Under the ACA, some safeguards were implemented to fix this issue. For example, insurers can’t cancel coverage for members when they get sick. However, protections for members who missed a payment aren’t clear cut, and members who don’t receive subsidies on the ACA exchanges don’t have as much protection. For instance, insurers can cancel plans if members provide false information on an application or don’t pay premiums.
In one story reported to California Healthline, a couple in Minnesota expecting a child said HealthPartners dropped their coverage abruptly after some billing mishaps. The couple changed their checking accounts and accidently sent their recurring online premium payment to a hospital owned by the health plan, but the hospital didn’t let the health plan know, the couple told California Healthline. In addition, they sent their next month’s payment to the correct place but had insufficient funds.
Because the couple didn’t qualify for a subsidy under the ACA, a 90-day grace period after missing a payment wasn’t granted to them. Instead, they had to follow state laws and faced a more sudden plan cancellation, according to the report.
In a statement to California Healthline, a HealthPartners spokesperson said its hospitals are supposed to let the health plan know of misplaced payments, but “even though we have this process, we are not always notified of this or not notified in a timely fashion.” HealthPartners ended up reinstating the couple’s coverage and covering medical bills they had incurred while being uninsured.
For the full report, click here.
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