What Does Inactive Insurance Mean?

  • Individuals, places, and entities having an active license or other legislative permission to offer professional services and who have basic professional liability insurance are considered active health care providers. The Fund’s coverage is in addition to the primary policy for active health care providers.
  • Individuals who no longer carry basic professional liability insurance because they no longer have an active license or other statutory permission to offer professional services as a Kansas health care provider are considered inactive health care professionals. When necessary, the Fund provides first-dollar defense coverage to eligible inactive health care practitioners.

For those periods of compliance when the health care provider satisfied the criterion of active health care provider, the Fund provides “tail” coverage at no additional expense to inactive health care providers. The amount of tail coverage (limit) is equal to the specified level of HCSF coverage plus the minimum needed basic coverage at the time of the incident that led in a claim against the health care provider.

What does it mean when it says your insurance is inactive?

Patients appreciate the help when it comes to resolving issues with benefit coordination, especially when they weren’t aware there was a problem with their coverage, according to White. “Some state insurance plans ask consumers to contribute to their plan on a monthly basis,” she explains. “Life gets in the way. When a payment is missed or forgotten, it becomes inactive for the duration of the service.”

When this occurs, White says, staff can provide the patient with the necessary information so that they can make the payment or contact the insurance company to confirm that payment was received.

Carole L. Sraver, director of patient access at Washington Adventist Hospital in Takoma Park, MD, says registrars phone patients before operations or treatments to explain the findings and ask, “Have you recently switched insurances?”

Patients may have picked a different insurance plan through their employer and forgotten that a new card with a different plan number will be sent to them. “As a result, the system will tell us that the patient’s benefits are inactive,” Sraver explains. “Typically, one of our queries will elicit a response from the patient about something they had forgotten to mention.”

Patients’ coverage may be inactive owing to nonpayment of premiums, a job change or loss, or a waiting period to qualify for Medicaid, according to Sammon.

“No matter what the scenario is, telling the patient that their insurance is temporarily inactive is always difficult,” she explains. “When I tell them this, I try to be very sympathetic and remain quite calm.”

Sammon double-checks all of the material. If everything appears to be in order, she provides the patient the opportunity to meet with a health benefit counselor about their alternatives.

“They may be eligible for charity, or they may be able to put down a small deposit and set up payment plans,” Sammon explains. “Most of the time, the patients believe you listened to their concerns, and the hospital still receives compensation.”

What does Medicare inactive mean?

A: If the SPOT returns data in the Inactive Periods area, it signifies that, despite being eligible for Medicare, the beneficiary is ineligible for Medicare benefits for a period of time due to one or more of the following reasons: The Medicare recipient has been imprisoned.

How do you check if your Medicaid is active?

  • Take a look at the summary of your coverage. If there is no information about Medicaid, it is most likely inactive. However, just to be sure, you can contact appropriate parties and inquire about your enrolment.
  • It is always possible to find out about your Medicaid status by contacting your state Medicaid office. The Centers for Medicare & Medicaid Services can assist you in locating the appropriate phone numbers. Then inquire as to whether you have Medicaid coverage and if it is active. Inquire about your Medicaid number as well. Keep in mind that you may be required to supply personal information in order to obtain the answers you require.
  • You can also call 1-800-MEDICARE (1-800-633-4227) if you know your Medicaid number or remember registering for the program. If you’re a TTY user, dial 1-877-486-2048 to find out where your state’s Medicaid office is located. Then give them your phone number and ask if your Medicaid is still active.
  • If you have a Medicaid card, you can check the status of your coverage by calling the numbers on the back.

What happens if you don’t pay your health insurance premium?

Q. What happens if I don’t pay my premium before the grace period expires?

A: You will lose your insurance coverage if you do not pay your premiums and the grace period for plans supplied via a health insurance marketplace has expired. Depending on whether you receive subsidies and whether you’ve paid at least one health insurance premium so far this year, the grace period is either one month or three months long.

Those who get federal subsidy help in the form of an advanced premium tax credit and have paid at least one full month’s premium within the benefit year are eligible for the three-month grace period. The grace period for people who do not receive a subsidy 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 payment is not made before the conclusion of the one-month grace period for subscribers who do not receive subsidies, coverage will be retroactively canceled to the end of the month for which the premium was last paid.

Enrollees who get subsidies (and have paid at least one month’s premium) will have their coverage cancelled retroactive to the end of the first month of the grace period if their premiums are three months late. If a subsidized enrollee pays the January premium but not the February, March, or April premiums, their coverage will stop at the end of February.

You must be completely paid-up by the end of the grace period to keep coverage in place past the grace period’s end. In other words, the grace period prevents consumers from falling three months behind on their premium payments indefinitely. If you fall behind on your payments (and you’re getting subsidies), you’ll have to pay for all three months of the grace period to keep your coverage.

It’s crucial to note that if your coverage is terminated back to the end of the first month of the grace period due to non-payment of premiums, you won’t be entitled for a premium tax credit (subsidy) for that month. In question 12 of their FAQs on Form 1095-A, New York State of Health (the state-run exchange in New York) explains this with an example. So, even though your coverage didn’t cease until the end of the first month of the grace period, the premium tax credit that was paid on your behalf for the first month of the grace period will need to be repaid when you file your taxes (ie, claims incurred during that month would have been paid by your carrier).

The IRS has also put together some FAQs about Form 1095-A, noting that it’s usual for customers to receive an inaccurate Form 1095-A if their coverage was canceled retroactively due to non-payment of premiums; in that instance, the exchange will issue a rectified Form 1095-A. If you have any questions, you should contact the exchange and/or your tax expert.

Individuals who lose coverage in the marketplace due to non-payment of premiums will not be eligible to rejoin until the next open enrollment period, unless they have a qualifying incident (and most qualifying events have a prior coverage requirement; most are designed to allow a person to change coverage, rather than go from being uninsured to insured). During the period you are uninsured, you will be responsible for any medical expenditures you incur.

(Note that in 2021, there will be a COVID-related special enrollment period.) It lasts through at least August 15, 2021 in most states, and there are no prerequisites for coverage.)

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

Historically, open enrollment has given consumers the opportunity to start over each year with fresh coverage, regardless of whether their previous year’s coverage was canceled due to non-payment throughout the year. However, HHS adopted market stability regulations in 2017, which allow insurers to collect past-due premiums when consumers try to re-enroll during open enrollment.

The new rules are detailed here, but in essence, if your coverage is terminated due to non-payment of premiums and you enroll in a plan offered by the same insurer within 12 months of your previous plan being terminated, the insurer may require you to pay your past-due premium before your new policy takes effect.

If your coverage was previously terminated owing to non-payment of premiums, the maximum you’d owe in past-due payments would be one month’s worth, because your plan termination date would have been the end of the grace period’s first month. You wouldn’t have any past-due payments if you weren’t receiving a premium subsidy because your plan would have been cancelled on the last date you paid for coverage (insurers cannot assess past-due premiums for months after the coverage termination date).

If you’re re-enrolling with the same insurer while still in the grace period (i.e., your coverage hasn’t been terminated), you could owe up to three months’ worth of past-due payments.

Although another insurer controlled by the same parent business that operated your previous insurer could make you to pay the past-due sum, you can enroll in a plan with a different insurer without having to pay back your past-due payment from the previous year. Furthermore, in some sections of the country (especially rural areas), just one insurer offers coverage. If the insurer chooses to impose the past-due premiums regulation, this makes it hard to escape it.

HHS stated in June 2021 that they are reviewing this rule to see if it “may offer unnecessary impediments to receiving health care,” and that they plan to revisit it in the 2023 Notice of Benefit and Payment Parameters.

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

Enrollees on HealthCare.gov who are in the grace period at the end of the year should be aware that if their plan is auto-renewed, the grace period does not reset at the end of the year.

So, if you didn’t pay your premiums in November and December and your plan is auto-renewed for January, you won’t be able to just pay January’s payment to keep your coverage for the coming year. You’d have to pay for all three months (November, December, and January) by the conclusion of the three-month grace period that began when the November payment was missed. Your coverage will be cancelled back to the end of November if the total sum is not paid in full by the conclusion of the grace period (this is the same system that would be used regardless of the time of year that the non-payment of premiums occurs).

If you enroll in a different plan for the future year (rather than allowing your current plan auto-renew), your previous plan will finish at the end of November, and your new plan will begin on January 1 if you pay the January premium.

How do I check my health insurance status?

You may easily and quickly check the status of your health insurance claim. As a policyholder, you have the option of checking the status of your medical insurance claim online or offline, as explained below.

Offline Mode

In the offline mode, health insurance policyholders can check the status of their health insurance claims as follows:

  • You can go to your health insurance company’s nearest branch office and get all the information you need about your policy.
  • You can also contact your insurer’s toll-free customer service line to inquire about the progress of your health insurance claim.
  • You can also inquire about the status of your policy claim by sending an email containing your health insurance policy number and other details to the email address provided by their health insurance company.

Now that you’re aware of the online and offline methods used by most health insurance companies to determine the status of a claim, you may use them to determine the status of your claim. Some health insurance firms provide policy claim status via SMS and chatbots, and you should be able to obtain this information by calling your insurance company.

The preceding procedure is suggested, and you should be able to monitor your claim status in either online or offline mode, depending on your option.

Will I lose Medicare if I start working?

If you return to work and can find adequate primary coverage via your employer, you can quit Medicare and re-enroll without penalty. You’ll be penalized if you drop Medicare and don’t have creditable employer coverage when you reapply for it.

Can you lose your Medicare benefits?

If you meet the age requirements for Medicare, you may be eligible for it for the rest of your life. The number of days that Medicare will pay for inpatient hospital and skilled nursing facility care over your lifetime is limited. You can still get Medicare coverage for other services, such as medical visits, even if these maximums are surpassed.

If you are eligible for Medicare before the age of 65 due to ALS, you may be eligible for it for the rest of your life. According to the Mayo Clinic, there is no cure for ALS, and the disease will eventually kill you.

If you qualify for Medicare because you have permanent kidney failure (and are not 65 or older or have another handicap), your coverage will usually expire 12 months after you stop dialysis treatments or 36 months after you undergo a kidney transplant.

Returning to work does not automatically stop your Medicare benefits if you were eligible for Medicare before the age of 65 due to a disability. According to the SSA, if you still have a debilitating handicap after your trial employment term, you may be eligible for 93 months of hospital and medical insurance (Medicare Part A and Part B). There will be no premiums for your Medicare Part A coverage. If you still have a disability at the end of the 93-month period, you can purchase Medicare Part A and Part B insurance after your premium-free Medicare coverage ends. If you get health insurance via your job, you can generally keep Medicare. Medicare is frequently a secondary payer, with your employer’s coverage serving as the primary.

Remember to notify Social Security if you return to work or if your medical condition improves. Many persons with disabilities should be able to recover thanks to medical improvements and therapy, according to the SSA.

You may be eligible for Medicaid if you lose your Medicare eligibility and do not have health insurance. Your Modified Adjusted Gross Income plays a role in determining your Medicaid eligibility.

Enter your zip code on this page to see if you qualify for a Medicare plan.

Can I get Medicare at 55?

en espaol | en espaol | en espaol | Medicare has provided health insurance to Americans 65 and older, as well as people with disabilities, for more than 55 years. However, acceptance into the program is not automatic.

How do I know if I have Medicaid?

Contact your state Medicaid office to see if you’re eligible for assistance. To get the phone number for your state Medicaid office, go to the Centers for Medicare & Medicaid Services.