Your premium is the monthly amount you pay to keep your health insurance active — regardless of whether you use any medical services that month. Think of it as the price of staying covered.
Your premium is separate from your deductible, copays, and coinsurance. You pay those when you actually use care. The premium is due every month no matter what.
Several factors affect how much your premium costs:
If you miss a premium payment, most plans have a 30-day grace period before your coverage is terminated. If you’re receiving an APTC, the grace period extends to 90 days, but claims may be held after day 30.
No. Your premium keeps your coverage active, but you’ll also pay out-of-pocket costs when you use care — including your deductible, copays, and coinsurance. Your out-of-pocket maximum caps how much those costs can total in a year, but your premium doesn’t count toward it.
If your income qualifies, a Premium Tax Credit (APTC) can significantly reduce or eliminate your monthly premium. Some families qualify for $0 premium Silver plans. A broker can calculate your exact subsidy amount based on your household size and income before you enroll.
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