Why Must I Pay My Health Insurance Premium on Time?

Feb. 11, 2015

This week, Texas Medical Association’s (TMA’s) “Hey, Doc” educational campaign about the health insurance marketplace addresses one part of insurance that many people don’t like: Paying premiums. People with health insurance must pay their monthly bill — the premium — to keep the policy in force. Once you pay your premiums, you can think about using your insurance for a doctor visit, but how do you know what kind of coverage you have, and whether you can use your insurance? TMA’s “Hey, Doc” explains:

Why is it important that I pay my marketplace insurance premium on time?

When you buy your insurance, you pay a set monthly fee, called a “premium,” to make sure it’s there for you when you need it. But for your insurance to actually work, you have to pay that premium on time.

If you don’t, you could be responsible for paying your entire health care bill out of your own pocket. Not paying your premiums on time also means you could miss out on other financial help for your medical bills.

Signing up for an insurance plan is step one. And having a marketplace insurance ID card does not necessarily mean you have active insurance coverage unless you are paying your premiums. Once you sign up, your insurance company will tell you when your payment is due. It will usually be the same time each month, depending on when you first signed up. Most health plans also offer different ways to pay your premiums, like by check, money order, mail, or automatic payments.

How do I know what kind of coverage I have and if I can use my insurance?

There are a few things you can do before you visit the doctor’s office so you know what your benefits and costs are.

First, you want to make sure you’ve paid your premiums on time so that your insurance takes effect. Just signing up is not enough.

All health plans in the marketplace must provide a summary of their benefits and coverage, which you can review on Healthcare.gov, or talk to a representative by calling (800) 318-2596. You can also call your insurance company to get details on the plan you chose. TMA has a list of marketplace plan websites and phone numbers to help.

If you’re just now enrolling in a health plan through the marketplace, either online or by phone, make sure you write down the member ID number you receive. You’ll need that number to check your benefits when you call your insurance company. Or if you already have a member ID card, you can use that information when you call. Your insurance company also should send you a welcome packet after you enroll. That should explain what type of plan you bought and what your benefits and costs are.

Lastly, some health plans have special websites you can use to verify your coverage with your member ID.

Marketplace Plan Websites and Phone Numbers

See each week’s “Hey, Doc” Q&A and a lot more at texmed.org/Heydoc as well as in TMA’s patient blog at MeAndMyDoctor.com. TMA produced “Hey, Doc” videos to help people understand how to navigate the marketplace.

TMA is the largest state medical society in the nation, representing more than 48,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.

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 Contacts:  
Brent Annear
phone: (512) 370-1381
cell: (512) 656-7320 
Brent Annear   

 

 

 Marcus Cooper
phone: (512) 370-1382
cell: (512) 650-5336 
 Marcus Cooper

 

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Check out  MeAndMyDoctor.com for interesting and timely news on health care issues and policy. 

Last Updated On

March 15, 2018