Grace Period

A grace period is a window of time after a missed health insurance premium payment during which your coverage remains active and your insurer cannot terminate your policy. It gives you time to catch up on a missed payment before losing coverage.

Grace period length depends on how you pay for your coverage:

  • ACA Marketplace plans with APTC: 90-day grace period. However, your insurer can suspend payment of claims after day 30. If you don’t pay by day 90, coverage is terminated retroactively to the end of day 30, and any claims paid between day 31 and day 90 may be clawed back from providers.
  • ACA Marketplace plans without APTC: 30-day grace period. Coverage terminates if the premium isn’t paid within 30 days.
  • Employer-sponsored plans: Grace period terms vary by employer and are governed by the plan documents.

If your coverage is terminated due to non-payment, losing coverage is a qualifying life event that opens a Special Enrollment Period to re-enroll. However, you may have a gap in coverage and any claims incurred after termination will not be covered.

Frequently Asked Questions

Can I still use my insurance during the grace period?

Yes, but with a risk. On APTC plans, the 90-day grace period appears generous, but providers may be notified that your claims are pending and could delay or refuse care after day 30. If you’re struggling to make a payment, contact your insurer immediately to discuss payment arrangements or update your Marketplace application to see if your subsidy can be adjusted.

What should I do if I can’t make a payment?

Contact your insurer’s billing department as soon as possible. Ask whether a payment arrangement is possible. If your income has changed, update your Marketplace application — an increased subsidy might reduce what you owe going forward. Letting the grace period expire without action is the worst outcome.

Could we improve this page?

Leave Feedback