable to hunger-causing stimuli
December 14, 2018 - Chronic opioid therapy associated with increased healthcare spending and hospital stays
December 14, 2018 - Blood Types
December 14, 2018 - Obesity linked to increased risk of early-onset colorectal cancer
December 14, 2018 - Blood test helps identify distinct molecular signatures in children with cystic fibrosis
December 14, 2018 - Scientists use water to track electrical activity of nerve cells
December 14, 2018 - Recurrence of urinary tract infection may depend on bacterial strain, study shows
December 14, 2018 - GBT Announces U.S. FDA Agrees with its Proposal Relating to Accelerated Approval Pathway for Voxelotor for the Treatment of Sickle Cell Disease and GBT Plans to Submit New Drug Application (NDA)
December 14, 2018 - Partial Thromboplastin Time (PTT) Test: MedlinePlus Lab Test Information
December 14, 2018 - Common tactics for health promotion at work may be detrimental to employees with obesity
December 14, 2018 - Myths about migration and health not supported by available evidence
December 14, 2018 - Recent findings on rare genetic disorder may help develop new treatment options
December 14, 2018 - New drug shows promise in treating sarcomas
December 14, 2018 - Scientists perform lung lavage as new approach for tuberculosis diagnosis in rhinoceros
December 14, 2018 - Answering the Biggest Neurological Research Questions of Today
December 14, 2018 - Recent winners of the Nobel Medicine Prize
December 14, 2018 - KHN’s ‘What the Health?’ Insurance enrollment is lagging — and there are lots of reasons why
December 14, 2018 - Study assesses safety and efficacy of new treatment for pancreatic cancer
December 14, 2018 - Weakened metabolism of immune T cells may account for serious complications in elderly
December 14, 2018 - Study finds drug targets for Ebola, Dengue, and Zika viruses
December 14, 2018 - Face masks may offer protection against staph bacteria for hog farm workers and their household members
December 14, 2018 - Shining new light on neuron firing
December 14, 2018 - Study highlights need for personalized approach to treat ICU acquired delirium
December 14, 2018 - Soot particles from road traffic significantly contribute to air pollution
December 14, 2018 - Massage helps relieve pain, improve mobility in patients with knee osteoarthritis
December 14, 2018 - Researchers explore home healthcare nurses’ knowledge attitudes toward infection control
December 14, 2018 - Average outpatient visit in the U.S. costs nearly $500, shows new study
December 14, 2018 - Reference Infliximab, Biosimilar Equivalent for Crohn’s Disease
December 14, 2018 - New contact lens to treat eye injuries
December 14, 2018 - Acne could have a genetic basis find researchers promising new cure
December 14, 2018 - Higher physical activity associated with improved mood
December 14, 2018 - New UGA study points to optimal hypertension treatment for stroke patients
December 14, 2018 - Study highlights factors that can reduce food cravings
December 14, 2018 - Researchers discover Ebola-fighting protein in human cells
December 14, 2018 - Fentanyl surpasses heroin in cause of U.S. drug overdose deaths
December 14, 2018 - When Heart Attack Strikes, Women Often Hesitate to Call for Help
December 14, 2018 - A warning about costume contacts
December 14, 2018 - Study examines link between peripheral artery disease and heart attack
December 14, 2018 - Researchers develop biotechnological tool to produce antifungal proteins in plants
December 14, 2018 - 3D-printed adaptive aids can benefit patients with arthritis
December 14, 2018 - Chronic bullying during adolescence impacts mental health
December 14, 2018 - Integral Molecular and Merus collaborate to develop bispecific antibody therapeutics
December 13, 2018 - Importance of cell cycle and cellular senescence in the placenta discovered
December 13, 2018 - Gold “nanoprisms” open new window into vessels and single cells
December 13, 2018 - Research findings could lead to new targets for cancer-fighting therapeutics
December 13, 2018 - Butantan Institute signs collaboration agreement with MSD to develop dengue vaccines
December 13, 2018 - Study explores how patients want to discuss symptoms with doctors
December 13, 2018 - RUDN medics first to gather scattered data on hepatitis morbidity in Somalia
December 13, 2018 - Age and gender disparities found in use of bed nets to prevent malaria in sub-Saharan Africa
December 13, 2018 - Caffeine therapy benefits developing brains of premature babies
Past-due premiums, missing tax forms may hamstring marketplace customers

Past-due premiums, missing tax forms may hamstring marketplace customers

image_pdfDownload PDFimage_print

The 2018 annual open-enrollment period for coverage on the health insurance marketplaces starts Wednesday. But if you don’t take care of lingering issues from your past coverage, they may come back to haunt you when you try to sign up this fall.

Unpaid Premiums

New rules will allow some insurers to require you to pay any back premiums you owe for the 12 months prior to the effective date of your new coverage.

The rule, which became effective in June, generally applies only if you try to enroll in a plan with the same insurer, not if you choose coverage from another company. It’s up to insurers to decide whether to come after you for the money.

But there may be only one insurer offering coverage in many areas. In those cases, if you’ve fallen behind on payments, “you really won’t be able to escape this policy,” said Tara Straw, a senior health policy analyst at the Center on Budget and Policy Priorities, a research and policy institute in Washington, D.C.

Insurers have to notify you before you miss premium payments if they plan to implement the rule.

The Affordable Care Act offers some protection for people who fall behind on their payments. Under the law, you have a 90-day grace period in which to catch up on unpaid premiums. Once that grace period ends, your coverage would be canceled retroactive to the end of the first month of delinquency and you’ll be responsible only for your portion of the first month’s unpaid premium. (You wouldn’t be responsible for premium tax credits paid by the government on your behalf to the insurer.)

But if you stop paying your premiums during the last three months of this year, you could get hit with a bill for a full three months of premiums if you re-enroll for 2018 coverage. This is because your 90-day grace period hasn’t ended.

“Effectively your coverage has never terminated, and therefore you owe for the full period,” said Timothy Jost, an emeritus professor of law at Washington and Lee University in Virginia who specializes in health law.

If you want to drop a marketplace plan, it’s not enough to just stop paying premiums.

“Make sure you go to the marketplace and terminate your plan,” said Straw. “Otherwise you could be on the hook for these payments during open enrollment or during a special enrollment period if you try to sign up again.”

Unfiled Tax Documents

Most people who get marketplace coverage qualify for tax credits that provide money to help pay for their premiums. Those are available to consumers whose income is less than 400 percent of the federal poverty level (about $48,000 for one person). If you had a marketplace plan in 2016, you were supposed to include a special document — IRS Form 8962 — when you filed your 2016 federal income taxes this year. This document reconciled how much you received in advance premium tax credits against how much you should have received based on your actual income for the year.

If you didn’t file the form with your taxes, “you’ll be able to sign up for coverage, but you won’t be able to get subsidies,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

To fix the problem, you’ll generally have to file the Form 8962, along with the second page of your income tax Form 1040 and the 1095-A form you received from the marketplace showing your 2016 enrollment details, said Straw. If you want to receive premium tax credits starting in January, you’ll need to get that done before the open-enrollment period ends Dec. 15.

This issue will primarily affect people who are automatically re-enrolled in a plan for the following year, as were 31 percent of marketplace customers last year. If you sign into your marketplace account to update your income and other personal information — as everyone should do for so many reasons — you’ll be asked whether you’ve filed and reconciled your taxes. That is a signal the issue needs to be addressed.

Some policy experts are concerned that this filing requirement will be particularly challenging for people whose annual income is below the usual threshold required to file an income tax return (about $10,000 for one person or $20,000 for a married couple) but who must do so now because they receive advance premium tax credits.

“It’s confusing enough, and many people don’t remember that they now have to file an income tax form,” said Mara Youdelman, managing attorney at the National Health Law Program, which has been working to ensure people receive proper notification that their benefit may be at risk if they don’t comply with filing requirements.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles