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Tucked inside nearly 11,000 pages of the Affordable Care Act is a little-known provision that doles out three months of free health care to individuals who choose to default on their premiums.
People who receive the federal subsidy to be part of Obamacare will be allowed to incur a three-month “grace period” if they can’t pay their premiums and then simply cancel their policies, stiffing the doctors and hospitals.
Their only repercussion is that they have to wait until the following year’s open enrollment if they want coverage on the exchange.
(d) Grace period for recipients of advance payments of the premium tax credit. A QHP issuer must provide a grace period of three consecutive months if an enrollee receiving advance payments of the premium tax credit has previously paid at least one full month's premium during the benefit year. During the grace period, the QHP issuer must:
(1) Pay all appropriate claims for services rendered to the enrollee during the first month of the grace period and may pend claims for services rendered to the enrollee in the second and third months of the grace period;
(2) Notify HHS of such non-payment; and,
(3) Notify providers of the possibility for denied claims when an enrollee is in the second and third months of the grace period.
.....
So the insurance companies HAVE to pay the claims, notify HHS of the delinquency and notify all the providers that claims after the grace period ends may not be paid. This is hardly "Obama leaving doctors on the hook."
(1) Pay all appropriate claims for services rendered to the enrollee during the first month of the grace period and may pend claims for services rendered to the enrollee in the second and third months of the grace period;
xuenchen
reply to post by theantediluvian
.....
So the insurance companies HAVE to pay the claims, notify HHS of the delinquency and notify all the providers that claims after the grace period ends may not be paid. This is hardly "Obama leaving doctors on the hook."
Sounds like the insurance only pays for the first month.
Then gets paid if and when the patient pays the premiums.
If the patient defaults or cancels, the insurance company might not pay for services incurred in the 2nd and 3rd month of the grace period.
(1) Pay all appropriate claims for services rendered to the enrollee during the first month of the grace period and may pend claims for services rendered to the enrollee in the second and third months of the grace period;
(c) Termination of coverage due to non-payment of premium. A QHP issuer must establish a standard policy for the termination of coverage of enrollees due to non-payment of premium as permitted by the Exchange in §155.430(b)(2)(ii) of this subchapter. This policy for the termination of coverage: